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Perception of electronic cigarettes in the general population: does their usefulness outweigh their risks?
  1. Jose M Martínez-Sánchez1,2,3,
  2. Marcela Fu1,2,4,
  3. Juan Carlos Martín-Sánchez3,
  4. Montse Ballbè1,2,4,5,
  5. Esteve Saltó6,7,
  6. Esteve Fernández1,2,4
  1. 1Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
  2. 2Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge—IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  3. 3Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
  4. 4Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
  5. 5Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
  6. 6Health Plan Directorate, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain
  7. 7Department of Public Health, Universitat de Barcelona, Barcelona, Spain
  1. Correspondence to Dr Jose M Martínez-Sánchez; jmmartinez{at}


Objective To describe and compare the perceptions of the general population about the harmful effects of electronic cigarettes (e-cigarettes) on users and on those passively exposed to e-cigarettes and the perceptions about e-cigarette usefulness for reducing or eliminating tobacco smoking.

Design, setting, and participants We analysed cross-sectional data from a longitudinal study of a representative sample of the general adult (≥16 years) population of Barcelona, Spain (336 men and 400 women). The fieldwork was conducted between May 2013 and February 2014. We computed the percentages, adjusted OR and their corresponding 95% CI among participants with some awareness of e-cigarettes (79.2% of the sample).

Primary and secondary outcome measures We assessed the perception about harmfulness for e-cigarette users and for passively exposed non-e-cigarette users, as well as the perception of usefulness for smokers of cigarette cessation and reduction.

Results In this sample, 40.1% thought that e-cigarettes had a harmful effect on users, and 27.1% thought that e-cigarettes had a harmful effect on passively exposed bystanders (p<0.001). Particularly, more never-smokers perceived that e-cigarettes had harmful effects on passively exposed bystanders than current smokers (34.4% vs 20.6%; OR=1.93, 95% CI 1.02 to 3.63). More people perceived e-cigarettes as being useful for reducing smoking than for quitting (50.6% vs 29.9%, p<0.001), as well as for reducing smoking than as being harmful to users (50.6% vs 40.1%, p=0.044).

Discussion The perception that e-cigarettes are useful for reducing tobacco consumption was more prevalent than the perception that e-cigarettes are harmful to users and to those passively exposed to e-cigarettes. Advertisements and messages about the use of e-cigarettes and their harmful effects should be regulated and based on scientific evidence to avoid creating erroneous ideas about their use.


This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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