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E-cigarettes: an evidence update <br /> <br />43 <br />Nevertheless, EC are penetrating the lower socioeconomic groups. Figure 13 shows the <br />social class breakdown of EC users by quarter over time , also derived from STS data. <br /> <br />Figure 13: E-cigarette use by social class over time (STS data) <br /> <br /> <br />From www.smokinginengland.info/latest-statistics/ <br />E-cigarette use in other disadvantaged groups <br />There are no GB data, to our knowledge, on EC use among groups where smoking <br />prevalence is known to be very high, such as offenders and people with serious mental <br />illness. There is emerging evidence on the effectiveness of EC in people with mental <br />illness (see Chapter 6). However, to some extent, usage among these groups will be <br />dependent on EC policies being introduced in prisons and mental health settings. <br /> <br />Recent NICE guidance on smoking cessation in secondary care settings [30] <br />recommended the implementation of smokefree policies in these settings, alongside <br />advice to stop smoking and nicotine dependence treatment. Trusts are now <br />implementing this guidance but many prohibit EC usage as well as cigarettes. The <br />rationale for such prohibition is unclear. <br /> <br />The South London and Maudsley NHS Foundation Trust (SLaM) was the second NHS <br />mental health trust to go comprehensively smoke free in England. It has developed an <br />EC policy alongside the smokefree policy which allows EC to be used in private spaces <br />or grounds, although EC are not to be offered as first line treatment or replace tobacco <br />cigarette smoking and can only be used as part of a care treatment pathway [31]. <br />Currently, the use of disposable products or rechargeable models with cartridges is <br />allowed (the latter only under supervision), but tanks are prohibited because of fears <br />0% <br />10% <br />20% <br />30% <br />40% <br />50% <br />60% <br />70% <br />80% <br />90% <br />100% <br />Q1 Q2 Q3 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 <br />2011 2012 2013 2014 2015 <br />E <br />D <br />C2 <br />C1 <br />AB