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E-cigarettes: an evidence update <br /> <br />55 <br />A national survey in New Zealand of 3,127 year 10 students (mostly aged 14 to 15) also <br />showed that the most frequently given reason for first trying EC was curiosity, <br />irrespective of smoking status (64.5% overall) [62]. <br /> <br />Reasons not to use EC are rarely assessed. The ASH Smokers’ survey 2014 asked <br />current and ex-smokers about advantages and disadvantages of EC. Among those who <br />had never used EC, the three most important disadvantages were “They might be too <br />expensive” (46%), “They might not be safe enough as a product” (39%) and “They <br />might not satisfy my desire to smoke enough” (31%). <br /> <br />Reasons why trial does not become use <br />The rates of ever having tried an EC in the ASH GB Smokefree adult survey are more <br />than three times those of current use; in the ASH GB Smokefree youth survey, about <br />five times as many respondents had tried an EC as were currently using an EC, <br />indicating that most of those who try EC do not progress to current use. A small <br />number of surveys assessed why respondents who had tried an EC did not continue <br />use. <br /> <br />In a national sample of 3,878 US adults who reported ever trying EC, two-thirds did not <br />continue to use them and this was linked to the main reason for trying them. Trial turned <br />into continued use for only a minority (19%) of those who did not know their main <br />reason for trying them or whose main reasons were curiosity, friends or family members <br />or advertising. Continued use was more common for those whose main reasons for trial <br />included help to quit smoking or reduce harm. Those who did not continue use were <br />asked for their reasons for stopping. The reason most often given was that they were <br />just experimenting (49%) [58]. <br /> <br />In the survey by Kong et al., reported previously, it appears that 98.5% of experimenting <br />students did not continue use. Reasons for discontinuation were assessed but <br />unfortunately the most commonly chosen response was ‘other’ (23.6%, open-ended <br />responses included “I don’t like it”, “I just tried once”) followed by “uncool” (16.3%) and <br />health risks (12.1%) [61]. <br /> <br />Some surveys can be used to assess why smokers may not continue to use EC. The <br />ASH Smokers’ survey in 2014 indicates that disappointment with the help EC provide in <br />reducing smoking urges may be an important reason. Among smokers who had tried <br />EC but did not continue using them, 44% said that a disadvantage of the products was <br />that “They might not satisfy my desire to smoke enough”. No other reason got a higher <br />rate of agreement in this group. A high proportion of smokers who were currently using <br />EC also stated this reason (37%), but the proportion was significantly (p<0.05) lower in <br />ex-smokers who had used (32%) or were currently using EC (7%), suggesting that <br />satisfaction with the device/s may be a correlate of stopping smoking.