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E-cigarettes: an evidence update <br /> <br />11 <br />Summary of Chapter 7: Reasons for use and discontinuation <br />A number of surveys in different populations provide evidence that reducing the harm <br />from smoking (such as through cutting down on their cigarette consumption or helping <br />with withdrawal during temporary abstinence) and the desire to quit smoking cigarettes <br />are the most important reasons for using EC. Curiosity appears to play a major role in <br />experimentation. Most trial of EC does not lead to regular use and while there is less <br />evidence on why trial does not become regular use, it appears that trial due to curiosity <br />is less likely to lead to regular use than trial for reasons such as stopping smoking or <br />reducing harm. Dissatisfaction with products and safety concerns may deter continued <br />EC use. <br /> <br />Policy implications <br />o Smokers frequently state that they are using EC to give up smoking. They should <br />therefore be provided with advice and support to encourage them to quit smoking <br />completely. <br /> <br />o Other reasons for use include reducing the harm from smoking and such efforts <br />should be supported but with a long-term goal of stopping smoking completely. <br /> <br />Summary of Chapter 8: Harm perceptions <br />Although the majority of adults and youth still correctly perceive EC to be less harmful <br />than tobacco cigarettes, there has been an overall shift towards the inaccurate <br />perception of EC being at least as harmful as cigarettes over the last year, for both <br />groups. Intriguingly, there is also some evidence that people believe EC to be less <br />harmful than medicinal nicotine replacement therapy (NRT). <br /> <br />Policy implications <br />o Clear and accurate information on relative harm of nicotine, EC and tobacco <br />cigarettes is needed urgently (see also Chapter 10). <br /> <br />o Research is needed to explore how health perceptions of EC are developed, in <br />relation to tobacco cigarettes and NRT, and how they can be influenced. <br /> <br />Summary of Chapter 9: E-cigarettes, nicotine content and delivery <br />The accuracy of labelling of nicotine content currently raises no major concerns. Poorly <br />labelled e-liquid and e-cartridges mostly contained less nicotine than declared. EC used