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E-cigarettes: an evidence update <br /> <br />26 <br />4. Prevalence of e-cigarette use in <br />England/Great Britain <br />This chapter assesses the use of EC by adults and young people in England by drawing <br />on recent surveys carried out in England and Great Britain (GB). A later chapter <br />discusses EC prevalence internationally. <br /> <br />Measures used <br />One of the main issues in measuring EC use is the lack of consistent and appropriate <br />terminology, for example some studies equate ever having used EC with current use of <br />EC which is clearly inappropriate. We recommend that definitions of usage catego ries <br />should be standardised similar to those used in smoking surveys. Appendix B lists the <br />different measures used in surveys focused on in this report, and gives definitions used <br />in the other studies included in this review. <br /> <br />Use of e-cigarettes by adults <br />First, we assess e-cigarette use in the adult population in England. We summarise <br />various data sources to provide an overview of EC use among the general population, <br />and then specifically smokers, recent and long-term ex-smokers, and never-smokers. <br />The two main surveys used in this chapter are the Smoking Toolkit Study (STS) and the <br />ASH Smokefree GB surveys. However, in addition to these surveys, findings from the <br />Office for National Statistics Opinions and Lifestyle Survey (ONS survey), a randomised <br />probability sample omnibus survey in GB, have also been included in this section <br />although the exact question used is not available [13]; preliminary released data from <br />Q1 2014 are reported here in advance of the complete data due for publication later in <br />2015. <br /> <br />Population use of e-cigarettes <br />Of the available datasets, just two – the Smoking Toolkit Study (STS, England) and the <br />ASH Smokefree GB adult surveys – provide information on population prevalence <br />(Table 1). Using the STS, it is estimated that 5.5% of the adult population of England <br />used EC in the first quarter of 2015 indicating a marked rise from 0.5% in 2011. The <br />measure of use in the STS is compiled from four survey questions and assesses current <br />use for any reason (Appendix B). A very similar estimate is obtained for GB using the <br />2015 ASH survey, with 5.4% of the population estimated to be current (defined as tried <br />EC and still use them, see Appendix B) EC users. This translates to about 2.6 million <br />EC users in GB in 2015 [14](for comparison there are about nine million tobacco