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E-cigarettes: an evidence update <br /> <br />36 <br />Concerns about impact of e-cigarette use on smoking <br />Three main concerns raised about EC use are that they might 1) renormalise smoking <br />2) reduce quitting and 3) act as a ‘gateway’ to smoking or nicotine uptake. An ultimate <br />test for the first concern, and to some extent all three concerns, is the impact of EC use <br />on smoking prevalence nationally which is explored first below. Evidence for <br />effectiveness of EC on quitting smoking is explored in more detail in Chapter 6. Whilst <br />other concerns have been raised such as renormalising the tobacco industry, we are <br />only able to comment on issues pertaining to the objectives of our report. <br /> <br />Recent trends in smoking prevalence <br />Since EC arrived on the market in England, smoking prevalence has continued to <br />decline among both adults and youth (Figures 1, 7 and 8). Evidence to date therefore <br />conflicts with any suggestion that EC are renormalising smoking. Whilst other factors <br />may be contributing to the decline in smoking, it is feasible that EC may be contributing <br />to reductions in smoking over and above any underlying decline. <br /> <br /> <br />Figure 7: Adult smoking prevalence in England 1980–20131 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />1 General Lifestyle Survey aged 16+(1980-2010); Integrated Household Survey aged 18+ (2011). Diagram courtesy of ASH. <br />0% <br />5% <br />10% <br />15% <br />20% <br />25% <br />30% <br />35% <br />40% <br />45% <br />1980 1983 1986 1989 1992 1995 1998 2001 2004 2007 2010 2013 <br />ad <br />u <br />l <br />t <br /> <br />s <br />m <br />o <br />k <br />i <br />n <br />g <br /> <br />p <br />r <br />e <br />v <br />a <br />l <br />e <br />n <br />c <br />e