Tobacco: E-cigarettes

While it appears that the regulatory environment in different countries can influence vaping prevalence, even in restricted environments, such as AU, vaping is still happening with consumers relying on online sources to purchase their nicotine vaping devices and supplies . In AU, the ban of sale of NVPs appears to have led to current vapers relying mainly on online purchasing sources, unless they are buying non-nicotine containing e-liquid, in which case, other retail outlets were the primary purchase location. In the US and EN the purchase locations were fairly evenly distributed among vape shops, online, and other. Table 1a–d display the bi-variate descriptive characteristics of NVP users by purchase location separately within each of the four countries. With the exception of NVP users in EN (42.5%), the majority of survey participants reported using NVP that allowed for adjustable power (61.7% in CA, 59.1% in the US, and 57.9% in AU), though this question did not assess the 259 participants who reported using disposable systems. Current vapers in all four countries reported having a high household income the most often, and a moderate education level (except in the US where the largest category of education level was "low"

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E-cigarettes as consumer products have not been proven to be effective for cessation at the population level. Further, many e-cigarettes are designed to allow the control of nicotine (which can reach dangerously high levels). Dual use, which is common, is at least as dangerous and likely more dangerous than smoking conventional cigarettes or using e-cigarettes alone. Further information on this incident, including a strong link of the EVALI outbreak to Vitamin E Acetate and the latest report, is available here, which is updated every week, as the evidence is not sufficient to exclude the contribution of other chemicals." E-cigarettes have also been linked to an episode of lung injury in the United States of America. Additionally, high quality epidemiology studies consistently demonstrate that e-cigarettes use increases conventional cigarette uptake, particularly among non-smoking youth, by nearly 3 times.
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In all four countries, most current vapers were categorized as daily vapers; in EN and AU greater than 50% of current vapers did not smoke at all, whereas in Canada the largest category of smoking frequency was daily smoking (45.2% of current vapers). Overall, in all four countries the majority of current vapers were white, and male. Frequencies and percentages were reported as well as odds ratios with 95% confidence intervals for pair-wise comparisons between countries (i.e. country vs country by location vs location