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Prev Med Rep. 2018 Apr 18;10:332-336. doi: 10.1016/j.pmedr.2018.04.009. eCollection 2018 Jun.

Beliefs and behavior regarding e-cigarettes in a large cross-sectional survey.

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Department of Respiratory Diseases and Thoracic Oncology, Centre Hospitalier Lyon Sud, Cancer Institute of Hospices Civils de Lyon, 165 chemin du Grand Revoyet, 69495 Pierre Bénite Cedex, France.
Department of Respiratory Diseases and Thoracic Oncology, Hôpital Calmette, Bd du Professeur Jules Leclercq, 59000 Lille, France.
Centre de lutte contre le cancer Paul Strauss de Strasbourg, Hôpitaux Universitaires de Strasbourg, 3 Rue de la Porte de l'Hôpital, 67 065 Strasbourg Cedex, France.
KantarHealth, 3 avenue Pierre Masse, 75014 Paris, France.
Department of Oncology and Hematology, Roche SAS, 30 cours de l'île Seguin, 92650 Boulogne-Billancourt, France.
University Claude Bernard Lyon I, Centre, Léon Bérard, 28 rue Laennec, 69008 Lyon, France.
Aix Marseille University, INSERM, SESSTIM, 13006 Marseille, France.
Institut Paoli-Calmettes (DASC), 232 boulevard Sainte Marguerite, BP 156 13273 Marseille Cedex 9, France.
Coordination Center for Cancer Screening, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044 Tours Cedex 9, France.
Department of Oncology-Hematology, Hôpital Paul Brousse, U1193-Paris 11, 12 avenue Paul Vaillant Couturier, 94804 Villejuif, France.
Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Department of Multidisciplinary Oncology and Therapeutic Innovations, Chemin des Bourrely, 13915 Marseille Cedex 20, France.


Although e-cigarette use is increasing dramatically, numerous concerns persist regarding toxicity and their role in smoking cessation. We assessed beliefs and behavior regarding e-cigarettes in an adult French population. The 4th French nationwide observational survey, EDIFICE 4, was conducted among representative samples of 1602 laypersons (age, 40-75 years) from 12 June-10 July 2014, using the quota method. Profile, beliefs and behavior were assessed by phone interviews of the participating lay population with no history of cancer (N = 1463). Tobacco use, nicotine dependence (Fagerström test) and e-cigarette use were assessed. E-cigarette users represented 6% of the study lay population. E-cigarette users regarded e-cigarettes as helpful for quitting tobacco smoking and reducing the risk of lung cancer. Current dual users (e-cigarettes + cigarettes) were more likely to attempt to quit than current exclusively cigarette smokers (odds ratio, 3.15 [1.74-5.70]), and to consider themselves at higher risk for lung cancer (OR 3.85 [2.47-5.99]). They also considered e-cigarette vapor to be less toxic than tobacco smoke in terms of both active and passive exposure. Dual users typically consider themselves at higher risk for cancer and intend to quit smoking. Physicians should be made aware of this specific sub-population for whom e-cigarettes may be a useful trigger in the smoking cessation process.


Electronic cigarettes; Lung neoplasms; Pulmonary disease; Risk factors; Smoke; Smoking cessation; Tobacco use

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