Perception of electronic cigarettes in the general population: does their usefulness outweigh their risks?

BMJ Open. 2015 Nov 3;5(11):e009218. doi: 10.1136/bmjopen-2015-009218.


Objective: To describe and compare the perceptions of the general population about the harmful effects of electronic cigarettes (e-cigarettes) on users and on those passively exposed to e-cigarettes and the perceptions about e-cigarette usefulness for reducing or eliminating tobacco smoking.

Design, setting, and participants: We analysed cross-sectional data from a longitudinal study of a representative sample of the general adult (≥16 years) population of Barcelona, Spain (336 men and 400 women). The fieldwork was conducted between May 2013 and February 2014. We computed the percentages, adjusted OR and their corresponding 95% CI among participants with some awareness of e-cigarettes (79.2% of the sample).

Primary and secondary outcome measures: We assessed the perception about harmfulness for e-cigarette users and for passively exposed non-e-cigarette users, as well as the perception of usefulness for smokers of cigarette cessation and reduction.

Results: In this sample, 40.1% thought that e-cigarettes had a harmful effect on users, and 27.1% thought that e-cigarettes had a harmful effect on passively exposed bystanders (p<0.001). Particularly, more never-smokers perceived that e-cigarettes had harmful effects on passively exposed bystanders than current smokers (34.4% vs 20.6%; OR=1.93, 95% CI 1.02 to 3.63). More people perceived e-cigarettes as being useful for reducing smoking than for quitting (50.6% vs 29.9%, p<0.001), as well as for reducing smoking than as being harmful to users (50.6% vs 40.1%, p=0.044).

Discussion: The perception that e-cigarettes are useful for reducing tobacco consumption was more prevalent than the perception that e-cigarettes are harmful to users and to those passively exposed to e-cigarettes. Advertisements and messages about the use of e-cigarettes and their harmful effects should be regulated and based on scientific evidence to avoid creating erroneous ideas about their use.


Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems / adverse effects
  • Electronic Nicotine Delivery Systems / psychology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Smoking / epidemiology*
  • Smoking Cessation / methods*
  • Smoking Cessation / psychology
  • Spain
  • Tobacco Use Disorder / psychology*