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Rüther, Tobias; Wissen, Franziska; Linhardt, Andrea; Aichert, Désirée S.; Pogarell, Oliver; Vries, Hein de (2016): Electronic Cigarettes-Attitudes and Use in Germany. In: Nicotine & Tobacco Research, Vol. 18, No. 5: pp. 660-669
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Abstract

Introduction: Smoking is the leading preventable cause of death and disease. Previous studies on electronic cigarette (e-cigarette) use have reported reduction and cessation of conventional cigarette smoking;however, health effects are still a matter of discussion. This cross-sectional study investigated the attitudes of adults in Germany towards using e-cigarettes instead of or in addition to cigarettes. Furthermore, it examined the extent to which e-cigarettes are used as a smoking cessation tool. Methods: In 2012, we recruited a sample of 319 participants comprising e-cigarette users (vapers, 33%), cigarette smokers (smokers, 37%) and smokers of both cigarette types (dual users, 30%). The Integrated Model for Change (I-Change Model) was used as a theoretical framework and a modified Fagerstrom Test of Nicotine Dependence was used to assess nicotine dependence. Data were collected by means of a questionnaire and smoking status was substantiated by measuring exhaled carbon monoxide. Results: The vapers were more often men, were less addicted to nicotine and had a higher motivation to stop smoking than the smokers. In addition, vapers reported better health and had a lower carbon monoxide concentration than smokers. Furthermore, vapers had a more positive attitude towards e-cigarettes and higher self-efficacy in terms of abstaining from cigarettes in certain situations. Conclusions: This is the first study to report on the use of e-cigarettes in Germany. Our results support those of previous studies in other populations. Further research is still needed on the potential health effects of e-cigarettes and their efficacy as a smoking cessation aid. Implications: The study is the first description of attitudes and use of e-cigarettes in Germany.