18.12 Public perceptions of the risks and benefits of e-cigarettes

Last updated:  February 2023

Suggested citation: Greenhalgh, EM, & Scollo, MM. 18.12 Public perceptions of the risks and benefits of e-cigarettes. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2023. Available from:  https://www.tobaccoinaustralia.org.au/chapter-18-e-cigarettes/18-12-public-perceptions-of-the-risks-and-benefits-of-e-cigarettes 


Despite having some of the most restrictive e-cigarette policies in the world, poor enforcement has meant that e-cigarette use has increased dramatically among Australians in recent years, including among people who have never smoked.1 Reasons for vaping and perceptions of the benefits and harms of e-cigarettes tend to vary by age and smoking status. This section discusses:

18.12.1 Perceptions among adults Reasons for vaping among e-cigarette users

In 2019, among Australians who had never smoked and had tried e-cigarettes, trying them out of curiosity was by far the most common reason (80%) for vaping, followed by thinking they are less harmful (13%) and taste better (12%) than tobacco cigarettes.2 People who smoke often report using e-cigarettes because they are perceived as less harmful than tobacco cigarettes, and as potentially helpful in their attempts at smoking reduction or cessation.3-15 (Refer to Section 18.7 for findings of research on efficacy for smoking cessation). In 2019 in Australia, common reasons for using e-cigarettes among smokers included helping them to quit (46%), to cut down on cigarettes (38%), or to try and prevent relapse to smoking (25%). Using them out of curiosity was also one of the most common responses (42%). Many also reported using e-cigarettes because they were perceived as less harmful (29%) and as cheaper (28%) than cigarettes.2

In the EU in 2022, people who vape also cited quitting or reducing tobacco consumption (57%), as well as believing that vaping was less harmful (37%) or cheaper (23%) than tobacco as reasons for vaping. Compared with 2017, fewer people cited quitting or reducing smoking, while more cited flavours, that they believed that vaping was less harmful, and that their friends used e-cigarettes.16 Canadian adult vapers similarly reported in 2022 quitting or cutting down smoking as the most common reasons for e-cigarette use, though younger adults were more likely to also report flavours and help with coping/stress as among their top reasons for vaping compared with older adults.17 In England, many dual users also report using e-cigarettes to obtain nicotine in settings where smoking is not permitted.18

Earlier research in the US, Canada, England and Australia found that for smokers, the top reasons for regular vaping were that it was deemed helpful for cutting down or quitting smoking, and less harmful to others. Smokers discontinued vaping if it was not satisfying, or if was perceived as not helpful for quitting or reducing cravings. For ex-smokers, current vaping was motivated by ‘enjoyment’, ‘affordability’, and ‘less harm to others’, while not needing e-cigarettes to stay quit, not being satisfying, and safety concerns motivated stopping vaping.15 Perceptions of harm and addictiveness

A survey of Australian adults in 2022 found that about four in five (81%) agreed that e-cigarettes are highly addictive, which was significantly higher than in 2021. Levels of agreement were similar across age groups and socioeconomic status, though were slightly higher among females than males.19, 20 An analysis of Australian and UK data from the International Tobacco Control (ITC) study found that, consistent with the country’s less stringent regulations, compared to those in Australia smokers and recent ex-smokers in the UK were more likely to perceive e-cigarettes as less harmful than cigarettes.21 Another ITC study found that among current and ex-smokers in Canada, the US, England, and Australia in 2016, 37.4% allowed smoking in the home, while 60.4% of current vapers allowed vaping.22

A 2022 survey of Canadian vapers found that while most (68%) perceive smoking as harmful, nicotine e-cigarette use was ranked about the same as drinking alcohol, eating junk food, and using cannabis in terms of harm (34% compared with 33–39%).17 Studies in the EU,23 the UK,24 and the US25-29 have found that the proportion of people who perceive vaping as less harmful than smoking has decreased over time. In the US, the proportion of adults who perceived e-cigarettes to be as harmful as or more harmful than cigarettes increased substantially from 2012 to 201728 and again between 2019 and 2020.30 Media reporting on e-cigarettes also appears to affect perceptions of safety, with attitudes to the products becoming more negative among people in the wake of the EVALI outbreak (a respiratory illness linked to vaping31-34—see Section Support for regulations on e-cigarettes

Although vaping is becoming more common in Australia, research consistently finds high levels of support for policies that aim to limit access to and use of e-cigarettes. In 2019, about two-thirds of all Australians aged 14+ supported restrictions on the advertising of e-cigarettes and vaping in public places, and about four in five supported prohibiting sales to minors.2 In 2022, a survey of Australian adults found that the large majority agreed that e-cigarettes should be carefully regulated to stop a new generation of Australians from becoming addicted to nicotine (87%); that the promotion and marketing of e-cigarettes through social and digital media should not be allowed (84%); that the advertising of e-cigarettes in and around shops should not be allowed (82%); and vaping should not be allowed on public transport, in pubs, restaurants, or other indoor venues (87%).19 Support has also strengthened over time; between 2016 and 20192 and 2020 and 202119 the proportion of Australians supporting restrictions on the sale, advertising and use of e-cigarettes significantly increased.  

In the EU in 2021, about seven in ten people were in favour of banning the use of e-cigarettes in environments where smoking is prohibited, and about half (47%) were in favour of banning flavours in e-cigarettes.16 Between 2017 and 2021 the proportion supporting restrictions on use and flavours increased.16 In the US, there is strong public support for regulations that would potentially reduce use by children, including banning flavours.35, 36 US research has also found majority support for banning e-cigarette use in multi-unit housing.37

18.12.2 Perceptions among young people

Adolescents’ perceptions of e-cigarettes are influenced by advertising, marketing, and peer and family networks.38 Among adolescents, e-cigarettes are generally perceived as less harmful than conventional cigarettes,39 and also as less addictive.40, 41 Such perceptions of lesser harm can stem from beliefs that nicotine in e-cigarettes is less addictive, that the products contain minimal chemicals, and that secondhand aerosol is safer for bystanders.38 Perceptions of lesser harm also predict later use of e-cigarettes.33, 42 In Canada, compared with older adults, vaping is more often a recreational activity and habit in its own right among young people; many take up vaping having never regularly smoked, and they are more likely to be heavily dependent on vaping with nicotine. Adolescents report that vaping helps them to relax/cope, and that they enjoy vaping with others.17 Similarly in the EU, younger people who vape are substantially less likely to cite quitting or reducing smoking as their reason for vaping compared with older people, and more likely to cite perceptions of lesser harm, flavours, and social norms.16

Compared with non-users, youth who have used e-cigarettes perceive them to have lower health harms,38 and to also perceive flavoured products as less harmful than non-flavoured.40 Several studies in the US have found that adolescents who have lower parental education and who are from lower income families report lower perceived health risks of e-cigarettes.43, 44 Qualitative research in the UK found that adolescents perceive the products are ‘fun’, and find the diverse range of flavours particularly appealing.45 The wide range of sweet flavours is one of the most commonly cited reasons for experimentation among children, along with curiosity.32, 38, 46-49 Young adults similarly cite curiosity50 and flavours51 as common reasons for initiating e-cigarette use. A review found that young people tend to highlight the trendiness of e-cigarettes as a perceived benefit, and perceive fewer health benefits than adults.52

Longitudinal research in the US found that while perceptions of the harmfulness of e-cigarettes have generally increased over time among adolescents, harm perceptions were lower among ever vapers.53 Surveys in England have similarly shown that among 11–18 year olds, the proportion who thought that vaping was less harmful than smoking declined between 2015 and 2020, though increased slightly in 2021.33

See Section 18.9 for a detailed discussion of influences on the uptake of e-cigarettes among young people.

18.1.3 Perceptions among health professionals

Surveys of health professionals have found uncertainty regarding the safety and efficacy of e-cigarettes. A review of the beliefs and practices of healthcare professionals found that although most believe that e-cigarettes are less harmful than cigarettes, they also express concern about the health risks of e-cigarettes, and uptake and ‘gateway effects’ among young people. While most do not proactively recommend e-cigarette use, they are more likely to support use among patients with smoking related co-morbidities, heavy smokers with previous unsuccessful quit attempts, or patients who express interest in trying them.54 A study of Australian pharmacy staff found many reported a lack of confidence in the safety of e-cigarettes that contained nicotine, although most regarded e-cigarettes as less harmful than tobacco cigarettes.55 An international review of pharmacists’ perceptions of e-cigarettes similarly found a lack of knowledge and confidence regarding the use of e-cigarettes as a cessation aid.56 A survey of Australian cardiothoracic surgeons found that although e-cigarettes were perceived as unlikely to be safe (although less harmful than cigarettes), they may have a role as a perioperative smoking cessation aid.57 Among a sample of Australian alcohol and other drug healthcare providers, only a minority agreed that e-cigarettes could help smokers quit (30%), that e-cigarettes were safer than tobacco smoking (25%), and that they would recommend e-cigarettes (19%).58

Results from the ITC Four Country Smoking and Vaping Survey showed that few health professionals in Australia, Canada, England, and the US are discussing with or recommending vaping products to patients.59 Among medical students in the UK, although most (90%) felt that e-cigarettes were beneficial for reducing smoking, only just over half (56%) reported that they would recommend them to patients and many (61%) reported a lack of confidence in giving advice about e-cigarettes.60 In the US, one study found that recommending e-cigarettes to patients appeared to be more common among physicians who were ex-smokers themselves, and also to older heavy smokers with multiple unsuccessful quit attempts.61 A recent systematic review found that GPs hold mixed views regarding e-cigarettes. While patients are increasingly seeking information and advice about e-cigarettes for smoking cessation, most GPs believed their knowledge and the information about e-cigarettes was insufficient to provide advice and guidance about their use as a cessation aid.62

People generally report greater trust in medical professionals and public health organisations for providing accurate information on e-cigarettes than those with commercial interests; health professionals therefore may be able to effectively counter misleading e-cigarette promotion and improve public knowledge.63  

Relevant news and research

For recent news items and research on this topic, click  here. ( Last updated January 2023)


1. Dessaix A, Jardine E, Freeman B, and Kameron C. Undermining Australian controls on electronic nicotine delivery systems: illicit imports and illegal sales. Tobacco Control, 2022; 31(6):689-90. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36265869

2. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 - 2. Tobacco smoking chapter, Supplementary data tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data

3. Adkison SE, O'Connor RJ, Bansal-Travers M, Hyland A, Borland R, et al. Electronic nicotine delivery systems: international tobacco control four-country survey. American Journal of Preventive Medicine, 2013; 44(3):207–15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23415116

4. Bauhoff S, Montero A, and Scharf D. Perceptions of e-cigarettes: a comparison of adult smokers and non-smokers in a Mechanical Turk sample. American Journal of Drug and Alcohol Abuse, 2017; 43(3):311–23. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27712126

5. Tomashefski A. The perceived effects of electronic cigarettes on health by adult users: A state of the science systematic literature review. Journal of the American Association of Nurse Practitioners, 2016; 28(9):510–5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26997487

6. Czoli CD, Fong GT, Mays D, and Hammond D. How do consumers perceive differences in risk across nicotine products? A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes. Tobacco Control, 2017; 26(e1):e49-e58. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27625408

7. Pepper JK, Emery SL, Ribisl KM, Rini CM, and Brewer NT. How risky is it to use e-cigarettes? Smokers' beliefs about their health risks from using novel and traditional tobacco products. Journal of Behavioral Medicine, 2015; 38(2):318–26. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25348584

8. Xu Y, Guo Y, Liu K, Liu Z, and Wang X. E-Cigarette Awareness, Use, and Harm Perception among Adults: A Meta-Analysis of Observational Studies. PLoS One, 2016; 11(11):e0165938. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27861501

9. Couraud S, Cortot AB, Pivot XB, Touboul C, Lhomel C, et al. Beliefs and behavior regarding e-cigarettes in a large cross-sectional survey. Preventive Medicine Reports, 2018; 10:332–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29868388

10. Goldberg RL, Dankiewicz C, and Cataldo JK. Older Smokers' Beliefs About e-Cigarettes and Intent to Quit Conventional Cigarettes. Journal of Gerontological Nursing, 2018; 44(12):17–24. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30484844

11. Merry S and Bullen CR. E-cigarette use in New Zealand-a systematic review and narrative synthesis. New Zealand Medical Journal, 2018; 131(1470):37–50. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29470471

12. Truman P, Glover M, and Fraser T. An Online Survey of New Zealand Vapers. International Journal of Environmental Research and Public Health, 2018; 15(2). Available from: https://www.ncbi.nlm.nih.gov/pubmed/29382129

13. Erku DA, Gartner CE, Tengphakwaen U, Morphett K, and Steadman KJ. Nicotine vaping product use, harm perception and policy support among pharmacy customers in Brisbane, Australia. Drug Alcohol Rev, 2019; 38(6):703–11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31486151

14. Riahi F, Rajkumar S, and Yach D. Tobacco smoking and nicotine delivery alternatives: patterns of product use and perceptions in 13 countries. F1000Res, 2019; 8:80. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31131094

15. Yong HH, Borland R, Cummings KM, Gravely S, Thrasher JF, et al. Reasons for regular vaping and for its discontinuation among smokers and recent ex-smokers: findings from the 2016 ITC Four Country Smoking and Vaping Survey. Addiction, 2019; 114 Suppl 1(Suppl 1):35–48. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30821861

16. European Commission. Special Eurobarometer 506: Attitudes of Europeans towards tobacco and electronic cigarettes (S2240_506_ENG).  2021. Available from: http://data.europa.eu/88u/dataset/S2240_506_ENG

17. Environics Research. Vapers Panel Baseline Survey 2022. Health Canada,  2022. Available from: https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2022/097-21-e/097-21-report.pdf

18. Jackson SE, Beard E, and Brown J. Smokers' Use of E-Cigarettes in Situations Where Smoking Is not Permitted in England: Quarterly Trends 2011-2020 and Associations With Sociodemographic and Smoking Characteristics. Nicotine & Tobacco Research, 2021; 23(11):1831–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34089607

19. Bain E, Mitsopoulos E, and Durkin S. Perceptions of and support for policies concerning the availability and use of e-cigarettes among Australian adults, 2021 and 2022. Melbourne, Australia: Cancer Council Victoria, 2023. Available from: https://www.cancervic.org.au/downloads/cbrc/E-cig-policies-2023-PUBLIC.pdf

20. Ilchenko E, Tabbakh T, Mitsopoulos E, Durkin S, and Wakefield M. Perceptions of and support for policies to regulate e-cigarettes among Australian adults. Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2022. Available from: https://www.cancervic.org.au/downloads/cbrc/R22_EI_Perceptions%20of%20and%20support%20for%20policies%20to%20regulate%20e-cigarettes%20among%20Australian%20adults.pdf

21. Yong HH, Borland R, Balmford J, Hitchman SC, Cummings KM, et al. Prevalence and Correlates of the Belief That Electronic Cigarettes are a Lot Less Harmful Than Conventional Cigarettes Under the Different Regulatory Environments of Australia and the United Kingdom. Nicotine & Tobacco Research, 2017; 19(2):258–63. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27190403

22. Nahhas GJ, Braak D, Cummings KM, Heckman BW, Alberg AJ, et al. Rules about smoking and vaping in the home: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey. Addiction, 2019; 114 Suppl 1(Suppl 1):107–14. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30710468

23. Filippidis FT, Laverty AA, Gerovasili V, and Vardavas CI. Two-year trends and predictors of e-cigarette use in 27 European Union member states. Tobacco Control, 2017; 26(1):98–104. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27220621

24. McNeill A, Brose LS, Calder R, Bauld L, and Robson D. Evidence review of e-cigarettes and heated tobacco products 2018: A report commissioned by Public Health England. Public Health England, London: Public Health England, 2018. Available from: https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review

25. Mincer J. US E-cigarette use stalls as health concerns grow: Reuters/Ipsos poll. Reuters,  2016. Available from: http://uk.reuters.com/article/us-usa-ecigarettes-poll-idUKKCN0YF0DE

26. Majeed BA, Weaver SR, Gregory KR, Whitney CF, Slovic P, et al. Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012-2015. American Journal of Preventive Medicine, 2017; 52(3):331–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28341303

27. Huerta TR, Walker DM, Mullen D, Johnson TJ, and Ford EW. Trends in E-Cigarette Awareness and Perceived Harmfulness in the U.S. American Journal of Preventive Medicine, 2017; 52(3):339–46. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27890516

28. Huang J, Feng B, Weaver SR, Pechacek TF, Slovic P, et al. Changing Perceptions of Harm of e-Cigarette vs Cigarette Use Among Adults in 2 US National Surveys From 2012 to 2017. JAMA Netw Open, 2019; 2(3):e191047. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30924893

29. Nyman AL, Huang J, Weaver SR, and Eriksen MP. Perceived Comparative Harm of Cigarettes and Electronic Nicotine Delivery Systems. JAMA Netw Open, 2019; 2(11):e1915680. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31747029

30. Bandi P, Asare S, Majmundar A, Nargis N, Jemal A, et al. Relative Harm Perceptions of E-Cigarettes Versus Cigarettes, U.S. Adults, 2018-2020. American Journal of Preventive Medicine, 2022; 63(2):186–94. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35868816

31. Alber JM, Ganjooi K, Gibbs S, Almeida R, and Jackson LD. E-Cigarette Beliefs and Intentions Among U.S. Adults Before and After EVALI Outbreak. American Journal of Health Promotion, 2021; 35(8):1071–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33977783

32. Gupta PS and Kalagher KM. Where There Is (No) Smoke, There Is Still Fire: a Review of Trends, Reasons for Use, Preferences and Harm Perceptions of Adolescent and Young Adult Electronic Cigarette Use. Curr Pediatr Rep, 2021; 9(3):47–51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33996271

33. McNeill A, Simonavičius E, Brose L, Taylor E, East K, et al. Nicotine vaping in England: 2022 evidence update. A report commissioned by the Office for Health Improvement and Disparities. London: Office for Health Improvement and Disparities,  2022. Available from: https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update

34. Morgan JC, Silver N, and Cappella JN. How did beliefs and perceptions about e-cigarettes change after national news coverage of the EVALI outbreak? PLoS One, 2021; 16(4):e0250908. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33930093

35. Campaign for Tobacco-Free Kids. New Poll: Voters Overwhelmingly Support Trump Administration’s Plan to Take Flavored E-Cigarettes off the Market. Tobacco Free Kids,  2019. Available from: https://www.tobaccofreekids.org/press-releases/2019_10_10_ecig_poll

36. Czaplicki L, Perks SN, Liu M, Cuccia A, Patel M, et al. Support for E-cigarette and Tobacco Control Policies Among Parents of Adolescents. Nicotine & Tobacco Research, 2020; 22(7):1139–47. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31793996

37. Patel M, Donovan EM, Liu M, Solomon-Maynard M, and Schillo BS. Policy Support for Smoke-Free and E-Cigarette Free Multiunit Housing. American Journal of Health Promotion, 2022; 36(1):106–16. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34344161

38. Sharma A, McCausland K, and Jancey J. Adolescent's Health Perceptions of E-Cigarettes: A Systematic Review. American Journal of Preventive Medicine, 2021; 60(5):716–25. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33775514

39. East K, Brose LS, McNeill A, Cheeseman H, Arnott D, et al. Harm perceptions of electronic cigarettes and nicotine: A nationally representative cross-sectional survey of young people in Great Britain. Drug and Alcohol Dependence, 2018; 192:257–63. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30300799

40. Cooper M, Harrell MB, Perez A, Delk J, and Perry CL. Flavorings and Perceived Harm and Addictiveness of E-cigarettes among Youth. Tobacco Regulatory Science, 2016; 2(3):278–89. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27722185

41. Cooper M, Loukas A, Harrell MB, and Perry CL. College students' perceptions of risk and addictiveness of e-cigarettes and cigarettes. J Am Coll Health, 2017; 65(2):103–11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27805472

42. Parker MA, Villanti AC, Quisenberry AJ, Stanton CA, Doogan NJ, et al. Tobacco Product Harm Perceptions and New Use. Pediatrics, 2018; 142(6). Available from: https://www.ncbi.nlm.nih.gov/pubmed/30397167

43. Kong G, Simon P, Mayer ME, Barrington-Trimis JL, Pacek LR, et al. Harm Perceptions of Alternative Tobacco Products among US Adolescents. Tobacco Regulatory Science, 2019; 5(3):242–52. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31840041

44. Vu TT, Groom A, Hart JL, Tran H, Landry RL, et al. Socioeconomic and Demographic Status and Perceived Health Risks of E-Cigarette Product Contents Among Youth: Results From a National Survey. Health Promotion Practice, 2020; 21(1_suppl):148S–56S. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31908196

45. Hilton S, Weishaar H, Sweeting H, Trevisan F, and Katikireddi SV. E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views. BMJ Open, 2016; 6(11):e013271. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27852721

46. Measham F, O’Brien K, and Turnbull G. “Skittles & Red Bull is my favourite flavour”: E-cigarettes, smoking, vaping and the changing landscape of nicotine consumption amongst British teenagers – implications for the normalisation debate. Drugs: Education, Prevention and Policy, 2016; 23(3):224–37. Available from: http://dx.doi.org/10.1080/09687637.2016.1178708

47. Kong G, Morean ME, Cavallo DA, Camenga DR, and Krishnan-Sarin S. Reasons for Electronic Cigarette Experimentation and Discontinuation Among Adolescents and Young Adults. Nicotine & Tobacco Research, 2015; 17(7):847–54. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25481917

48. Harrell MB, Weaver SR, Loukas A, Creamer M, Marti CN, et al. Flavored e-cigarette use: Characterizing youth, young adult, and adult users. Preventive Medicine Reports, 2017; 5:33–40. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27896041

49. Pepper JK, Ribisl KM, and Brewer NT. Adolescents' interest in trying flavoured e-cigarettes. Tobacco Control, 2016; 25(Suppl 2):ii62–ii6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27633762

50. Kinouani S, Leflot C, Vanderkam P, Auriacombe M, Langlois E, et al. Motivations for using electronic cigarettes in young adults: A systematic review. Substance Abuse, 2020; 41(3):315–22. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31638872

51. Landry RL, Groom AL, Vu TT, Stokes AC, Berry KM, et al. The role of flavors in vaping initiation and satisfaction among U.S. adults. Addictive Behaviors, 2019; 99:106077. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31437770

52. Romijnders K, van Osch L, de Vries H, and Talhout R. Perceptions and Reasons Regarding E-Cigarette Use among Users and Non-Users: A Narrative Literature Review. International Journal of Environmental Research and Public Health, 2018; 15(6). Available from: https://www.ncbi.nlm.nih.gov/pubmed/29882828

53. Li W, Osibogun O, Li T, Sutherland MT, and Maziak W. Changes in harm perception of ENDS and their predictors among US adolescents: findings from the population assessment of tobacco and health (PATH) study, 2013-2018. Preventive Medicine, 2022; 155:106957. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35065977

54. Erku DA, Gartner CE, Morphett K, and Steadman KJ. Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis. Nicotine & Tobacco Research, 2020; 22(5):619–29. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30938442

55. Erku DA, Gartner CE, Do JT, Morphett K, and Steadman KJ. Electronic nicotine delivery systems (e-cigarettes) as a smoking cessation aid: A survey among pharmacy staff in Queensland, Australia. Addictive Behaviors, 2019; 91:227–33. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30224155

56. Barrett R and Aldamkhi H. An Evaluation of the Knowledge and Perceptions of Pharmacy Staff and Pre-Registration Students of E-Cigarettes Use: A Systematic Review. Tob Use Insights, 2021; 14:1179173X211016867. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34188579

57. Luxton NA, Shih P, and Rahman MA. Electronic Cigarettes and Smoking Cessation in the Perioperative Period of Cardiothoracic Surgery: Views of Australian Clinicians. International Journal of Environmental Research and Public Health, 2018; 15(11). Available from: https://www.ncbi.nlm.nih.gov/pubmed/30405035

58. Skelton E, Guillaumier A, Tzelepis F, Walsberger S, Paul CL, et al. Alcohol and other drug health-care providers and their client's perceptions of e-cigarette use, safety and harm reduction. Drug Alcohol Rev, 2021; 40(6):998–1002. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33774886

59. Gravely S, Thrasher JF, Cummings KM, Ouimet J, McNeill A, et al. Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey. Addiction, 2019; 114 Suppl 1(Suppl 1):71–85. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30548374

60. Afzal M, Ellis-Parkinson M, Holdsworth L, Sykes DL, and Crooks MG. Electronic cigarette use and perceptions amongst UK medical students: A cross-sectional study. Tob Prev Cessat, 2021; 7:13. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33644495

61. Delnevo CD, Jeong M, Teotia A, Bover Manderski MM, Singh B, et al. Communication Between US Physicians and Patients Regarding Electronic Cigarette Use. JAMA Netw Open, 2022; 5(4):e226692. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35426926

62. Selamoglu M, Erbas B, Kasiviswanathan K, and Barton C. General practitioners' knowledge, attitudes, beliefs and practices surrounding the prescription of e-cigarettes for smoking cessation: a mixed-methods systematic review. BMC Public Health, 2022; 22(1):2415. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36550439

63. Owusu D, Weaver SR, Yang B, Ashley DL, and Popova L. Trends in Trust in the Sources of Health Information on E-Cigarettes Among US Adults, 2015-2017. American Journal of Public Health, 2019; 109(1):145–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30496009