Electronic Cigarettes in Germany: Patterns of Use and Perceived Health Improvement

The aim of the study was to characterize e-cigarette users in terms of their consumption patterns, motives, and the perceived health benefits they experience from using e-cigarettes.

The study was a cross-sectional online survey in 2015. A total of 3,320 German e-cigarette users were enrolled. A total of 91.5% were former tobacco smokers, 7.5% used both e-cigarettes and tobacco products, 1.0% were never-smokers.

No differences were found between ex-smokers and dual users with regard to sociodemographic and smoking history (mean age 40.8 years, 81% men, 45% with a high school degree or above). Both groups had smoked 26.4 tobacco cigarettes a day for 22 years, had unsuccessfully tried to quit smoking using various other nicotine replacement products, and had used e-cigarettes for an average of 2 years. Ex-smokers consumed lower nicotine strength and more liquid per month, experienced more positive health changes, and had made vaping their hobby. Never-smokers were about 5 years younger, used liquid without nicotine and without tobacco flavor, and had no physical dependency.

E-cigarettes were primarily used as an alternative to smoking and a substitute for nicotine. More dual users than ex-smokers used e-cigarettes in places where smoking is forbidden. Positive health changes were more pronounced in ex-smokers than dual users.