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Updated: Feb 8, 2026

Comparing the Effects of Electronic Cigarette Vapor and Cigarette Smoke in a Novel In Vivo Exposure System
Published on: May 24, 2017
Barriers to electronic cigarette use
Thomas MacAndrew English1, Todd Brenton Smith2, Xiaochuan Song1
1Department of Management, The University of Alabama, Tuscaloosa, AL, USA.
Objective:
Recent studies suggest that electronic cigarettes (e-cigarettes) may be a better alternative to traditional smoking cessation therapies for cigarette smokers. This study explores the barriers traditional smokers face when switching to e-cigarettes.
Design And Sample:
A convenience sample of adult male and female tobacco and/or e-cigarette smokers (n = 446) were recruited through an online survey.
Measurements:
The survey included questions used to determine the barriers a smoker may experience in regards to their use of e-cigarettes, as well as the characteristics regarding their use of tobacco and/or e-cigarettes.
Results:
The majority (74%) of tobacco smokers who tried e-cigarettes did not perceive e-cigarettes to be an effective replacement for tobacco cigarettes, and 69% indicated the initial cost and health concerns as reasons to not continue using e-cigarettes. Both current e-cigarette users and those who discontinued use of e-cigarettes noted health or lack of information on side effects as a concern. The majority of e-cigarette users indicated that it took more than a week to settle on a proper dose. We found that for each additional cigarette smoked per day individuals were 4.0% (p = .001) more likely to use e-cigarettes.
Conclusion:
This exploratory study informs future cessation trials involving e-cigarettes about the barriers users face. Given that individuals who smoke a greater number of tobacco cigarettes are more likely to try e-cigarettes, greater attention to nicotine dosing is necessary.
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