Can Smoking Cessation Clinics Reflect a Country's Tobacco Control Status? Trends in Electronic Cigarette Use Among...

The increasing use of electronic cigarettes (e-cigarettes) has emerged as a significant challenge for tobacco control efforts. Despite legal restrictions in Türkiye, e-cigarette use is becoming increasingly widespread. This study aimed to assess annual trends in e-cigarette use, motivations for use, and supply patterns among individuals who visited a smoking cessation clinic between 2017 and 2023.

This retrospective study included 7,140 individuals who visited a Smoking Cessation Clinic of a public hospital between January 1, 2017, and December 31, 2023. Annual trends in e-cigarette use, reasons for use, dual use characteristics, awareness of product content, and supply sources were analyzed using descriptive frequency analyses.

Overall, 13.1% of the participants (n = 935) reported using e-cigarettes before, during, or after their smoking cessation process. The annual prevalence of e-cigarette use has increased significantly over time, rising from 0.2% in 2017 to 39.9% in 2023. While the most frequently reported reason for use in 2017 was "curiosity," the most common motivation in 2023 was "the intention to quit smoking." Between 2017 and 2021, e-cigarettes were predominantly obtained through online shopping, while their availability from physical retail outlets increased in subsequent years. Although applications to smoking cessation clinics decreased over time, e-cigarette use and its use in enclosed spaces steadily increased.

The significant increase in e-cigarette use among individuals applying to smoking cessation clinics between 2017 and 2023 indicates a worrying weakening of tobacco control efforts in Türkiye. The findings raise significant concerns about the societal normalization of e-cigarette use, increased accessibility through online and informal markets, and non-compliance with smoke-free environment policies.