Over the years, electronic smoke has been controversial.

Because of the sense of technology of electronic cigarette products, many people think it attracts non-smokers, which leads to users' addiction to tobacco.

But according to the latest paper published by China CDC in the international authoritative medical journal Lancet public health, Chinese adult e-cigarettes users are mainly traditional smokers, and non smokers rarely use electronic cigarettes.

The study is entitled "the use of e-cigarettes in Chinese adults: the results of repeated cross-sectional surveys in 2015-16 and 2018-19" to determine the trend and related factors of e-cigarettes use in China.

The survey was conducted in 298 national disease monitoring sites in 31 provinces in China, and adopted multi-stage, stratified and cluster random sampling design. This is the first time that the current situation and trend of Chinese e-cigarettes are reported from the national level.

Investigation and research group, disease control paper in the source of map

The authors involved in the investigation include Gao Fu, director of CDC, zhoumaigeng, deputy director of China Center for chronic disease control, etc., which shows that the report has certain authority.

From this paper, we found that in recent years, the main characteristics of Chinese e-cigarette users are: men, smokers, tobacco addiction, and desire to quit smoking.

Therefore, the current domestic e-cigarette users are still traditional smokers, and they do not spread to non-smokers, and electronic cigarettes are not the first cigarettes for non-smokers.

It is undeniable that although e-cigarettes reduce many harmful substances of traditional cigarettes, the current research results on e-cigarettes are still relatively limited. There is still a large space for exploration on the specific effectiveness and degree of reduction of e-cigarettes.

However, the current e-cigarette users, mainly old smokers, many of them want to quit smoking, for this purpose, targeted at specific groups, to customized solutions, may reduce the number of people who smoke cigarettes to a certain extent.

Who is consuming e-cigarettes?

With the increasing attention of consumers to health and the environment of national tobacco control policies, more and more smokers choose to switch to electronic cigarettes, which also leads to the expansion of the global e-cigarette market.

According to the statistics of frost Sullivan, the global e-cigarette market size in 2014 was US $12.4 billion, which was US $36.7 billion by 2019, with an annual composite growth rate of 24.2%.

The United States is the largest country in e-cigarettes, with a market scale of 20.7 billion US dollars in 2019, accounting for 56.4% of the world's e-cigarettes consumption. The EU and the UK are the second largest consumer market of e-cigarettes in the world, contributing 19.89% of the market share.

Compared with the traditional cigarette, electronic cigarette has the characteristics of whether it needs to be burned or not, and it provides nicotine but no tar.

According to the smoke out mode, the electronic smoke can be divided into steam type electronic smoke and heating non combustion electronic smoke. Among them, the steam type electronic smoke is mainly used to form fog gas by atomizer, while the non burning electronic smoke can meet the needs of smokers by heating the tobacco.

Because heating non burning electronic smoke needs to buy cigarette ends, which contains tobacco, it is banned in China. Therefore, domestic e-cigarettes are basically steam type electronic cigarettes.

Before, due to the hot electronic smoke, attracted a lot of attention, but also caused people to worry that e-cigarettes will expand the smoking group, such as women, which will cause adverse effects, but this conclusion is not supported by professional data.

Recently, the latest paper published by the CDC gives answers to concerns about e-cigarettes.

The study uses the survey data of China chronic disease and nutrition monitoring in 2015-2016 and 2018-2019. The total number of adults surveyed reaches 400000, which shows that the sample size is large and has national representative.

Distribution of Chinese adults using electronic smoke, paper on disease control in tuyuan

The results show that from 2015 to 2019, the utilization rate of adult e-cigarettes in China rose from 1.3% to 1.6%, of which male users accounted for almost the majority, accounting for about 97%.

It can be seen that although the characteristics of e-cigarettes are mainly focused on technology, the main users are male groups, and thus attract more female users.

In addition, the study also found that between 2015 and 2016, smokers accounted for 93% of the Chinese e-cigarettes users; In 2018-2019, the proportion of smokers is about 96.2%, that is, the proportion of non smokers is less than 4%.

Through the estimation of weighted epidemic value from 2018 to 2019, there are about 16.9 million adult e-cigarettes users in China in this year, of which 16.2 million were originally smokers.

That is to say, most users who use electronic cigarettes are still the original smokers, and their attraction to non smokers is not very big.

Is electronic smoke the first smoke for non smokers?

For a long time, because more and more users switch to e-cigarettes, it is always thought that e-cigarettes will attract many non-smokers, but it is not.

In the latest paper published by CDC, the research team conducted a sample survey of more than 370000 respondents across the country. The results showed that only 83 of the 370000 respondents changed from non-smokers to e-cigarettes users, with a probability of only 0.02%.

From this probability, it can be said that e-cigarettes are not the first cigarettes for non-smokers. The author of the paper also emphasizes that non-smokers rarely use e-cigarettes.

It is worth noting that this study not only analyzes the basic proportion characteristics of Chinese e-cigarette users, but also evaluates the use mode of e-cigarettes users in China in detail in gender, age, region, income and other dimensions.

Finally, multiple research dimensions show that e-cigarettes are very popular with the old smokers, and the main reason why they contact and turn to e-cigarettes is to reduce their dependence on cigarettes.

In the study, it also showed that e-cigarettes are more attractive to smokers who want to quit smoking and frequently smoke every day, especially those who smoke more than 20 cigarettes a day.

It can be found that the old smokers have been addicted to smoking for many years. Even if they know that smoking is bad for their health, it is difficult to quit smoking successfully because of the habit they have developed for many years.

Nowadays, the emergence of electronic cigarettes can be said to provide a way to get rid of traditional cigarettes for the old smokers. This is also the reason why people who are addicted to cigarettes and understand the harm of smoking are more likely to choose e-cigarettes.

More and more old smokers choose electronic cigarettes, which means that the harm reduction effect of e-cigarettes has been recognized.

According to the China survey report of the international tobacco control policy assessment project (ITC project), from 2009 to 2014, the proportion of smokers who knew that e-cigarettes had increased from 29% to 60%, and the number of smokers who actively understood and changed to e-cigarettes was also increasing.

The data collected by CDC in 2015-2019 coincided with the international tobacco control policy assessment China survey. It is also found that after understanding the electronic cigarettes, more and more smokers choose to use electronic cigarettes, so as to reduce the use of traditional cigarettes.

At present, not only in domestic smokers choose more electronic cigarettes, in other countries, traditional smokers are also the main force of e-cigarettes.

According to data released by the UK action on smoking and health (ash) in 2019, the proportion of adult e-cigarettes consumers in Great Britain (excluding Northern Ireland) in the UK increased from 1.7% in 2012 to 7.1% in 2019, an increase of 5.4% to 3.6 million.

2012-2019 UK adult e-cigarette consumer ratio change, source ash

As the second largest consumer market of e-cigarettes in the world, the UK attitude towards e-cigarettes has certain reference value.

Currently, British doctors, public health experts and cancer charities agree that electronic cigarettes are less harmful than traditional cigarettes based on available data.

This conclusion has also been supported by the relevant authorities in the UK. According to the survey by the British Ministry of public health, the harm of using electronic cigarettes is 95% less than that of traditional cigarettes.

How to view e-cigarettes?

According to the data of the World Health Organization, there are more than 300 million smokers in China, accounting for one third of the world's total smokers.

According to the latest published paper by CDC, the proportion of Chinese adults who have used e-cigarettes in the past 30 days increased from 1.3% in 2015 to 2016, to 1.6% from 2018 to 2019, with an overall increase of only 0.3%.

From the current situation, e-cigarettes are not "growing crazily" as the outside world has been preached.

"We call on the public health community to focus on the short-term and long-term impact of e-cigarettes on health, and to develop differentiated policies and public education strategies for different populations." The author of the paper "the use of electronic cigarettes for adults in China" mentioned.

In october2020, the international authoritative evidence-based medical academic organization, Cochrane cooperation organization, published a review of the latest research. 50 professional studies conducted by the international authoritative evidence-based medical academic organization (ICO) on over 10000 adult smokers in the world proved that e-cigarettes have the role of assisting smoking cessation and the effect is better than nicotine replacement therapy.

The study found 50 studies from 13 countries, including the United States and the United Kingdom, involving more than 12000 adult smokers. Compared with the people who used nicotine replacement therapy, such as nicotine gum or non nicotine free e-cigarettes, more people used nicotine e-cigarettes to assist in quitting smoking for at least six months.

"This new review of e-cigarettes shows that for many smokers, e-cigarettes are an effective tool to help quit smoking. It is also important to note that, for two years, none of these studies have found any evidence that the use of e-cigarettes can harm people. " Professor Peter Hajek, the co-author of the Cochrane Review and director of the tobacco dependence research group at Queen Mary University in London, said.

Last year, an independent study at the University College of London also pointed out that e-cigarettes helped 50000 to 70000 users in the UK every year to stay away from traditional cigarettes.

Meanwhile, the Ministry of Public Health said that there are many misunderstandings about nicotine among the British public. Only less than 10% of adults know that smoking is not caused by nicotine, and the harm of electronic cigarettes is far lower than that of traditional cigarettes.

The UK government website published a report from the UK Ministry of public health, which noted that the risk of cancer among e-smokers was significantly reduced by reducing more than 70 known carcinogens in traditional cigarettes - less than 0.5 per cent of the potential risk of cancer among e-smokers.

The UK's public health ministry also believes that the prevalence of electronic cigarettes has a potential relationship with the decline in cigarette smoking.

In 2017, about 2.9 million adults in the UK used e-cigarettes, accounting for 6% of the total population. However, in recent two years, the number of people using e-cigarettes and traditional cigarettes has stopped growing, and more and more smokers have completely turned from traditional cigarettes to e-cigarettes.

Thus, electronic cigarette is helpful to the old smokers to get rid of cigarettes.

However, in recent years, China's e-cigarettes have just developed, and relevant national departments are actively regulating the development of e-cigarettes industry. It is believed that the joint control of the whole industry by regulatory departments and enterprises will make e-cigarettes play a role