Nearly two thirds of electronic cigarette users are smokers, and a third are ex-smokers. This suggests that around 700,000 Britons are smoke-free and using electronic cigarettes. Gerry Stimson, Emeritus Professor at Imperial College London commented that “if sustained this is a remarkable public health achievement, and firmly establishes tobacco harm reduction as the way forward to reduce the huge personal and public costs of smoking cigarettes”.

The figures confirm previous ASH surveys that electronic cigarette use amongst non-smokers is miniscule – at around 0.1%, and only 1% of those who have never smoked report ever having tried an electronic cigarette. This is further confirmation that fears by anti-electronic cigarette campaigners that electronic cigarettes are a gateway to nicotine use are implausible and unfounded. ASH Chief Executive Deborah Arnott affirmed that “there is no evidence from our research that e-cigarettes are acting as a gateway into smoking.”

The YouGov survey sampled 12,269 adults in Britain and is representative of all adults aged 18 plus, and was undertaken between 5th and 14th March 2014.

One in every two smokers or ex-smokers has now tried an electronic cigarette. The survey reveals major year-on-year increase in current and ex-smokers who have tried electronic cigarettes over the past four years. In ASH’s 2010 survey, only 8.2 per cent of current or ex-smokers had ever tried electronic cigarettes. By 2014, this figure had risen to 51.7 per cent. There has been a corresponding increase in the proportion of smokers and ex-smokers who use electronic cigarettes on a regular basis increasing six fold over the four years, from 2.7% in 2010 to 17.7% in 2014.

This increase in electronic cigarette use is remarkable given the lack of enthusiasm for electronic cigarettes among NHS public health directors, that the main NHS policy position in Scotland, Wales and England is to ban their use on NHS premises, and the antipathy to electronic cigarettes shown by some medical leaders [1].

More people support the view that electronic cigarettes are good for public health, with over a third of adults in Britain (35% ) agreeing with this, while under a quarter disagree (22%).

The survey data come on top of information from the Smoking Toolkit Study that show that electronic cigarettes are now the resource of choice for people who want to switch from smoking, being more popular that Nicotine Replacement therapy and NHS stop smoking clinics [2]. Electronic cigarettes are more effective than NRT  in real-world attempts to switch from smoking.

The survey also reveals important information on preferences for different types of electronic cigarettes. Less than one in five started with a disposable electronic cigarettes, over a half started off using rechargeable electronic cigarettes with prefilled cartridges, and one in four starting by using devices with a tank or reservoir.

The picture is very different with current users – only 8% use disposables, 47% use rechargables with prefilled cartridges and 41% use a device with a refillable tank. This 41% will be the most affected by European legislation to limit the size of refillable devices.

The increase in electronic cigarette use has happened is the context of light touch regulation. John Diver, coordinator of the UK’s New Nicotine Alliance comments that “Whether they like it or not, these numbers say that there's a significant number who could lose out if the Government take a hard line on the implementation of the Tobacco Products Directive. People who have switched to safer nicotine products need to be supported, not prevented, from using the device of their choice.”

The popularity of refillables also has implications for major electronic cigarette companies, many of whom have invested in rechargeable cigalikes rather than refillables. US estimates from Wells Fargo  also put the size of the tanks market as about equal to the cigalike market.

The ASH survey also gives insights into why people use electronic cigarettes. Among smokers and ex-smokers the main reasons were help “to help me stop smoking entirely” (71%) and “to help me keep off tobacco” (48%). For dual users (current smokers who were also using electronic cigarettes) the main reason was to “help me reduce the amount of tobacco I smoke, but not stop completely” (48%) followed by “to save money compared with smoking tobacco” (37%); and “to help me stop smoking entirely” (36%).

[1] Gerry V. Stimson. Public health leadership and electronic cigarette users. The European Journal of Public Health 2014; doi: 10.1093/eurpub/cku049.

[2] West R, Brown J & Beard E. Trends in electronic cigarette use in England. Smoking Toolkit Study. University College London, 4th April 2014 update.