GKT School of Medical Education, King's College London, London, UK.
Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Nicotine Tob Res. 2020 Apr 21;22(5):705-712. doi: 10.1093/ntr/ntz008.
In line with the European Union's Tobacco Products Directive (TPD), new regulations for electronic cigarettes implemented in the United Kingdom between May 2016 and May 2017 included limiting refills to 10 mL, tank and cartridge sizes to 2 mL, and nicotine concentrations to 20 mg/mL.
To investigate the (1) awareness of new regulations, (2) product use before and after implementation, and (3) association between use of compliant products and subsequent smoking.
A UK online longitudinal survey of smokers, ex-smokers, and vapers was conducted between May and June 2016 (wave 4) and September 2017 (wave 5).The following methods were used: (1) to assess awareness of changes, proportions were calculated by smoking and vaping status (n = 1606). (2) Comparison of refill volume, tank and cartridge volumes, nicotine concentration at waves 4 and 5 (n = 199-388) was conducted. (3) Association was studied between number of TPD-compliant products used at wave 4 and smoking at wave 5, adjusted for wave 4 vaping status, age, gender, income, urges to smoke, and device type (n = 480).
Awareness of regulations was highest for refill volume (10.1%; 37.4% among exclusive vapers) and nicotine concentration (9.5%; 27.3%). Higher proportions used TPD-compliant refill volumes (60.0%-73.7%, χ2(1) = 10.9, p = .001) and nicotine concentrations (89.2%-93.9%, χ2(1) = 7.41, p = .007) in wave 5 than wave 4, with little change for tank or cartridge volumes (77.1-75.5%, χ2(1) = 0.38, p = .540). The likelihood of smoking was similar for those using no or one TPD-compliant products as it was for those using two (OR = 1.10, 95% CI = 0.47-2.59) or three (OR = 1.56, 95% CI = 0.69-3.55).
Several months after full implementation, awareness of new regulations was low and most vapers used TPD-compliant products. Use of compliant products was not associated with subsequent smoking.
Using a longitudinal survey at the beginning and a few months after the end of the transition period for implementation of new regulation on electronic cigarettes, this is the first study to assess awareness of regulation and use of compliant products. After full implementation, awareness of changes was low overall (smokers, ex-smokers, and vapers combined) although higher among those who vaped. Nevertheless, most vapers (74%-94%) used products that were compliant with the new regulations and the use of products compliant with incoming regulations did not predict whether they were smoking cigarettes after implementation.
根据欧盟烟草产品指令（TPD），英国于 2016 年 5 月至 2017 年 5 月实施的电子烟新规定包括将电子烟油容量限制为 10 毫升、烟弹和烟管容量限制为 2 毫升以及尼古丁浓度限制为 20 毫克/毫升。
调查（1）新规定的认知情况，（2）实施前后的产品使用情况，以及（3）使用符合规定产品与随后吸烟之间的关系。
2016 年 5 月至 6 月（第 4 波）和 2017 年 9 月（第 5 波）期间，对英国进行了一项在线纵向吸烟者、戒烟者和电子烟使用者调查。采用以下方法：（1）评估对变化的认知，按吸烟和电子烟使用情况计算比例（n = 1606）。（2）比较第 4 波和第 5 波的烟油填充量、烟管和烟弹容量、尼古丁浓度（n = 199-388）。（3）在第 4 波使用的符合 TPD 规定的产品数量与第 5 波的吸烟情况之间进行关联研究，调整第 4 波的电子烟使用情况、年龄、性别、收入、吸烟冲动和设备类型（n = 480）。
对填充量（10.1%；电子烟专用者中有 37.4%）和尼古丁浓度（9.5%；有 27.3%）的规定认知度最高。第 5 波中，使用符合 TPD 规定的填充量（60.0%-73.7%，χ2(1) = 10.9，p =.001）和尼古丁浓度（89.2%-93.9%，χ2(1) = 7.41，p =.007）的比例高于第 4 波，而烟管或烟弹的容量变化不大（77.1-75.5%，χ2(1) = 0.38，p =.540）。与使用一个或两个符合 TPD 规定的产品相比，不使用或使用一个符合 TPD 规定的产品与吸烟的可能性相似（OR = 1.10，95%CI = 0.47-2.59）或使用三个（OR = 1.56，95%CI = 0.69-3.55）。
在新的电子烟规定全面实施几个月后，人们对新规定的认识较低，大多数电子烟使用者使用符合 TPD 规定的产品。使用符合规定的产品与随后的吸烟无关。
通过在电子烟新规定实施过渡期结束前后进行纵向调查，这是第一项评估对规定认知和使用符合规定产品的研究。全面实施后，总体而言（吸烟者、戒烟者和电子烟使用者综合考虑）对变化的认识较低，尽管电子烟使用者的认知度更高。尽管如此，大多数电子烟使用者（74%-94%）使用了符合新规定的产品，并且使用符合即将出台的规定的产品并不能预测他们在实施后是否会吸烟。
