Publications list

E-cigarette use and support for banning e-cigarette use in public places in the European Union

Anthony A.Laverty, Filippos T.Filippidis, Esteve Fernandez and Constantine I.Vardavas
Preventive Medicine, 2017, ISSN 0091-7435
Publish date: 16 August 2017
DOI: 10.1016/j.ypmed.2017.08.007


We investigated the factors associated with support for banning e-cigarette use in public places in the European Union (EU) and how this varies by socio-demographic determinants, use of tobacco, ever use of e-cigarettes and their perceived harm.

Data are from the representative Special Eurobarometer for Tobacco survey performed in 2014 (n = 27,801) in 28 EU member states. Analyses were conducted separately by tobacco use status (never, current, and former smokers) and e-cigarette experimentation status. 70.9% of never smokers, 63.1% of former smokers and 45.7% of current smokers in the EU supported a ban on the use of e-cigarettes in public places.

In all groups, support for banning e-cigarettes in public places was lower among those who had experimented with e-cigarettes (adjusted odds ratios (aOR) 0.43 vs. 0.50 vs. 0.61, among never, current and former smokers respectively) and higher among those who perceived e-cigarettes as harmful (aORs 2.49 vs 2.35 vs. 2.40, among never, current and former smokers respectively). 40.5% of those who had experimented with e-cigarettes supported a ban on use in public places, although levels of support were lower among those who started using e-cigarettes in order to circumvent existing smoking bans (aOR 0.54, 95% Confidence Interval 0.45–0.64). Bans of e-cigarette use in public places in Europe have high levels of public support even among former and current tobacco smokers, although this does vary across population groups.

As legislators consider approaches to e-cigarette use, public opinion is likely to become more important to the passing and enforcement of any legislation.

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The association between occupational secondhand smoke exposure and life satisfaction among adults in the European Union

Nikita B. Rajani, Iris T. Vlachantoni, Constantine I. Vardavas and Filippos T. Filippidis
Tobacco Induced Diseases 2017, 15:19
Publish date: 23 March 2017
DOI: 10.1186/s12971-017-0127-x


Despite existing legislation, a large proportion of the European Union (EU) population is exposed to occupational secondhand smoke (SHS). The aim of this study was to explore associations between occupational exposure to SHS and self-reported life satisfaction.

We analysed data collected through the Eurobarometer survey (wave 82.4) from n = 11,788 individuals working in indoor spaces. The sample was representative of the population of the 28 EU member states. We fitted a multilevel logistic regression model adjusting for smoking, age, gender, occupation, area of residence, education, difficulty paying bills, marital status and social class.

27.5% of those working indoors reported at least some occupational exposure to SHS. People exposed to occupational SHS were less likely to report that they were satisfied with the life they lead (adjusted Odds Ratio = 0.72, 95% Confidence Interval: 0.60-0.87). The effect of occupational exposure on life satisfaction did not differ by smoking status, with all interaction terms between smoking status and occupational exposure to SHS not statistically significant.

Exposure to SHS at the workplace does not only have negative consequences on physical health, but it can also impact life satisfaction of smokers and non-smokers. Our findings highlight the need for stricter enforcement of smokefree environments at the workplace in the EU.

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Experimentation with e-cigarettes as a smoking cessation aid: a cross-sectional study in 28 European Union member states

Filippos T Filippidis, Anthony A Laverty, Constantine I Vardavas
BMJ Open 6
Publish date: 6 October 2016
DOI: 10.1136/bmjopen-2016-012084  


To describe patterns of experimentation with electronic cigarettes as a smoking cessation aid, their self-reported impact on smoking cessation and to identify factors associated with self-reported successful quit attempts within the European Union (EU).As electronic or e-cigarettes grow in popularity, scientists are racing to find out how they affect health, not just of users but for those around them.

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Design and marketing features influencing choice of e-cigarettes and tobacco in the EU

Anthony A. Laverty, Constantine I. Vardavas, Filippos T. Filippidis
European Journal of Public Health 1-4
Publish date: 26 July 2016
DOI: 10.1093/eurpub/ckw109


Data were analysed from the 2014 Special Eurobarometer for Tobacco survey. We estimated self-rated importance of various factors in the choice of both tobacco and electronic cigarettes (e-cigarettes) among tobacco smokers who had ever used an e-cigarette. Among ever users of tobacco and e-cigarettes (N = 2430), taste (39.4%), price (39.2%) and amount of nicotine (27.3%) were the most commonly cited reasons for choosing their brand of e-cigarettes. Those aged 15–24 were more likely to cite external packaging [adjusted prevalence ratio (aPR = 2.06, 95% CI 1.00–4.23)] and design features (aPR = 1.99, 1.20–3.29) as important. As further legislation is debated and enacted enhanced regulation of price, design and marketing features of e-cigarettes may help to reduce the appeal of e-cigarettes.
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Two-year trends and predictors of e-cigarette use in 27 European Union member states

Filippos T Filippidis, Anthony A Laverty, Vasiliki Gerovasili, Constantine I Vardavas
Tob Control 2016; 0:1–7
Publish date: 24 May 2016
DOI: 10.1136/tobaccocontrol-2015-052771  


This study assessed changes in levels of ever use, perceptions of harm from e-cigarettes and sociodemographic correlates of use among European Union (EU) adults during 2012–2014, as well as determinants of current use in 2014.

The study analysed data from the 2012 (n=26 751) and 2014 (n=26 792) waves of the adult Special Eurobarometer for Tobacco survey. Point prevalence of current and ever use was calculated and logistic regression assessed correlates of current use and changes in ever use, and perception of harm. Correlates examined included age, gender, tobacco smoking, education, area of residence, difficulties in paying bills and reasons for trying an e-cigarette.

The prevalence of ever use of e-cigarettes increased from 7.2% in 2012 to 11.6% in 2014 (adjusted OR (aOR)=1.91). EU-wide coefficient of variation in ever e-cigarette use was 42.1% in 2012 and 33.4% in 2014. The perception that e-cigarettes are harmful increased from 27.1% in 2012 to 51.6% in 2014 (aOR=2.99), but there were major differences in prevalence and trends between member states. Among those who reported that they had ever tried an e-cigarette in the 2014 survey, 15.3% defined themselves as current users. Those who tried an e-cigarette to quit smoking were more likely to be current users (aOR=2.82).

Ever use of e-cigarettes increased during 2012–2014. People who started using e-cigarettes to quit smoking tobacco were more likely to be current users, but the trends vary by country. These findings underscore the need for more research into factors influencing e-cigarette use and its potential benefits and harms.
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EUREST PLUS - European Regulatory Science on Tobacco: Policy implementation to reduce lung diseases - Proposal (Horizon2020)

Constantine Vardavas, European Network for Smoking and Tobacco Prevention (ENSP)
Tob. Prev. Cessation2016; 2 (April Supplement): 27
Publish date: 2016-03-31


EUREST-PLUS, a thirteen –partner EU joint proposal, coordinated by ENSP (Coordinator: Constantine Vardavas), aims to monitor and evaluate the impact of the TPD at an EU level. The specific objectives of the proposal are: 1. To evaluate the psychosocial and behavioural impact of TPD implementation and FCTC implementation, through the creation of a longitudinal cohort of adult smokers in 6 EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) in a pre- vs. post- study design. 2. To assess support for TPD implementation through secondary dataset analyses of the 2015 Special Eurobarometer on Tobacco Survey (SETS), and through trend analyses on the merged datasets of the 2009, 2012 and2015 SETS datasets. 3. To document changes in e-cigarette product parameters (technical design, labelling, packaging and chemical composition) following implementation of Article 20 of the TPD. 4. To enhance innovative joint research collaborations, through the pooling and comparisons across both other EU countries of the International Tobacco Control (ITC) Project, and other non-EU countries.
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