healthier alternatives to conventional tobacco products,
rather than as aids to ending nicotine dependence [3].
Proponents stress their harm reduction benefits in moving
smokers away from the damaging toxins in conventional
tobacco products, and their potential in helping
them quit smoking altogether [4,5]. However, opponents
highlight their unknown quality, safety and efficacy; their
deleterious impact on the ‘no smoking’ health message;
and their potential to harm children, including as a
possible gateway to cigarette smoking [2,4,6]. Thus, despite
growing consensus among health professionals that
e-cigarettes are a less damaging delivery mechanism for
nicotine than conventional tobacco products [6], a lack
of regulation governing them in many countries means
that an addictive drug can be promoted to, and cheaply
accessed by, children [7]. However, the extent of children’s
access to e-cigarettes and the characteristics of
those that access them remain poorly defined.
Research on e-cigarette use in children is only just
emerging, yet studies in several countries are showing
their rapid penetration into adolescent markets. In the
USA, studies show that lifetime e-cigarette use in grades
6-12 school students (~age 11-18) more than doubled
from 3.3% in 2011 to 6.8% in 2012 [1]. Whilst most
e-cigarette users in the 2012 survey were current smokers,
9.3% had never smoked a conventional cigarette. In
France, a 2012 study of Parisian school students aged 12-
19 years found that 8.1% had tried e-cigarettes, with
prevalence ranging from 4.4% of non-smokers up to
33.4% of regular smokers [8]. In Korea, prevalence of ever
using e-cigarettes in 13-18 year old was found to have increased
almost 20-fold between 2008 and 2011, from 0.5%
to 9.4%, with 1.4% of e-cigarette users in 2011 having
never smoked cigarettes