A new era of smoking: Young peoples perceptions of emerging tobacco products.

Young people are thought more likely to use electronic cigarettes (E-cigarettes) than adults, but their reasons for uptake and their attitudes toward e-cigarette safety and regulation are unknown. An online survey was conducted among Australians aged 18-30 years, recruited through university mailing lists and social media pages. Participants were asked questions about first exposure to E-cigarettes, perceived safety of e-cigarettes and the regulations surrounding e-cigarette use. 174 participants (73% Female, Mean age 21.0 (SD±2.53) years, 96% University students) completed the survey, of whom 25.4% were past/current e-cigarette users and 29.9% were past/current tobacco cigarette smokers. Participants most commonly reported that their first exposure to e-cigarettes was via social media (56%) or friends (55%). Among past/present users, the most common reason for initiating e-cigarette use was curiosity (91%), friends using them (41%) and/or considering them better for health than tobacco cigarettes (32%). Indeed, 86% of all respondents thought nicotine e-cigarettes had lower health risk than tobacco cigarettes and only half (54%) thought nicotine e-cigarettes could cause similar damage to their lungs. Moreover 60% of participants thought cannabis and 56% thought fast food carried less risk than nicotine e-cigarettes. More respondents agreed nicotine e-cigarettes are bad for your health than non-nicotine e-cigarettes (76% vs 32%). There was also confusion as to where E-cigarettes can be used in Australia. The lack of understanding of potential health risks indicates the poor public health communication and confusion around e-cigarettes which must be urgently addressed.