The ETHRA EU Nicotine Users Survey Report

73.7% of snus users and 83.5% of vapers had stopped smoking. 

Launched online by ETHRA in the last quarter of 2020, the questionnaire which asked EU consumers about the use of nicotine products, included questions related to smoking cessation such as any desire to quit, the use of safer nicotine alternatives and any barriers to switching to such products caused by any EU wide and/or national regulations.

Over 37,000 people participated in the survey, 35,000 of which were EU residents. While data sets and comments for individual EU countries will be published on the ETHRA site at a later date, the report opens with the following key facts:

  1. Safer nicotine products help hugely with quitting smoking. Among those who were ever smokers, 73.7% of snus users and 83.5% of vapers had stopped smoking. 
  2. Harm reduction was the most strongly cited reason for adopting snus (75%) and vapes (93%), followed by quitting smoking for 60% of snus users and more than 90% of vapers. Reduced costs, flavours, availability of products and (specifically for vapers) the ability to adjust vaping products, are all important factors for consumers when adopting harm reduction products. 
  3. More than 31% of current smokers would be interested in trying snus if it was legalised in the EU. Vape taxes, flavour bans and lack of access are barriers to quitting smoking 
  4. More than 67% of smokers want to quit smoking. However, these smokers encounter barriers in their desire to be smoke-free. Nearly a quarter (24.3%) of EU smokers who want to quit are deterred by the high price of low-risk alternatives. This proportion increased to 34.5% in the 12 EU countries with a vape tax in 2020 and to 44.7% in the three countries with a high vape tax (Finland, Portugal and Estonia). 
  5. Taxes on vaping products are a significant barrier to quitting smoking for people who vape and smoke (‘dual users’). The proportion of dual users from the 12 countries with a vape tax who are prevented from switching exclusively to vaping (28.1%) because of the cost is more than three times higher than for dual users from the 16 countries without vape excise (8.6%). 
  6. Vape flavour bans, in Finland and Estonia, and the vape sales state monopoly in Hungary, are making it more difficult for people to stop smoking. One of the main consequences is that consumers are using the black market and other alternative sources, or buying from abroad. In these three countries, only 45% of vapers used a ETHRA – THE EU NICOTINE USERS SURVEY 2O2O 5 local conventional source to get e-liquids, compared to 92.8% in countries without vape tax and flavours ban. TPD limits had unintended consequences on vape consumption 
  7. Compared to a large online survey conducted in 2013, before the current TPD was implemented1 , the average volume of e-liquid used per day has significantly increased – from 3 ml/day in 2013 to 10 ml/day in 2020 – while the nicotine concentration of these e-liquids has significantly decreased – from 12 mg/ml in 2013 to 5 mg/ml in 2020. Two thirds (65.9%) of vapers are using e-liquid with a nicotine concentration below 6 mg/ml. This trend appears to be in large part a consequence of the TPD 20 mg/ml nicotine concentration limit and the 10 ml volume limit on e-liquid bottles. Because of nicotine self-titration, vapers who use e-liquids with a lower nicotine concentration are likely to compensate by consuming a higher volume of liquid. • Should the 20 mg/ml nicotine limit be lifted, 24% of vapers declared that they would consume less e-liquid and 30.3% of people who vape and smoke think they could quit smoking completely. • Should the 10 ml bottle limit be repealed, 87% of vapers would buy larger bottles to reduce the cost and 89% would buy larger bottles to reduce plastic waste, while only 35.5% said they would probably continue to buy short-fills and add nicotine themselves. These limits should be revised upwards in the next TPD. An EU vape tax and/or flavour ban would fuel the black and grey markets
  8. The survey also asked participants about other possible European regulatory developments. On the cost issue, a large proportion of vapers could or would not tolerate price increases. If an EU wide high excise was applied to e-liquid, more than 60% of users would look for alternative untaxed sources.
  9. If flavours were banned, more than 71% of vapers would look for alternative sources to the legal market. EU vapers want access to clear and objective information 
  10. A vast majority of vapers support public access to EU databases on vaping products, for data on e-liquid ingredients (83%), resistance elements (66%) and characteristics of integrated circuits (56%). Also 74% would find an information page on vaping useful, such as the website provided by the New Zealand authorities

Over 27,000 survey participants had completely quit smoking via vapes, snus and nicotine pouches

The report pointed out that over 27,000 of the survey participants had completely quit smoking, with vapes, snus and nicotine pouches being the main harm reduction tools used. Amongst the respondents who had ever smoked, 83.5% of vapers, and 73.7% of snus users had successfully stopped smoking, and over 93% of vapers and 75% of snus users cited harm reduction and improvements to health as their reasons for choosing these products.

In line with countless studies, the report showed that the availability of flavours, the availability of products, the ability to adjust vaping products and the reduced cost compared to smoking, are some of the major motivators for consumers to switch to harm reduction products.

Amongst the barriers to smoking cessation, the report listed the lack of availability of safer nicotine alternatives. As an example the EU ban on the sale of snus (except for in Sweden) was mentioned, as 31% of current smokers indicating that they would be interested in trying snus if its sale was legalised across the EU.

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