E-cigarettes in airports and on flights: Europe and the US.

BACKGROUND: While progress has been made to create smoke-free airports, sales of e-cigarettes at airports and airplanes and the presence of advertisements might detract from these smoke-free policies. The objective of this study is to describe the presence of policies, advertising, sales and use of e-cigarettes in airports and on flights in Europe and the US.

METHODS: A cross-sectional study was conducted between March-May, 2014. The study included 21 large and mid-sized airports of Europe and the US as well as 19 flights. A standardised protocol was used to observe points of sales and advertisements and to collect information on the implementation of policies on e-cigarette use. In addition, a series of questions were developed to obtain policy details from airport personnel and flight attendants.

RESULTS: Retail outlets selling e-cigarettes in airports were present in approximately 20% and 40% of the observed pre and post-security areas, respectively. In post-security, 27.8% of the airport staff reported that the use of e-cigarettes indoors was not allowed, 22.2% reported that they did not know, 27.8% reported that it was only allowed in the smoking room, and 22.2% reported that it was allowed anywhere. Smoking ban announcements were made on all flights. However, only 15.8% of the flights made a specific announcement regarding the ban of using e-cigarettes. Conclusions. In light of our results, it seems necessary to reinforce in-flight e-cigarette smoking ban announcements and to instruct airport employees about the existence of e-cigarette smoking policies. Furthermore, airports themselves should also be encouraged to adopt smoke-free policies.