England: Vaping on the rise and smoking on the decline among 11- to 15-year-olds

Recent data from the National Health Service in England shows a decrease in the number of schoolchildren currently smoking traditional cigarettes, but an increase in vaping, with 9% of 11- to 15-year-olds currently using e-cigarettes compared to 6% in 2018.[1].

The 2021 Smoking, Drinking and Drug Use Among Young People in England report presents the results of a survey of 9,289 secondary school students, mostly aged 11 to 15, conducted between September 2021 and February 2022 in 119 schools. The survey covered the smoking, alcohol use, and other drug use of the young people surveyed.

A record smoking prevalence of 3% among middle school students

One of the measures in the Tobacco Control Plan to achieve a tobacco-free generation in England was to reduce the number of 15-year-olds who smoke regularly from 8% to 3% or less between 2017 and 2022. This target has been achieved, as the report shows that the proportion of pupils reporting being occasional or regular smokers has fallen from 5% in 2018 to 3% in 2021 – a record low.

In 2021, 12% of 11- to 15-year-old students had smoked at least once in their lives, compared to 16% of 11- to 15-year-old students in 2018, the lowest level ever recorded by this survey. This rate has been steadily declining since 1996, when 49% of students of this age had smoked at least once.

E-cigarette use on the rise, especially among teenage girls

The proportion of students currently using e-cigarettes, on the other hand, increased from 6 in 2018 to 9 in 2021. More than one in five students (22 in 3) reported having already used e-cigarettes at least once, compared to 25 in 2018.

Current e-cigarette use increases with age, from 1 % among 11-year-olds to 11 % among 14-year-olds and reaching 18 % among 15-year-olds. According to the study, more than a fifth (21 %) of 15-year-old girls are considered current e-cigarette users, compared to 10 % in 2021. This proportion is higher than that of boys of the same age: 14 %.

The proportion of vaping smokers among these adolescents more than doubled between 2018 and 2021, going from 29% to 61%.

Although it has been illegal to sell e-cigarettes to children under 18 in England since 2015, 57% of them reported that they could easily obtain them in shops (newsagents, specialist shops or supermarkets). The most common reasons given by students to explain why they think young people their age smoke/vape are: "to look cool in front of friends" (81%), because they are "addicted to cigarettes" (73%) and "their friends push them to smoke" (72%).

Consumption exacerbated by the influence of the immediate environment and peers

Nearly all current middle school smokers had a friend who smoked, compared to about a third of nonsmokers. Current smokers were also more likely to have a family member who smoked (72%) than nonsmokers (58%).

Only 31% of current smokers reported not knowing anyone who smokes, compared to 30% of non-smokers. The proportion of student smokers also increased with the number of smokers in the household. 16% of students who lived with three or more smokers were current smokers themselves, compared to 91% who lived with two smokers and only 11% in households with no other smokers.

Keywords: England, NHS, adolescents, smoking, vaping, e-cigarette

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[1] Smoking, Drinking and Drug Use among Young People in England, 2021, NHS report, published 6 September 2022, accessed 7 September 2022