England: Vaping up and smoking down among 11-15 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 11-15 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 pupils, mostly aged 11 to 15, conducted between September 2021 and February 2022 in 119 schools. The survey looked at the smoking, drinking and other drug use of the young people surveyed.

A smoking prevalence of 3% among middle school students, a record

One of the measures in the Tackling Smoking Plan to achieve a smoke-free generation in England was to reduce the number of 15-year-olds who smoke regularly from 8% to 3% or less by 2017 to 2022. This was 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 students aged 11-15 had already smoked at least once in their life, compared to 16 % of students in 2018, the lowest level ever recorded by this survey. A rate that 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%) said they had 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 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 were able to get them easily from shops (newsagents, specialist shops or supermarkets). The most common reasons given by students to explain why they think young people their age smoke/vape were: “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 with about a third of nonsmokers. Current smokers were also more likely to have a family member who smoked (72 %) than nonsmokers (58 %).

Only 3% 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 themselves current smokers, compared to 9% who lived with two smokers and only 1% 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