England: increasing trend in vaping over time among adults

A study[1] A recent study published in the British Medical Journal analyzed trends in vaping among adults in England between 2013 and 2023. Over the period studied, the prevalence of long-term vaping increased from 1.3 % to 10 %.

Long-term vaping was defined as the consumption of these products for 6 months or more during the survey. Data were obtained from the Smoking Toolkit Study, a monthly cross-sectional survey of people aged 16 and over in England. On the basis of random sampling, an adjustment was carried out incorporating quotas for socio-demographic and geographical representativeness and concerned exclusively adults aged 18 and over. The final sample included 179,725 participants.

An increase in consumption fueled by the arrival of disposable electronic cigarettes in England

Throughout the period studied, long-term vaping increased from 1.3 % to 10 % among adults, with no notable difference between men and women. This increase was not linear, since it went from 1.3 % to 3.3 % between October 2013 and July 2017. The prevalence then remained stable until August 2019, then increased sharply, especially in from the end of 2021, reaching 10 % in October 2023. Segmented regression analysis indicates that this increase coincides with the arrival and growing popularity of disposable e-cigarettes (puffs) in England. Before June 2021, long-term vaping increased by 11.3 % per year; However, after the widespread use of disposable devices, long-term vaping consumption increased by 38.6 % per year.

Long-term vaping with disposable devices increased from 0.1 % in 2021 to 4.9 % in October 2023. Use of open and rechargeable devices increased from 2.5 % to 4.6 %, while the use of pod devices increased from 0.3 % to 1% of the adult population over the same period. For the authors, this indicates that many vapers continue to use disposable devices over the long term, rather than switching to rechargeable devices.

The authors warn that long-term vaping with disposable e-cigarettes can also have a substantial environmental impact: because these products are designed for single use, they generate more waste than refillable vaping products, namely rechargeable devices and pods.

More young adults report being vapers over time

According to the study, the prevalence of long-term vaping increased more quickly among young adults than among older adults after 2019; thus 22.7 % of young people aged 18 declare that they are long-term vapers compared to 4.3 % of people aged 65 and over. A similar trend is observed among those who have never regularly smoked traditional cigarettes: 16.1% of young people aged 18 compared to 0.3% of people aged 65 and over are long-term vapers but have never smoked.

The study also revealed that the increase in the number of vapers over time mainly concerned smokers and former smokers of tobacco products.[2], excluding heated tobacco. The proportion of current smokers who vape over time increased from 4.8 % to 23.1 % between 2013 and 2023. Regarding recent ex-smokers (having stopped less than a year ago), this proportion is respectively 5.7 % in 2013 and 36.1 % in 2023. Longer-term ex-smokers (having stopped more than a year ago) were 1.4 % vaping in 2013 and this proportion is 16.2 % in 2023. An increase is however also observed among people who have never regularly smoked tobacco products, excluding heated tobacco since the prevalence of vaping within this population has increased from 0.1 % in 2013 to 3 % in 2023.

Greater daily vaping over time

The study data also suggests that a growing number of consumers over time are daily consumers. There were 0.6% of daily consumers in 2013, then 3% in 2021 and 6.8% in 2023. This observation also concerns more than two thirds of those who have never smoked regularly. In other words, the authors emphasize that consumption increases over time but that it is also more frequent. However, this progression between 2021 and 2023 coincides with the popularization of disposable devices.

A previous British study[3] also showed that the arrival of disposable vaping devices in 2021 had led to a higher use of vaping products with high nicotine content among adult vapers in Great Britain. The number of vapers using products containing 20mg/ml of nicotine or more increased from 6.6 % on average between June 2021 to 33 % in January 2024. Nearly one in two vapers (47.9%) using devices with high levels of nicotine mainly use disposable devices.

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[1] Jackson SE, Tattan-Birch H, Shahab L, Brown J. Trends in long term vaping among adults in England, 2013-23: population based study BMJ 2024; 386:e079016 doi:10.1136/bmj-2023-079016

[2] Manufactured cigarettes, rolled cigarettes, pipes, hookahs

[3] Jackson SE, Brown J, Shahab L, Arnott D, Bauld L, Cox S. Nicotine strength of e-liquids used by adult vapers in Great Britain: A population survey 2016 to 2024. Addiction. 2024. https://doi.org/10.1111/add.16576