1 million adult vapers in England have never regularly smoked

By Priyanjana Pramanik, MSc.Reviewed by Benedette Cuffari, M.Sc.Oct 8 2024

This rapid increase between 2021 and 2024 was particularly among younger age groups.

Study: Vaping among adults in England who have never regularly smoked: a population-based study, 2016–24. Image Credit: Zeynep Demir Aslim / Shutterstock.com

In a recent study published in The Lancet Public Health, researchers estimate trends in vaping among adults in the United Kingdom who have not smoked regularly.

The health implications of vaping

In the past, vaping or the use of e-cigarettes in England was primarily reported among current or former smokers trying to reduce or quit smoking. If vaping were only adopted by those who would otherwise smoke, the overall rate of smoking or vaping would remain constant or show signs of declining rather than increasing.

The rising rate of vaping could be attributed to the widespread availability of disposable e-cigarettes in recent years, which has led to a rapid increase in vaping among regular and non-regular smokers.

Although e-cigarettes may be less harmful than smoking, these devices contain toxic chemicals that the user consumes. In fact, several studies indicate that vapers are exposed to higher levels of toxicants than non-users.

About the study

Researchers collected data using a monthly cross-sectional survey across England, Wales, and Scotland to ensure a nationally representative sample. Approximately 2,450 individuals participated in the survey each month between 2016 and early 2024.

The vaping status of adults who reported never regularly smoking was evaluated using questions about their current e-cigarette use, daily or non-daily e-cigarette use, as well as as the type of device and strength of nicotine used. Study participants also provided sociodemographic data such as gender, age, and social class, as well as lifestyle information such as alcohol consumption.

Statistical models were used to calculate trends in the prevalence of smoking after adjusting for alcohol consumption and sociodemographic characteristics. These trends were then assessed according to age, with the prevalence of vaping compared before and after the increased availability of disposable e-cigarettes.

Study findings

The analysis included 94,107 unique never-regular smokers, as well as younger individuals who had never smoked. Vaping among never-regular smokers was stable at approximately 0.5% until 2021.

From 2021 onwards, vaping increased rapidly to 3.5% in April 2024. This increased prevalence of vaping was primarily attributed to younger adults under the age of 24, 14.4% of whom vaped, as compared to those over the age of 48, less than 1% of whom vaped. Although age differences were significant, trends were similar across social class and gender.

Alcohol consumption was positively correlated with vaping prevalence, with heavy drinkers more likely to vape at a rate of 22.1%. Comparatively, only 3% of low-risk drinkers and 1.3% of non-drinkers vaped.

Throughout the analysis period, non-daily vaping was less common than daily vaping, but the prevalence of daily vaping was four times greater than that of non-daily vaping.

Researchers also found clear indications that disposable e-cigarettes are implicated in these trends. In the post-disposable period, users were more likely to report longer vaping durations, with a reduced prevalence of short-term use.

Since disposable devices have become more common, vapers are increasingly younger, heavier drinkers, and more likely to be female. There is also a pronounced shift towards disposable e-cigarettes and devices with higher nicotine strengths. More purchases were also reported from convenience stores or supermarkets, and fewer from vape shops.

Conclusions

The study findings demonstrate the significant rise in vaping rates in England over the past three years, specifically among those who are not regular smokers, as well as younger adults and heavier drinkers.

In 2021, one in 200 never-regular smokers reported vaping. By April 2024, this rate increased to one in 28. Disposable e-cigarettes, which appear to appeal to younger adults and women, may encourage the use of higher nicotine strengths.

The health impacts of these behavioral shifts may be significant, particularly among individuals who would not typically engage in vaping, which increases their exposure to toxins they would have otherwise avoided.

Addressing these issues is associated with various challenges as policymakers seek to reduce vaping among non-smokers while ensuring that e-cigarettes are available and remain attractive to smokers who would like to quit. Stricter regulations on the appearance, pricing, and marketing of these products may support these public health efforts to reduce the appeal of vaping.