Vaping in England: Evidence Update Summary February 2019

Summary of Study

Bottom Line: Combining electronic cigarettes (the most popular source of support used by smokers in the general population), with stop smoking service support (the most effective type of support), should be a recommended option available to all smokers. Stop smoking practitioners and health professionals should provide behavioral support to smokers who want to use an EC to help them quit smoking.

Overall, England continues to take small progressive steps towards ensuring vaping remains an accessible and appealing alternative to smoking. If the House of Commons Science and Technology Committee’s recommendations are fully carried out by government, they have the potential to broaden this accessibility and appeal further, particularly in mental health settings, where smoking rates are high.

However, there is still no medicinally licensed EC in England, or anywhere else in the world. It is possible that more smokers may be attracted to vaping if a licensed EC was made available. Barriers to licensing and the commercialising of licensed products need further exploration.

In England and in Great Britain as a whole, experimentation with EC has steadily increased in recent years. However, regular use remains low, with 1.7% of 11-to-18 year olds in Great Britain reporting at least weekly use in 2018 (it was 0.4% among 11 year olds and 2.6% among 18 year olds).

The proportion of 13 and 15 year olds who have ever smoked declined steadily between 1998 and 2015, including after the introduction of EC. In this period, young people’s attitudes became more negative towards smoking. Further analyses of the period beyond 2015 are underway.

Data from several representative surveys suggest that vaping prevalence among all adults in Great Britain has remained stable since 2015. In 2017 to 2018, estimates for prevalence were:

  • 5.4% to 6.2% for all adults
  • 14.9% to 18.5% for current smokers
  • 0.4% to 0.8% for people who had never smoked
  • 10.3% to 11.3% for ex-smokers (vaping prevalence declined as the time since they had stopped smoking increased)

Smoking prevalence ranged from 13.7% to 17.3% for the adult population but was substantially higher in lower socio-economic groups (for example, 35% in people living in social housing smoked). Just over a third of all current smokers had never tried EC.

Over time, most vapers report either continuing to use the same nicotine strength (44.7% of participants in one survey, 54.4% in another) or reducing the nicotine strength (40.1% and 49.2% respectively in the same surveys).

Quitting smoking remains the main reason for vaping in all socio-economic groups. People from higher socio-economic groups were possibly more likely to vape for enjoyment than those from lower groups, who may be more likely to vape for financial reasons than those from higher groups.

Smokers should be advised to stop smoking as soon as possible and explore all available options for support, including EC.

In stop smoking services, the proportion of quit attempts using an EC remains very small (4.1% of all quit attempts in stop smoking services).

Read the full report here.