One million adults in England who weren’t regular smokers now vape

One million adults in England who did not regularly smoke have now started vaping, according to new research.

The estimates come from a survey published in the Lancet Public Health journal on Thursday and reveal a sevenfold increase in the number of adults who were not regular smokers but have turned to vaping since 2021.

This increase is driven by young adults, the study authors said, with 14 per cent of 18 to 24-year-old non-regular smokers now using e-cigarettes.

Sarah Jackson, the study’s lead author and a principal research fellow at University College London’s Alcohol and Tobacco Research Group, says the public health impact of the survey results depends on whether these people would have otherwise smoked tobacco.

“It is likely that some would have smoked if vaping were not an available option. In this case, vaping is clearly less harmful,” Jackson said in a statement.

“However, for those who would not have gone on to smoke, vaping regularly over a sustained period poses more risk than not vaping”.

The estimates were based on survey data from more than 153,000 adults in England collected between 2016 and 2024.

Around 60 per cent of those surveyed were not regular smokers, meaning they responded that they had never smoked for a year or more.

The researchers found that up to 2021, the proportion of adult non-smokers who vaped was stable at 0.5 per cent, but from 2021, this increased to 3.5 per cent. The authors also note that new disposable e-cigarettes became popular in 2020 and 2021 in the UK.

Would those who are vaping normally be smoking cigarettes?

Peter Hajek, a professor at Queen Mary University of London who focuses on modifying health behaviour such as tobacco dependence, said in a statement that some people are discovering vaping “without becoming smokers first” but that if vaping did not exist they would be smoking.

“If much less risky alternatives are allowed to continue to compete with cigarettes, smoking (and heart disease, lung disease and cancers that it causes) will continue to decline as well,” said Hajek, who was not involved in the study.

The number of people who smoke in the UK has decreased since the 1970s and is currently at around 12.9 per cent.

As e-cigarettes are less harmful than smoking cigarettes, they’ve been used in the UK as a smoking cessation tool and were the most popular aid for trying to quit in 2020.

“Efforts are needed to limit use of nicotine products in adolescents but if more adults (as well as adolescents) are taking up vaping instead of smoking, it may be in fact good news,” Hajek added.

The survey also found that people who drink more heavily were more likely to vape, something that other research has shown for cigarette smoking as well.

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In April 2024, the authors estimate that the prevalence of vaping among heavy drinkers was around 22 per cent compared to it being at 3 per cent for those drinking at low levels and 1.3 per cent for those who do not drink.

Overall, the new study found that people who vape who were not previously regular smokers tended to be younger, women, and heavier drinkers. These groups were more likely to use disposable devices and high-strength nicotine e-liquids.

The authors also say the question remains whether or not those who are currently vaping would have otherwise been smoking.

“If vaping was only being taken up by people who would otherwise smoke, we would expect the total proportion of adults who either smoke or vape to remain stable or decline,” the authors wrote in the study’s introduction.

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But as this proportion has increased, it “suggests there are now people who would not have otherwise taken up smoking who have started vaping regularly,” they added.

As the UK government considers stricter regulations on e-cigarettes, the situation “creates a challenge” on how to strike a balance between minimising vaping among those who wouldn’t have smoked and making sure it’s attractive to those who are using it to quit, the authors wrote.

Meanwhile, a Department of Health and Social Care spokesperson said “vapes can be an effective way for adult smokers to quit, but we have always been clear children and adult non-smokers should not vape”.