One million who never smoked cigarettes start vaping in England

Study authors call for more regulation to minimise the health effects

The increase in vaping never-smokers is largely driven by young adults. AFP

About one million people in England who have never smoked cigarettes are vaping, a sharp increase in users as more women and young people take up the habit, a study has found.

That is a sevenfold increase since 2021, with most of them vaping daily and over a sustained period, according to the study published in Lancet Public Health. Now, study authors are calling for more regulation to minimise the health effects.

“The public health impact of this substantial rise in vaping among people who have never regularly smoked will depend on what these people would otherwise be doing,” said lead author Dr Sarah Jackson, from University College London Institute of Epidemiology and Health Care.

“It is likely that some would have smoked if vaping were not an available option. In this case, vaping is clearly less harmful. However, for those who would not have gone on to smoke, vaping regularly over a sustained period poses more risk than not vaping.”

This increase was largely driven by young adults – with an estimated one in seven of those aged between 18 and 24 who never regularly smoked now using e-cigarettes.

Survey respondents were classed as “never-regular-smokers” if they agreed with the statement “I have never been a smoker (ie, smoked for a year or more)”.

Researchers noted that this population is broader than those who have never smoked a single cigarette and prevalence estimates of vaping among people who have never smoked at all would likely have been lower.

Senior author Prof Jamie Brown said: “These findings are a reminder that action is required to try to minimise vaping among young people who have never previously smoked. However, a balancing act is required to avoid deterring smokers from using e-cigarettes to quit.

“Banning disposables, as the UK government currently plans, is unlikely to fix the issue as popular brands have already launched reusable products with very similar designs and prices.

“A sensible next step would be to introduce stricter regulation around product appearance, packaging and marketing, as those are less likely to reduce the effectiveness of e-cigarettes for smoking cessation – unlike, for instance, flavour bans.

“The fact that overall vaping prevalence appears to have levelled off since 2023 may reassure policymakers that it would be reasonable to begin with these measures and assess their impact.”

Before 2021, the proportion of never-regular-smokers who vaped was very low, at about 0.5 per cent between 2016 and 2020. By April 2024 that had increased to 3.5 per cent, or about one million vapers. Among these, more than half were aged between 18 and 24.

The sharpest increase in the never-regular-smokers group was among those classed as the heaviest drinkers, of all ages, of whom 22 per cent vaped.

That suggests vaping may be more common among people who would otherwise have gone on to smoke, as smoking rates are also higher among people who drink more heavily.