The number of adults in England who report vaping for more than six months has increased substantially from around one in 80 in 2013 to one in 10 in 2023, according to a new study led by UCL researchers.
The study, published in The BMJ, found that much of this increase had occurred since 2021, coinciding with the rapid rise in popularity of disposable e-cigarettes, especially among young adults, including those who had never regularly smoked.
It was already established that vaping rates have increased substantially in England since new disposable e-cigarettes became popular in mid-2021, particularly among adolescents and young adults, but it was unclear how far this reflected an increase in experimental use versus long term (more than six months) regular use.
Little was also known about how the types of products used by long term vapers (more than six months) were changing over time.
To explore this further, researchers drew on data for 179,725 adults taking part in the Smoking Toolkit Study, a nationally representative survey that collects detailed data on vaping among adults in England each month.
Between October 2013 and October 2023, participants were asked about use of a range of nicotine products, depending on their smoking status.
Those who reported vaping for more than six months were considered long-term vapers. Details of vaping frequency (daily or non-daily), main type of device used (disposable, refillable, or pod), age, sex, and occupational social grade were also recorded.
Over the study period, the proportion of adults reporting long-term vaping increased from 1.3% in October 2013 to 10% in October 2023, with a particularly sharp rise from 2021. This included an increase in long-term daily vaping, from 0.6% to 6.7%.
The increase in long term vaping occurred predominantly among current and former smokers, but a recent rise also occurred among those who had never regularly smoked (from less than 0.5% up to March 2021 to 3% by October 2023).
Growth was also more pronounced in young adults (reaching 23% of 18 year olds v 4.3% of 65 year olds) including among those who had never regularly smoked (reaching 16% of 18 year olds v 0.3% of 65 year olds).
The rate of long-term vaping was higher among men than women between June 2015 and December 2022, but by October 2023 the rates were similar between men and women.
The rate of long-term vaping was also consistently higher among those from less advantaged social grades compared with more advantaged social grades.
The researchers also note that half of long-term vapers now mainly or exclusively use disposable devices, which has a substantial impact on the environment.
Lead author Dr Sarah Jackson, of the UCL Institute of Epidemiology & Health Care, said: "Our results show there has been an exceptionally steep rise in the number of young adults vaping for more than six months since new disposable e-cigarettes were introduced to the market. While most long-term vapers have a history of smoking, rates have also increased among those who have never regularly smoked.
"In addition to helping people quit smoking, vaping is probably diverting some people away from ever starting to smoke, which will reduce their exposure to harmful toxicants.
"However, it is likely that a growing number of adults who vape would not have otherwise smoked. For these people, vaping regularly over a sustained period will expose them to more harm than if they had neither smoked nor vaped."
Senior author Professor Jamie Brown, of the UCL Institute of Epidemiology & Health Care, said: "New vaping policies are needed to curb youth vaping in England but must be balanced to avoid discouraging smokers from using vaping products to quit smoking.
"Policies most likely to achieve this balance may be those focused on retail displays, appealing product design and packaging, product descriptions and cost.
"England has excellent vaping and smoking surveillance and will be able to provide a rapid indication of the extent to which new policies achieve these goals. Future regulations should include a degree of flexibility to allow recalibration as required."
As the study was observational, no firm conclusions can be drawn about cause and effect, and the authors acknowledge several limitations relating to study design and measures that may have influenced their results.
Nevertheless, they say, long-term vaping has increased substantially among young adults since 2021, including among those who have never regularly smoked, suggesting that disposable e-cigarettes may be leading young adults to establish longer term e-cigarette use.
