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Trends in electronic cigarette use in Wales

Loren Kock, Robert West, Emma Beard, Dimitra Kale, Jamie Brown

Updated 19th October 2021

Background

Electronic cigarette use has become prevalent in many countries

In Wales, electronic cigarettes are currently regulated as consumer products

It is important to track use of electronic cigarettes and assess how far they appear to be promoting or detracting from reduction in prevalence of cigarette smoking

Aims

To track use of electronic cigarettes over time and assess how far any increase is accompanied by changes in:

  • use of other aids to cessation or smoking reduction
  • key performance indicators for tobacco control (smoking prevalence, smoking cessation rates, attempts to stop smoking, success of attempts to stop smoking

To assess prevalence of use of electronic cigarettes in people who have never smoked regularly or stopped for more than a year

To estimate changes in the total tobacco and nicotine market

The following indicators will be added in October 2021:

  • Proportion of daily e-cigarette and NRT users who are smokers
  • Frequency of e-cigarette use among smokers and ex-smokers
  • Characteristics of e-cigarettes
  • Source of e-cigarette purchase
  • Use of e-cigarettes by age, social grade and sex
  • Use of nicotine products in recent ex-smokers
  • Aids used to stop smoking in most recent quit attempt

Methods

Monthly household surveys

Each month involves a new representative sample (18 and over) of ~300 respondents.

Due to the pandemic, from April 2020 surveys conducted by telephone (rather than face-to-face) and among adults aged 18 and over

Kock et al., (2021). Protocol for expansion of an existing national monthly survey of smoking behaviour and alcohol use in England to Scotland and Wales: The Smoking and Alcohol Toolkit Study. Wellcome Open Research6(67), 67.

Summary I

An estimated 6-8% of the adult population in Wales use e-cigarettes

Use of Juul and heated tobacco products is rare

Approximately 1 in 10 long-term ex-smokers (quit >1 year) use e-cigarettes, but use among never smokers is rare

Around half of all EC users are dual users (also smoke)

A smaller proportion of e-cigarette daily users are ‘dual users’ (also smoke)

Summary II

The majority of e-cigarettes used contain nicotine

Ex-smokers and smokers use e-liquids with similar concentrations of nicotine. A minority did not know the strength

Specialist vape shops (including online specialist) and supermarkets are the most popular source for purchase

Summary III

Approximately 1 in 4 smokers use e-cigarettes

E-cigarettes are a popular aid used in a smoking quit attempt

Summary IV

Around 1 in 3 smokers believe believe that e-cigarettes are less harmful than cigarettes and a similar proportion believe they are equally harmful.

A minority (1 in 10) smokers believe e-cigarettes are more harmful than cigarettes