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Trends in electronic cigarette use in Wales

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

Updated 18th January 2024

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

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.

From January 2022 data collection resumed among those aged 16 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 12-14% of the adult population in Wales use e-cigarettes

Use of Juul and heated tobacco products is rare

Approximately 1 in 5 long-term ex-smokers (quit >1 year) use e-cigarettes, but use among never smokers is relatively rare

Around 30-40% of e-cigarette users are dual users (also smoke)

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

Summary II

The majority of e-cigarettes used contain nicotine

Never smokers are most likely to use disposables and e-liquids with 20mg or more of nicotine. A minority of users did not know the strength

Specialist vape shops (including online specialist) are most popular source for purchase among smokers and ex-smokers

Newsagents are most popular among never smokers

Summary III

Approximately 1 in 3 smokers use e-cigarettes

E-cigarettes and over-the-counter NRT are the most popular aid used in a smoking quit attempt

Summary IV

Around 30-40% of smokers believe that e-cigarettes and cigarettes are equally harmful.

Roughly 1 in 4 smokers believe e-cigarettes are more harmful than cigarettes and a similar proportion believe they are less harmful.