Trends in electronic cigarette use in Wales
Vera Buss, Loren Kock, Robert West, Emma Beard, Dimitra Kale, Jamie Brown
Updated 25th April 2025
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Background
E-cigarette use has become prevalent in many countries
In Wales, e-cigarettes are currently regulated as consumer products
It is important to track use of e-cigarettes and assess how far they appear to be promoting or detracting from reduction in prevalence of cigarette smoking
Aims
To track use of e-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 Research, 6(67), 67.
Summary I
An estimated 12-15% of the adult population in Wales use e-cigarettes
Use of 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 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
Supermarkets are most popular among never smokers
Summary III
Approximately 1 in 3 smokers use e-cigarettes
E-cigarettes are the most popular aid used in a smoking quit attempt
Summary IV
Roughly 1 in 3 smokers believe e-cigarettes are more harmful than cigarettes and a similar proportion believe they are equally harmful
