Trends in long-term vaping among adults in England, 2013-2023

ObjectivesTo examine trends in long-term (>6 months) vaping among adults in England. DesignNationally-representative monthly cross-sectional survey. SettingEngland. Participants179,725 adults ([≥]18y) surveyed between October 2013 and October 2023. Main outcome measuresWe used logistic regression to estimate time trends in the prevalence of long-term vaping, overall and by vaping frequency (daily/non-daily) and the main device type used (disposable/refillable/pod). ResultsThe proportion of adults reporting long-term vaping increased non-linearly from 1.3% [95%CI 1.1-1.5%] in October 2013 to 10.0% [9.2-10.9%] in October 2023, with a particularly pronounced rise since 2021. This included an increase in long-term daily vaping, which rose from 0.6% [0.5-0.8%] to 6.7% [6.0-7.4%], respectively. The absolute increases in long-term vaping were most pronounced among ever smokers (current smokers: 4.8% [4.0-5.8%] to 23.1% [20.4-25.9%]; recent ex-smokers: 5.7% [3.4-9.2%] to 36.1% [27.6-45.4%]; long-term ex-smokers: 1.4% [1.0-1.9%] to 16.2% [14.2-18.4%]), but there was also an increase among never smokers (0.1% [0.0-0.2%] to 3.0% [2.3-3.8%]). Growth was also most pronounced in younger adults (e.g., reaching 22.7% [19.2-26.5%] of 18-year-olds vs. 4.3% [3.6-5.2%] of 65-year-olds), including among never smokers (reaching 16.1% [11.1-22.7%] among 18-year-olds vs. 0.3% [0.1-0.6%] of 65-year-olds). Up to March 2021, most long-term vapers mainly/exclusively used refillable e-cigarettes (2.5-3.3% of adults) and very few (0.1% of adults) used disposables. However, prevalence of long-term disposable vaping subsequently rose rapidly and by October 2023, similar proportions mainly/exclusively used refillable and disposable devices (4.6% [4.0-5.3%] and 4.9% [4.2-5.7%] of adults, respectively). ConclusionsThe prevalence of long-term (>6 months) vaping has increased substantially among adults in England over the past decade. Much of this increase in prevalence has occurred since 2021, coinciding with the rapid rise in popularity of disposable e-cigarettes. Half of long-term vapers now mainly or exclusively use disposable devices. The growth has been concentrated among ever smokers but there has also been an increase among never smokers, especially younger adults. What is already known on this topicO_LIVaping prevalence has increased substantially in England since new disposable e-cigarettes became popular in mid-2021, particularly among young people. C_LIO_LIIt is not clear how far this reflects an increase in experimental use versus long-term, regular use. C_LIO_LIIn addition, little is known about how the types of products used by long-term vapers is changing over time. C_LI What this study addsO_LIThere has been an exceptionally steep rise in long-term vaping among young adults since 2021, including among never smoking youth, and it does not yet show signs of stopping. C_LIO_LIHalf of long-term vapers now mainly or exclusively use disposables, and most are using them every day. C_LIO_LITherefore, urgent action is needed to curb the rise in vaping among young people and encourage long-term vapers to transition to less environmentally damaging products. C_LI