Trends in electronic cigarette use in Scotland
Vera Buss, Loren Kock, Robert West, Emma Beard, Dimitra Kale, Jamie Brown
Updated 27th April 2023
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Background
Electronic cigarette use has become prevalent in many countries
In Scotland, 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 ~450 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
Approximately 10-13% of the adult population in Scotland use e-cigarettes
Use of Juul and heated tobacco products is rare
Approximately 13-18% long-term ex-smokers (quit >1 year) use e-cigarettes, but use among never smokers is relatively rare
Almost half of all EC users are dual users (also smoke)
A smaller proportion of both e-cigarette and NRT daily users are ‘dual users’ (also smoke)
Summary II
Frequency of use among users is greater in ex-smokers
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) are most popular source for purchase
Summary III
Approximately 2 in 5 smokers and recent ex-smokers (quit in the past year) use e-cigarettes
E-cigarettes are the most popular aid used in a smoking quit attempt
Summary IV
The majority of current smokers in Scotland believe e-cigarettes are as harmful as cigarettes.
The number of smokers who believe e-cigarettes are more harmful than cigarettes has increased.
Conclusions
Approximately 7% of the adult population in Scotland use e-cigarettes, but use of e-cigarettes by never smokers remains very rare and similar to use of licensed nicotine products.
