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Trends in electronic cigarette use in Scotland

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

Updated 18th July 2024

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 15-25% long-term ex-smokers (quit >1 year) use e-cigarettes, but use among never smokers is relatively rare

Approximately 32-42% of e-cigarette users are dual users (also smoke)

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

Summary II

Frequency of use among users is greatest in ex-smokers

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

Newsagents are most popular among never smokers

E-cigarette use is most popular with younger people and among less advantaged social grades

Summary III

Approximately 20-30% of 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 largest proportion of current smokers believe e-cigarettes are equally or more harmful than cigarettes

Conclusions

Approximately 10-13% of the adult population in Scotland use e-cigarettes, but use of e-cigarettes by never smokers remains rare (~2.5%)