What are e-cigarettes?

An e-cigarette

Electronic cigarette (e-cigarettes) are devices that enable the user to inhale nicotine. They work by heating and vaporising a solution that contains nicotine, glycerine and sometimes flavourings. Inhaling nicotine from an e-cigarette is referred to as vaping.

Since there is no burning involved with e-cigarettes there is no smoke produced and hence no tar or carbon monoxide, which are two of the most toxic products of smoking. The vapour from e-cigarettes has been found to contain some potentially harmful chemicals but these are at much lower levels than they are in conventional tobacco smoke. However, some recent studies have linked the flavourings in some e-cigarettes to lung damage.

While there are some public health concerns over the uptake of e-cigarettes by non-smokers, many doctors believe that they can help smokers quit or reduce their tobacco consumption. In fact, they may begin to be prescribed on the NHS to help people stop smoking. If so, it would be the first country in the world to do so.

How e-cigarettes work (Image from the BBC)

According to a 2021 report into vaping from PHE:

Vaping among young people:

  • Smoking prevalence (including those who smoked sometimes or more than once a week) in March 2020 was 6.7% (compared with 6.3% in March 2019) and has changed little since 2015 when it was 7.1%
  • There was little change in levels of vaping over the last few years with current vaping (at least once per month) prevalence being 4.8% in March 2020, the same as in March 2019
  • Smoking prevalence is at 6.2% (defined as smoking more than 100 cigarettes in their life and having smoked in the past 30 days)
  • Current vaping prevalence is at 7.7% (defined as vaping on more than 10 days in their lifetime and having vaped in the past 30 days)

Based on the socioeconomic status of 11 to 18 year olds, the estimates for smoking and vaping prevalence were higher among more advantaged groups in social grades A, B and C1 (7.1% for smoking, 5.3% for vaping) than for more disadvantaged groups in social grades C2, D and E (5.7% for smoking, 3.5% for vaping).

Most young people who had never smoked had also never vaped. Between 0.8% and 1.3% of young people who had never smoked were current vapers.

The main reasons for vaping were to:

  • “give it a try”
  • “for fun/I like it”
  • “liking the flavours”

Of the 11 to 18 year olds who vaped, 11.9% reported doing so to quit smoking.

Most current vapers were either former or current smokers.

Vaping among adults:

  • Smoking prevalence among adults in England continues to fall and was between 13.8% and 16.0% depending on the survey, equating to about 6 to 7 million smokers.
  • There was some variation in smoking prevalence by socio-demographics, such as a higher prevalence among adults from more disadvantaged groups. There was also variation between surveys, most notably for smoking prevalence in young adults.
  • Vaping prevalence was lower than smoking prevalence across all groups and continues to be around 6% (between 5.5% and 6.3%), equating to about 2.7 million adult vapers in England.

Vaping and smoking cessation:

  • Using a vaping product is the most popular aid used by people trying to quit smoking. In 2020, 27.2% of people used a vaping product in a quit attempt in the previous 12 months. This compares with 15.5% who used NRT over the counter or on prescription (2.7%), and 4.4% who used varenicline.
  • Vaping is positively associated with quitting smoking successfully. In 2017, over 50,000 smokers stopped smoking with a vaping product who would otherwise have carried on smoking.
  • Prescription medication and licensing NRT for harm reduction were also positively associated with successfully quitting smoking. This shows how important it is for people who smoke to have access to a wide choice of cessation aids.
  • The extensive use of vaping products in quit attempts compared with licensed medication suggests vaping products may reach more people who smoke and so have more impact than NRT and varenicline.

Further reading:

Vaping in England: evidence update February 2021
This update looks at the prevalence of vaping among young people and adults. It also reviews research literature on vaping among pregnant women and people with mental health conditions | PHE, UK

Burning Issues: The Global State of Tobacco Harm Reduction 2020
The central theme of this report, enshrined in many international treaties, is the universal right to health, including for those who for whatever reason continue to engage in risky behaviours. Harm reduction refers to a range of pragmatic policies, regulations and actions which either reduce health risks by providing safer forms of products or substances, or encourage less risky behaviours. Harm reduction does not focus primarily on the eradication of products or behaviours | KAC, UK

Updated November 2021