Vaping Promotes Smoking Cessation — More Data From the UK

The UK's National Health Service just published the results of its survey Smoking, Drinking and Drug Use among Young People in England. The media amplified the report's finding that teen vaping increased slightly, from six to nine percent, between 2018 and 2021. Headlines and commentary were everything you'd expect from public health officials and journalists.

“Doctors say children are being targeted by e-cigarette companies, with bright packaging, exotic flavors and enticing names,” BBC reported. One official with the Royal College of Pediatrics and Child Health told the news outlet he was "deeply disturbed" by the rise in teen vaping.

I, too, am troubled by underage nicotine use. But a closer look at the results reveals some very good news: teen smoking continues to decline in England, and vaping has been an important part of this public health victory. This is an outcome worth celebrating wherever you are in the world because it adds to the existing evidence supporting e-cigarettes as a smoking-cessation tool.

Vaping promotes smoking cessation

The survey is conducted every two years among teenagers between 11 and 15 years old. This particular report included responses from 9,289 participants across 119 schools. Two survey results deserve special attention. First, most teenagers who took up vaping are or were smokers. “56% of ex-smokers were current e-cigarette users,” the report noted. Moreover, “Regular smokers who were regular e-cigarette users has more than doubled; from 29% in 2018 to 61% in 2021.”

This means that vaping, which is widely recognized as less harmful than smoking, has helped many young people replace some or all of their cigarette consumption. Put another way, the increase in vaping largely mirrored a decrease in smoking. Nobody wants teens using nicotine-containing products. But if they're going to violate public health rules, as adolescents are wont to do, vaping is the less harmful way to rebel.

Keep in mind that just three percent of students in the survey were classified as current smokers, meaning that both vaping and smoking in England are quite low.

Non-smokers don't vape

Next up and equally important is that few non-smoking teens are interested in vaping. “Only 1% of pupils who had never smoked were regular e-cigarette users,” the survey found. Additionally, “Most regular smokers (92%) reported having ever used e-cigarettes. This compares to just 13% of pupils who had never smoked." These stats should be viewed in light of another figure: 88 percent of survey respondents “were aware of e-cigarettes.” Most teens know what vaping is but don't try it.

Studies conducted in the US have produced similar results. The CDC reported in October that three percent of US high-school students vape nicotine daily, and most of them smoked before trying e-cigarettes. Smoking history (or lack thereof) tends to predict an individual's interest in e-cigarettes, as the NHS authors put it:

Pupils who had ever smoked were much more likely to also have ever used an e-cigarette, than those who had never smoked.

While the report did indeed find an increase in current vaping, lifetime vaping didn't rise during the survey period. That figure actually decreased slightly:

The rise in current use was not seen for lifetime use. 22% … of pupils reported they had ever used e-cigarettes, compared to 25% in 2018 (not a significant change). [1]

We should remember that these results are based on self-reported answers from teenagers, so the data should be interpreted with caution. [2] That said, if the numbers are at all accurate, they paint an encouraging picture. Teen smoking is declining in England, just as it is in the United States. In a world filled with bad news, let's celebrate the small victories when they come along.

[1] The definition of “current vaping” included regular users (defined as "usually using an e-cigarette at least once per week"); and occasional users (defined as "using an e-cigarette sometimes but less than once per week, but excluding those who had tried them just once or twice in total").

[2] This data seems a little more reliable than most questionnaire-based studies. Students were not allowed to discuss the questions with each other or look at others’ answers. Teachers were present while the survey was administered, but they were not allowed to see the questionnaires “at any stage of the survey.” All the reported information was kept confidential. See the study's appendix A for more details.