Background

E-cigarettes are increasingly used by smokers and ex-smokers, often to support smoking cessation, but also among those who have never regularly smoked. The aim of our study is to estimate time trends in vaping prevalence among adults who have never regularly smoked and describe the profile of adult never-regular-smokers who vape.

Methods

In this nationally representative, monthly cross-sectional survey in England, 153 073 participants (aged ≥18 years) were recruited from July, 2016, to April, 2024. 94 107 (61·5%) of the 153 073 participants had never regularly smoked. Logistic regression estimated associations between survey wave and current vaping, overall, and by sociodemographic characteristics and alcohol consumption.

Findings

Vaping prevalence among never-regular-smokers was relatively stable up to 2021, at an average of 0·5% (95% CI 0·5–0·6) between July, 2016, and December, 2020; it then increased rapidly, reaching 3·5% (2·8–4·4) in April, 2024. This increase was largely driven by young adults (19·0% [13·9–25·4] among individuals aged 18 years) and those with higher alcohol consumption levels (22·1% [11·7–37·8%] among the heaviest drinkers). By contrast, trends among all adults (including current and former smokers) suggested the rise in vaping prevalence plateaued among all ages by early 2023. In 2023–24, 55·6% (48·2–62·8) of never-regular-smokers who vaped reported vaping daily; 81·7% (75·4–86·7) had been vaping for 6 months or more. The most used devices in 2023–24 were disposables (50·2% [42·9–57·5]) and the most commonly used e-liquids contained 20 mg/mL or more nicotine (44·6% [37·4–52·0]).

Interpretation

The number of adults in England who vape but have never regularly smoked rose rapidly between 2021 and 2024, particularly in younger age groups and most of these individuals reported vaping regularly over a sustained period. The public health impacts of this finding will depend on what these people would otherwise be doing: it is likely that some might have smoked if vaping were not an available option (exposing them to more harm), whereas others might not have smoked or vaped.

Funding

Cancer Research UK.

中文翻译：

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英国从未经常吸烟的成年人吸电子烟的情况：一项基于人群的研究，2016-24

 背景

电子烟越来越多地被吸烟者和戒烟者使用，通常是为了支持戒烟，但也包括那些从未经常吸烟的人。我们研究的目的是估计从未经常吸烟的成年人中电子烟流行率的时间趋势，并描述从不经常吸烟的成年人的概况。

 方法

在英格兰这项具有全国代表性的月度横断面调查中，从 2016 年 7 月至 2024 年 4 月招募了 153 073 名参与者（年龄≥18 岁）。 153 073 名参与者中的 94 107 名（61·5%）从未定期参加过熏制。逻辑回归估计了调查浪潮与当前电子烟之间的总体关联，以及社会人口特征和饮酒量。

 发现

截至 2021 年，从不经常吸烟者的电子烟流行率相对稳定，2016 年 7 月至 2020 年 12 月期间平均为 0·5% (95% CI 0·5–0·6)；随后迅速增加，于 2024 年 4 月达到 3·5% (2·8–4·4)。这一增长主要是由年轻人推动的（18 岁人群中为 19·0% [13·9–25·4]）年）和酒精消费水平较高的人（22·1% [11·7–37·8%] 属于最重度饮酒者）。相比之下，所有成年人（包括当前和曾经吸烟者）的趋势表明，到 2023 年初，所有年龄段的电子烟流行率上升趋于稳定。2023-24 年，55·6% (48·2–62·8) 的人从不定期使用电子烟。 - 吸电子烟的吸烟者报告每天吸电子烟； 81·7% (75·4–86·7) 已经吸电子烟 6 个月或更长时间。 2023-24 年最常用的设备是一次性设备 (50·2% [42·9–57·5])，最常用的电子烟液含有 20 mg/mL 或更多尼古丁 (44·6% [37·4] –52·0]）。

 解释

2021 年至 2024 年间，英格兰吸电子烟但从未经常吸电子烟的成年人数量迅速增加，特别是在较年轻的年龄组中，其中大多数人报告在持续一段时间内定期吸电子烟。这一发现对公共健康的影响将取决于这些人否则会做什么：如果电子烟不是一种可用的选择，有些人可能会吸烟（使他们受到更多伤害），而其他人可能不会吸烟或电子烟。

 资金

 英国癌症研究中心。