TOPLINE:

The prevalence of vaping increased fivefold among 18- to 24-year-olds in England from 2014 to 2024, surpassing smoking rates and driving an overall rise in nicotine use in this youngest age group; over one third of current vapers had never regularly smoked.

METHODOLOGY:

• Researchers conducted a repeat monthly cross-sectional analysis of data from a nationally representative survey (the Smoking Toolkit Study) to monitor smoking trends in England.
• The study analysed data of 217,433 adults aged 18 years or older (weighted mean (SD) age, 49.6 (19.0) years; 49.8% women) collected between January 2014 and December 2024.
• The prevalence was stratified by six age groups (18-24, 25-34, 35-44, 45-54, 55-64, and ≥ 65 years) and calendar year.
• Response categories encompassed current smoking, daily cigarette smoking, non-daily cigarette smoking, exclusive non-cigarette tobacco smoking, recent former smoking, long-term former smoking, and never regular smoking.
• Relative changes were reported as prevalence ratios (PRs), comparing prevalence in 2024 with that in 2014, calculated using appropriate statistical methods.

TAKEAWAY:

• Among adults aged 18-24 years, the prevalence of vaping increased fivefold from 5.0% in 2014 to 25.0% in 2024 (PR, 5.00; 95% CI, 4.18-5.91), contributing to an overall rise in nicotine use from 26.1% to 36.5% (PR, 1.40; 95% CI, 1.29-1.53) despite declining smoking rates.
• The prevalence of exclusive vaping among 18- to 24-year-olds who used nicotine products increased from 3.0% to 43.7% (PR, 14.6; 95% CI, 9.66-25.3), whereas the prevalence of exclusive smoking fell sharply by 51.1% (PR, 0.37; 95% CI, 0.32-0.42).
• Particularly after 2020, daily cigarette smoking among smokers aged 18-24 years decreased sharply from 84.5% to 46.7% (PR, 0.55; 95% CI, 0.50-0.62).
• The proportion of 18- to 24-year-old vapers who had never regularly smoked increased from 4.3% to 34.3% (PR, 7.98; 95% CI, 4.56-26.2); older age groups also showed smaller increases in never smoker vaping.

IN PRACTICE:

"This dual effect underscores the complexity of the evolving nicotine landscape and suggests policies must strike a balance between minimising harm and preventing new uptake," the authors wrote.

"Given e-cigarettes expose users to much lower numbers and levels of toxicants compared to combustible tobacco, a continued shift in nicotine use from smoking toward vaping and other less harmful products would likely yield a net public health benefit," they added.

SOURCE:

This study was led by Sarah E. Jackson, University College London, London, England. It was published online on December 07, 2025, in Addiction.

LIMITATIONS:

The cross-sectional design prevented establishing causal relationships between the observed trends. Despite the large sample size, CIs were wide for the less common outcomes. The analysis could not definitively separate age, period, and cohort influences. Additionally, this study did not explore underlying motivations for changes in nicotine use behaviours, such as the influence of peer groups, marketing, or public health policies.

DISCLOSURES:

This study was supported by Cancer Research United Kingdom. Some authors report being members of the Behavioural Research UK Leadership Hub supported by the Economic and Social Research Council. Some authors reported receiving unrestricted research funding, grants, travel expenses, and honoraria from pharmaceutical companies manufacturing smoking cessation medications. All the authors declared having no links with tobacco companies or manufacturers of tobacco-related products.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.