Nicotine strength of e-liquids used by adult vapers in Great Britain: A population survey 2016 to 2024.

disposable vapes e‐cigarette tax e‐cigarettes vaping vaping duty vaping tax

Journal

Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118

Informations de publication

Date de publication:
19 Jun 2024
Historique:
received: 13 03 2024
accepted: 07 05 2024
medline: 20 6 2024
pubmed: 20 6 2024
entrez: 19 6 2024
Statut: aheadofprint

Résumé

In March 2024, the UK government announced plans to introduce a Vaping Products Duty that will tax e-liquids based on their nicotine strength. This study examined trends in the nicotine strength of e-liquids used by adult vapers and differences in those currently used across relevant subgroups. Nationally-representative, cross-sectional household survey, July 2016 to January 2024. Great Britain. 7981 adult vapers. Participants were asked whether the e-cigarette they mainly use contains nicotine (yes/no) and the e-liquid strength (no nicotine, >0-≤ 6, 7-11, 12-19 or ≥20 mg/ml). We also collected information on the main device type used (disposable/refillable/pod), age, gender, occupational social grade, history of ≥1 mental health conditions, smoking status and (among past-year smokers) level of cigarette addiction. The proportion of vapers in England using high-strength (≥20 mg/ml) e-liquids increased from an average of 3.8% (95% confidence interval [CI] = 2.9-5.0) up to June 2021 to 32.5% (CI = 27.9-37.4) in January 2024 (the vast majority of whom [93.3% in January 2024] reported using exactly 20 mg/ml; the legal limit). This rise was most pronounced among those using disposable e-cigarettes, those aged 18-24 years and all smoking statuses (including never smokers) except long-term (≥1y) ex-smokers. Of those surveyed in 2022-2024 in Great Britain, overall, 89.5% (CI = 88.1-90.8) said they usually used e-cigarettes containing nicotine, 8.7% (CI = 7.5-10.0) used nicotine-free e-cigarettes, and 1.8% (CI = 1.2-2.4) were unsure. The proportion using ≥20 mg/ml was higher among those mainly using disposable (47.9%) compared with pod (16.3%) or refillable (11.5%) devices; never smokers (36.0%), current smokers (28.8%) or recent (<1y) ex-smokers (27.4%), compared with long-term ex-smokers (13.9%); and younger (16-24y; 44.2%) compared with older (≥25y; range 9.4-25.1%) age groups. There were no notable differences across other subgroups of interest. Use of high-strength nicotine e-liquids in England appears to have increased sharply in recent years. Most adult vapers in Great Britain appear to use e-cigarettes that contain nicotine but different subgroups use different strengths: nicotine strengths tend to be higher among those who mainly use disposable devices and those aged 16-24y, and lower among long-term ex-smokers.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
In March 2024, the UK government announced plans to introduce a Vaping Products Duty that will tax e-liquids based on their nicotine strength. This study examined trends in the nicotine strength of e-liquids used by adult vapers and differences in those currently used across relevant subgroups.
DESIGN METHODS
Nationally-representative, cross-sectional household survey, July 2016 to January 2024.
SETTING METHODS
Great Britain.
PARTICIPANTS METHODS
7981 adult vapers.
MEASUREMENTS METHODS
Participants were asked whether the e-cigarette they mainly use contains nicotine (yes/no) and the e-liquid strength (no nicotine, >0-≤ 6, 7-11, 12-19 or ≥20 mg/ml). We also collected information on the main device type used (disposable/refillable/pod), age, gender, occupational social grade, history of ≥1 mental health conditions, smoking status and (among past-year smokers) level of cigarette addiction.
FINDINGS RESULTS
The proportion of vapers in England using high-strength (≥20 mg/ml) e-liquids increased from an average of 3.8% (95% confidence interval [CI] = 2.9-5.0) up to June 2021 to 32.5% (CI = 27.9-37.4) in January 2024 (the vast majority of whom [93.3% in January 2024] reported using exactly 20 mg/ml; the legal limit). This rise was most pronounced among those using disposable e-cigarettes, those aged 18-24 years and all smoking statuses (including never smokers) except long-term (≥1y) ex-smokers. Of those surveyed in 2022-2024 in Great Britain, overall, 89.5% (CI = 88.1-90.8) said they usually used e-cigarettes containing nicotine, 8.7% (CI = 7.5-10.0) used nicotine-free e-cigarettes, and 1.8% (CI = 1.2-2.4) were unsure. The proportion using ≥20 mg/ml was higher among those mainly using disposable (47.9%) compared with pod (16.3%) or refillable (11.5%) devices; never smokers (36.0%), current smokers (28.8%) or recent (<1y) ex-smokers (27.4%), compared with long-term ex-smokers (13.9%); and younger (16-24y; 44.2%) compared with older (≥25y; range 9.4-25.1%) age groups. There were no notable differences across other subgroups of interest.
CONCLUSIONS CONCLUSIONS
Use of high-strength nicotine e-liquids in England appears to have increased sharply in recent years. Most adult vapers in Great Britain appear to use e-cigarettes that contain nicotine but different subgroups use different strengths: nicotine strengths tend to be higher among those who mainly use disposable devices and those aged 16-24y, and lower among long-term ex-smokers.

Identifiants

pubmed: 38897583
doi: 10.1111/add.16576
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Cancer Research UK
ID : PRCRPG-Nov21\100002
Pays : United Kingdom

Informations de copyright

© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Références

Action on Smoking and Health. Use of e‐cigarettes (vapes) among young people in Great Britain. https://ash.org.uk/resources/view/use-of-e-cigarettes-among-young-people-in-great-britain (2023). Accessed 17 Aug 2023.
Tattan‐Birch H, Jackson SE, Kock L, Dockrell M, Brown J. Rapid growth in disposable e‐cigarette vaping among young adults in Great Britain from 2021 to 2022: a repeat cross‐sectional survey. Addiction. 2023;118(2):382–386. https://doi.org/10.1111/add.16044
Action on Smoking and Health. Use of e‐cigarettes among adults in Great Britain. https://ash.org.uk/resources/view/use-of-e-cigarettes-among-adults-in-great-britain-2021 (2023). Accessed 30 Oct 2023.
Smith MJ, MacKintosh AM, Ford A, Hilton S. Youth's engagement and perceptions of disposable e‐cigarettes: a UK focus group study. BMJ Open. 2023;13(3):e068466. https://doi.org/10.1136/bmjopen-2022-068466
Talih S, Salman R, Soule E, El‐Hage R, Karam E, Karaoghlanian N, et al. Electrical features, liquid composition and toxicant emissions from'pod‐mod’‐like disposable electronic cigarettes. Tob Control. 2022;31(5):667–670. https://doi.org/10.1136/tobaccocontrol-2020-056362
Leventhal AM, Madden DR, Peraza N, Schiff SJ, Lebovitz L, Whitted L, et al. Effect of exposure to e‐cigarettes with salt vs Free‐Base nicotine on the appeal and sensory experience of vaping: a randomized clinical trial. JAMA Netw Open. 2021;4(1):e2032757. https://doi.org/10.1001/jamanetworkopen.2020.32757
Department of Health and Social Care, The Scottish Government, Welsh Government, Department of Health (Northern Ireland). Creating a smokefree generation and tackling youth vaping GOV.UK. https://www.gov.uk/government/consultations/creating-a-smokefree-generation-and-tackling-youth-vaping (2023). Accessed 5 Mar 2024.
Department of Health and Social Care, Prime Minister's Office, 10 Downing Street, Department for Environment, Food & Rural Affairs, HM Revenue & Customs, The Rt Hon, Andrea Leadsom MP. Disposable vapes banned to protect children's health GOV.UK. https://www.gov.uk/government/news/disposable-vapes-banned-to-protect-childrens-health (2024). Accessed 26 Feb 2024.
Department of Health and Social Care. Creating a smokefree generation and tackling youth vaping consultation: government response GOV.UK. https://www.gov.uk/government/consultations/creating-a-smokefree-generation-and-tackling-youth-vaping/outcome/creating-a-smokefree-generation-and-tackling-youth-vaping-consultation-government-response (2024). Accessed 5 Mar 2024.
HM Treasury. Vaping Products Duty consultation GOV.UK. https://www.gov.uk/government/consultations/vaping-products-duty-consultation (2024). Accessed 6 Mar 2024.
Hammond D, Reid JL, Burkhalter R, O'Connor RJ, Goniewicz ML, Wackowski OA, et al. Trends in e‐cigarette brands, devices and the nicotine profile of products used by youth in England, Canada and the USA: 2017–2019. Tob Control. 2023;32(1):19–29. https://doi.org/10.1136/tobaccocontrol-2020-056371
Etter J‐F. Explaining the effects of electronic cigarettes on craving for tobacco in recent quitters. Drug Alcohol Depend. 2015;148:102–108. https://doi.org/10.1016/j.drugalcdep.2014.12.030
Lindson N, Butler AR, McRobbie H, Bullen C, Hajek P, Begh R, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2024;2024(1):CD010216. https://doi.org/10.1002/14651858.CD010216.pub8
Cobb CO, Foulds J, Yen M‐S, Veldheer S, Lopez AA, Yingst JM, et al. Effect of an electronic nicotine delivery system with 0, 8, or 36 mg/mL liquid nicotine versus a cigarette substitute on tobacco‐related toxicant exposure: a four‐arm, parallel‐group, randomised, controlled trial. Lancet Respir Med. 2021;9(8):840–850. https://doi.org/10.1016/S2213-2600(21)00022-9
Dawkins L, Cox S, Goniewicz M, McRobbie H, Kimber C, Doig M, et al. ‘Real‐world’ compensatory behaviour with low nicotine concentration e‐liquid: subjective effects and nicotine, acrolein and formaldehyde exposure. Addiction. 2018;113(10):1874–1882. https://doi.org/10.1111/add.14271
McNeill A, Simonavicius E, Brose LS, Taylor E, East K, Zuikova E, et al. Nicotine vaping in England: an evidence update including health risks and perceptions, September 2022. In: A report commissioned by the Office for Health Improvement and Disparities London: Office for Health Improvement and Disparities. https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update (2022). Accessed 3 Oct 2022.
Cox S, Leigh NJ, Vanderbush TS, Choo E, Goniewicz ML, Dawkins L. An exploration into “do‐it‐yourself” (DIY) e‐liquid mixing: Users' motivations, practices and product laboratory analysis. Addict Behav Rep. 2019;9:100151. https://doi.org/10.1016/j.abrep.2018.100151
Brose LS, Brown J, Robson D, McNeill A. Mental health, smoking, harm reduction and quit attempts – a population survey in England. BMC Public Health. 2020;20(1):1237. https://doi.org/10.1186/s12889-020-09308-x
Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2012;1248(1):107–123. https://doi.org/10.1111/j.1749-6632.2011.06202.x
Fidler JA, Shahab L, West O, Jarvis MJ, McEwen A, Stapleton JA, et al. ‘The smoking toolkit study’: a national study of smoking and smoking cessation in England. BMC Public Health. 2011;11(1):479. https://doi.org/10.1186/1471-2458-11-479
Kock L, Shahab L, Moore G, Beard E, Bauld L, Reid G, et al. 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 Res. 2021;6:67. https://doi.org/10.12688/wellcomeopenres.16700.1
Jackson SE, Beard E, Kujawski B, Sunyer E, Michie S, Shahab L, et al. Comparison of trends in self‐reported cigarette consumption and sales in England, 2011 to 2018. JAMA Netw Open. 2019;2(8):e1910161. https://doi.org/10.1001/jamanetworkopen.2019.10161
Kock L, Tattan‐Birch H, Jackson S, Shahab L, Brown J. Socio‐demographic, smoking and drinking characteristics in GB: a comparison of independent telephone and face‐to‐face smoking and alcohol toolkit surveys conducted in march 2022. Qeios. 2022. https://doi.org/10.32388/CLXK4D
Fidler JA, Shahab L, West R. Strength of urges to smoke as a measure of severity of cigarette dependence: comparison with the Fagerström test for nicotine dependence and its components. Addiction. 2011;106(3):631–638. https://doi.org/10.1111/j.1360-0443.2010.03226.x
Tattan‐Birch H, Brown J, Shahab L, Beard E, Jackson S. Trends in vaping and smoking following the rise of disposable e‐cigarettes: a repeat cross‐sectional study in England between 2016 and 2023. Lancet Regional Health ‐ Europe. 2024; 100924. https://doi.org/10.1016/j.lanepe.2024.100924.
Jackson SE, Tattan‐Birch H, Shahab L, Oldham M, Kale D, Brose L et al. Who would be affected by a ban on disposable vapes? A population study in Great Britain. 2023; 2023.10.23.23297396.
Jackson SE, Tattan‐Birch H, Brown J. Trends in where people buy their vaping products and differences by user and device characteristics: a population study in England, 2016–23. Addiction. https://doi.org/10.1111/add.16387
Ward E, Cox S, Dawkins L, Jakes S, Holland R, Notley C. A qualitative exploration of the role of vape shop environments in supporting smoking abstinence. Int J Environ Res Public Health. 2018;15(2):297. https://doi.org/10.3390/ijerph15020297
Cox S, Ward E, Ross L, Notley C. How a sample of English stop smoking services and vape shops adapted during the early COVID‐19 pandemic: a mixed‐methods cross‐sectional survey. Harm Reduct J. 2021;18(1):95. https://doi.org/10.1186/s12954-021-00541-0
Jackson SE, McGowan JA, Ubhi HK, Proudfoot H, Shahab L, Brown J, et al. Modelling continuous abstinence rates over time from clinical trials of pharmacological interventions for smoking cessation. Addiction. 2019;114(5):787–797. https://doi.org/10.1111/add.14549
Jackson SE, Tattan‐Birch H, East K, Cox S, Shahab L, Brown J. Trends in harm perceptions of E‐cigarettes vs cigarettes among adults who smoke in England, 2014‐2023. JAMA Netw Open. 2024;7(2):e240582. https://doi.org/10.1001/jamanetworkopen.2024.0582
East K, Brose LS, McNeill A, Cheeseman H, Arnott D, Hitchman SC. Harm perceptions of electronic cigarettes and nicotine: a nationally representative cross‐sectional survey of young people in Great Britain. Drug Alcohol Depend. 2018;192:257–263. https://doi.org/10.1016/j.drugalcdep.2018.08.016
Wilson S, Partos T, McNeill A, Brose LS. Harm perceptions of e‐cigarettes and other nicotine products in a UK sample. Addiction. 2019;114(5):879–888. https://doi.org/10.1111/add.14502
Jackson SE, Tattan‐Birch H, Shahab L, Brown J. How has expenditure on nicotine products changed in a fast‐evolving marketplace? A representative population survey in England, 2018–2022. Nicotine Tob Res. 2023;(9):1585–1593. https://doi.org/10.1093/ntr/ntad074
Department of Health and Social Care, O'Brien N. Smokers urged to swap cigarettes for vapes in world first scheme. https://www.gov.uk/government/news/smokers-urged-to-swap-cigarettes-for-vapes-in-world-first-scheme (2023). Accessed 21 Nov 2023.
Pesola F, Phillips‐Waller A, Beard E, Shahab L, Sweanor D, Jarvis M, et al. Effects of reduced‐risk nicotine‐delivery products on smoking prevalence and cigarette sales: an observational study. Public Health Res Southampt Engl. 2023;11:1–39. https://doi.org/10.3310/RPDN7327
Levy DT, Warner KE, Cummings KM, Hammond D, Kuo C, Fong GT, et al. Examining the relationship of vaping to smoking initiation among US youth and young adults: a reality check. Tob Control. 2019;28(6):629–635. https://doi.org/10.1136/tobaccocontrol-2018-054446

Auteurs

Sarah E Jackson (SE)

Department of Behavioural Science and Health, University College London, London, United Kingdom.
SPECTRUM Consortium, United Kingdom.

Jamie Brown (J)

Department of Behavioural Science and Health, University College London, London, United Kingdom.
SPECTRUM Consortium, United Kingdom.
Behavioural Research UK, United Kingdom.

Lion Shahab (L)

Department of Behavioural Science and Health, University College London, London, United Kingdom.
SPECTRUM Consortium, United Kingdom.

Deborah Arnott (D)

Department of Behavioural Science and Health, University College London, London, United Kingdom.
Action on Smoking and Health, United Kingdom.

Linda Bauld (L)

SPECTRUM Consortium, United Kingdom.
Behavioural Research UK, United Kingdom.
Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Sharon Cox (S)

Department of Behavioural Science and Health, University College London, London, United Kingdom.
SPECTRUM Consortium, United Kingdom.
Behavioural Research UK, United Kingdom.

Classifications MeSH