29 August 2017
UK’s largest ever analysis of data shows no evidence that e-cigarettes are leading young people into smoking
Concerns that use of e-cigarettes by young people in the UK could be leading to smoking are so far not borne out by the evidence, shows a new study published today.
The study, a collaboration between UK Centre for Tobacco and Alcohol Studies, Public Health England, Action on Smoking and Health, and the DECIPHer Centre at the University of Cardiff is an analysis of five large-scale surveys conducted in the period 2015-17 involving over 60,000 11-16 year-olds. 
The findings show a consistent pattern: most e-cigarette experimentation among young people does not lead to regular use, and levels of regular e-cigarette use in young people who have never smoked remain very low. 
Regular (at least weekly) use of e-cigarettes amongst all young people surveyed was 3% or less. This was highly concentrated in those who also smoked tobacco. Among young people who smoke regularly (at least weekly), use of electronic cigarettes ranged from 7% to 38%. . However, among young people who have never smoked, regular use of e-cigarettes was negligible – between 0.1% and 0.5% across the five surveys. 
Most studies of e-cigarettes and young people in the UK and elsewhere have looked at experimentation – involving ever or recent use, rather than regular use. Some of these studies have suggested that trying an e-cigarette leads to young people becoming smokers, which is not justified by the evidence.
Professor Linda Bauld, Professor of Health Policy, University of Stirling:
“Recent studies have generated alarming headlines that e-cigarettes are leading to smoking. Our analysis of the latest surveys from all parts of the United Kingdom, involving thousands of teenagers shows clearly that for those teens who don’t smoke, e-cig experimentation is simply not translating into regular use.
“Our study also shows that smoking rates in young people are continuing to decline. Future studies on this subject need to continue to monitor both experimentation and regular use of e-cigarettes and take into account trends in tobacco use if we are to provide the public with accurate information.”
Martin Dockrell, Tobacco Policy Manager, Public Health England:
“The findings in this study suggest that in terms of protecting children we are broadly getting the balance right in the UK. We have a regulatory system that aims to protect children and young people while ensuring adult smokers have access to safer nicotine products that can help them stop smoking. This includes a minimum age of sale, tight restrictions on marketing, and comprehensive quality and safety requirements. We will continue to monitor the trends in e-cigarette use alongside those in smoking.”
Deborah Arnott, Chief Executive, Action on Smoking and Health:
“ASH will continue to monitor the potential impact of e-cigarettes on young people, however this study provides reassurance that to date fears that they are a gateway into smoking are just not born out by the facts on the ground. A small proportion of young people do experiment with e-cigs, but this does not appear to be leading to regular vaping or smoking in any numbers, indeed smoking rates in young people are continuing to decline.”
Graham Moore, Deputy Director, DECIPHer:
“Few people would argue that e-cigarette use in young people should be encouraged. However, these surveys consistently show that the rapid growth in experimentation with e-cigarettes among young people throughout the UK has so far not resulted in widespread regular use among non-smokers. Taken alongside our other recent analyses which suggest that among young people who use both e-cigarettes and tobacco, tobacco nearly always comes first, concerns that e-cigarettes are leading large numbers of young people into addiction and tobacco use increasingly seem to be implausible.”
Young people are defined as aged from 11-16 in the surveys analysed.
Contributors to the research paper include: Public Health England, Action on Smoking and Health (ASH), members of the UK Centre for Tobacco and Alcohol Studies (The Institute for Social Marketing at the University of Stirling, The Addictions Department at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London) and The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement at Cardiff University.
Contributors are available for interview. Please contact Stevie Benton from Action on Smoking and Health (ASH) on 020 7404 0242
 The five surveys are:
 Bauld L et al Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015-2017, International Journal of Environmental Research and Public Health 2017, 14, 29 August 2017 http://www.mdpi.com/1660-4601/14/9/973/pdf