A million people in England are vaping despite never having smoked regularly, research shows

One million people in England now vape despite never having smoked regularly, a sevenfold increase in just three years, according to research that has sparked concern among health experts.

E-cigarette use among adults who had never smoked regularly was stable until 2021, when one in 200 – about 133,000 people – were vapers. However, the proportion has risen sharply to one in 28 in 2024 – 1,006,000 people – a study published in the journal The Lancet Public Health suggests.

Separate figures from the Office for National Statistics, also published this week, show that 5.1 million people aged 16 or over in Britain – around one in ten – use e-cigarettes. The vaping rate was highest among young people aged 16 to 24, at 15.8%. the ONS found.

Prof Nick Hopkinson, a respiratory physician and chairman of Action on Smoking and Health, said: “Vaping has helped millions of adults quit smoking and is far less harmful than smoking. However, it is not without risks and the high levels of use among young people and increasing use among never smokers are of concern.”

Prof. Sanjay Agrawal, the Royal College of Physician’s special adviser on tobacco, said “urgent action” was needed to tackle the rise in vaping among young people and those who had never smoked.

He said: “While e-cigarettes remain a valuable tool to help smokers quit, it is essential that their use does not pose new risks to public health, especially among children.”

The UCL-led Lancet study found that most people now using e-cigarettes who had never smoked regularly vaped daily and for an extended period of time. The dramatic increase was largely driven by young adults, with one in seven 18 to 24-year-olds (14%) in England who never smoked regularly now using e-cigarettes, the researchers said.

They warned that banning disposable vapes, which the government plans to do, would likely not solve the problem, as some brands had already launched reusable products. Instead, they suggested, there should be stricter regulations to make the products look less attractive.

Prof. Jamie Brown, from the UCL Institute of Epidemiology and Health Care and senior author of the study, said: “These findings remind us that action is needed to try to minimize vaping among young people who have never smoked before. However, a balancing act is required to avoid discouraging smokers from using e-cigarettes to quit.

“Banning single-use items, as the UK government is currently planning, is unlikely to solve the problem as popular brands have already launched reusable products with very similar designs and prices.

“A sensible next step would be to introduce stricter regulations around the appearance, packaging and marketing of products, as these are less likely to reduce the effectiveness of e-cigarettes in smoking cessation – unlike, for example, taste prohibited.

“The fact that the overall prevalence of vaping appears to have leveled off since 2023 may reassure policymakers that it would be reasonable to initiate these measures and assess their impact.”

The Lancet study looked at survey data collected between 2016 and 2024 among 153,073 adults in England, 94,107 of whom had never smoked tobacco regularly. People were classified as never-regular smokers if they said, “I have never been a smoker (smoked for a year or more).”

Before 2021, the proportion of never-regular smokers who vaped in England was low, averaging 0.5% between 2016 and 2020. This rose to 3.5% in April 2024 – just over 1 million vapers. Among them, more than half (an estimated 588,000) were between 18 and 24 years old, the study found.

The researchers also found that people who had never smoked regularly in recent years tended to be younger, more likely to be women, and to drink more at higher or higher risk levels.

They also often had been vaping for a longer time, were more likely to use disposable devices and e-liquids with the highest nicotine strength, and purchased products in supermarkets or convenience stores.

The lead author, Dr Sarah Jackson from the UCL Institute of Epidemiology and Health Care, said: “The public health impact of this substantial increase in vaping among people who have never smoked regularly will depend on what these people would do differently.

“It is likely that some would have smoked if vaping was not an available option. In this case, vaping is clearly less harmful. However, for those who would not have taken up smoking, vaping regularly for an extended period of time carries more risk than not vaping.”

Individual, a second study published simultaneously in the Lancet Public Health concluded that accelerating action to eliminate tobacco smoking could help increase life expectancy and prevent millions of premature deaths worldwide by 2050.

A third study was published at the same time in the same journal suggested that banning the sale of tobacco to people born between 2006 and 2010 could prevent 1.2 million deaths from lung cancer worldwide by 2095.