Young people in Wales now substantially more likely to try e-cigarettes than tobacco

Young people in Wales are now almost twice as likely to try an e-cigarette compared to tobacco, new research by Cardiff University shows.

While there is no evidence that e-cigarettes make young people more likely to smoke, youth e-cigarette use may become a public health issue if left unmonitored, the researchers from the University’s Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), suggest in a paper published in the British Medical Journal.

In one of the largest studies of youth e-cigarette use in the UK, the DECIPHer team, based in the University’s School of Social Sciences, asked 11-16 year olds in Wales about their e-cigarette use, including among smokers, ex-smokers and non-smokers.

They also examined associations with other types of substance use - cannabis, alcohol, mephedrone and laughing gas.

They found that since 2013, youth experimentation with e-cigarettes has grown rapidly in Wales and is now almost twice as common as experimentation with tobacco, although most young people who had used both e-cigarettes and tobacco had used tobacco first. Regular use of e-cigarettes has almost doubled, and while still very low among never and non-smokers, it is growing.

Older students, and male students were most likely to have used an e-cigarette.

The research also revealed a clear pattern according to smoking characteristics with the vast majority of experimental smokers and regular smokers, as well as experimental and regular cannabis users, reporting that they had also tried an e-cigarette. Alcohol, mephedrone and laughing gas use were also strongly associated with experimental e-cigarette use.

Elen de Lacy, lead author of the study, said: “Our data suggest that e-cigarette use is rapidly increasing among youth. While there remains no evidence that it represents a new pathway into smoking, a concern for public health professionals and policymakers is that e-cigarettes could be a new route into nicotine addiction for a large number of young people who have never smoked, if widespread regular use occurs.

“Regular use by non-smokers remains very low, but is growing. If left unmonitored, young people’s use of e-cigarettes may be on course to become a public health problem regardless of its links to smoking. So, it is important to understand how this upward trajectory might be prevented.

“The real need now, is for further research to examine long-term youth e-cigarette and tobacco use, and to understand e-cigarette use from young people’s perspectives. It is also important to monitor the impact of very recent changes in legislation, which have restricted sales to under 18s and banned many forms of marketing, on youth e-cigarette use.”

32,479 young people from 87 schools in Wales, took part in the study in 2015. The data was collected from the Wales School Health Research Network, a multiagency partnership led by DECIPHer with Welsh Government, Public Health Wales, Cancer Research UK and 113 secondary schools which aims to improve the quality of school-based health improvement research in Wales.

Cross-sectional study examining the prevalence, correlates and sequencing of electronic cigarette and tobacco use among 11–16-year olds in schools in Wales is published in BMJ Open and available online here.