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

Abstract

Background and aims: 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: Nationally-representative, cross-sectional household survey, July 2016 to January 2024.

Setting: Great Britain.

Participants: 7981 adult vapers.

Measurements: 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: 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: 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.

Keywords: disposable vapes; e‐cigarette tax; e‐cigarettes; vaping; vaping duty; vaping tax.

FIGURE 1

Trends in nicotine strengths of e‐liquids used by adult (≥18 years) vapers in England, July 2016 to January 2024. Unweighted sample size: n = 7314. Lines represent the modelled weighted proportion by monthly survey wave (modelled non‐linearly using restricted cubic splines with five knots). Shaded bands represent 95% CI. Points represent the unmodelled weighted proportion by month. The vertical dashed line indicates the timing of the start of the rise in popularity of disposable vaping in June 2021.

FIGURE 2

Trends in nicotine strengths of e‐liquids used by adult (≥18 years) vapers in England, July 2016 to January 2024, by the main device type used. Unweighted sample sizes: n = 5197 refillable; n = 880 disposable; n = 1131 pod. Lines represent the modelled weighted proportion by monthly survey wave (modelled non‐linearly using restricted cubic splines with five knots) and the main device type used. Shaded bands represent 95% CI. Points represent the unmodelled weighted proportion by month. The vertical dashed line indicates the timing of the start of the rise in popularity of disposable vaping in June 2021.

FIGURE 3

Trends in nicotine strengths of e‐liquids used by adult (≥18 years) vapers in England, July 2016 to January 2024, by age. Unweighted sample sizes: n = 1209 18‐ to 24‐year‐olds; n = 1650 25‐ to 34‐year‐olds; n = 1302 35‐ to 44‐year‐olds; n = 1337 45‐ to 54‐year‐olds; n = 1080 55‐ to 64‐year‐olds; n = 736 ≥65‐year‐olds. Lines represent the modelled weighted proportion by monthly survey wave (modelled non‐linearly using restricted cubic splines with five knots) and age. Shaded bands represent 95% CI. Points represent the unmodelled weighted proportion by month. The vertical dashed line indicates the timing of the start of the rise in popularity of disposable vaping in June 2021.

FIGURE 4

Trends in nicotine strengths of e‐liquids used by adult (≥18 years) vapers in England, July 2016 to January 2024, by smoking status. Unweighted sample sizes: n = 530 never smokers; n = 2251 long‐term (≥1 years) ex‐smokers; n = 624 recent (<1 year) ex‐smokers; n = 3909 current smokers. Lines represent the modelled weighted proportion by monthly survey wave (modelled non‐linearly using restricted cubic splines with five knots) and smoking status. Shaded bands represent 95% CI. Points represent the unmodelled weighted proportion by month. The vertical dashed line indicates the timing of the start of the rise in popularity of disposable vaping in June 2021. *Trends are not reported for recent ex‐smokers in (f) or for never, long‐term ex‐ or recent ex‐smokers in (g) because fewer than 30 participants in these groups endorsed these response options over the entire period, introducing substantial imprecision into the estimates.