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. 2025 Jun 26:55:101352.
doi: 10.1016/j.lanepe.2025.101352. eCollection 2025 Aug.

Evolution of nicotine product use in Ireland 2015-2023, and associations with quit intentions and attempts: an analysis of nationally representative repeated cross-sectional surveys

Margaret M Brennan  1   2 , Andrea K Bowe  3 , Aishling Sheridan  4 , Frank Doyle  5 , Fiona Boland  6 , Paul Kavanagh  1   4   7
Affiliations

Evolution of nicotine product use in Ireland 2015-2023, and associations with quit intentions and attempts: an analysis of nationally representative repeated cross-sectional surveys

Margaret M Brennan et al. Lancet Reg Health Eur. .

Abstract

Background: Nicotine product use (NPU; including combustible tobacco products and/or e-cigarettes) is changing rapidly worldwide. Aiming to inform an agile policy response, this study examined NPU trends, and associations with intentions and attempts to quit tobacco.

Methods: Survey-weighted prevalences of NPU (tobacco and/or e-cigarette), tobacco, e-cigarette, and dual (tobacco and e-cigarette) use were estimated from 2015 to 2023 (excluding 2020 and 2021) using seven waves of the nationally representative Healthy Ireland survey (combined N = 52,167). Associations between sociodemographic factors and NPU, as well as between NPU and quit intentions and attempts, were examined using survey-weighted regression in the 2015 and 2023 waves.

Findings: Between 2015 and 2023, decreases in NPU were non-significant (24·6% (1846/7502) to 22·9% (1688/7356), ptrend = 0·120), while tobacco use decreased (22·8% (1713/7502) to 17·7% (1303/7356), ptrend = 0·012), e-cigarette use increased (3·1% (230/7502) to 8·4% (614/7356), ptrend = 0·001) and dual use increased (1·3% (97/7502) to 3·1% (230/7356), ptrend = 0·006). Among those aged 15-24, NPU increased from 19·6% (214/1095) in 2015 to 30·0% (345/1149) in 2023. In 2015, dual use was strongly associated with higher odds of quit intentions and attempts to quit tobacco, compared to tobacco-only, but this was no longer the case in 2023.

Interpretation: E-cigarette and dual use have more than doubled in Ireland, while tobacco declines have slowed. The most substantial changes occurred among 15-24-year-olds. Concurrently, the link between dual use and quit intentions and attempts attenuated. These findings underscore the need for stronger e-cigarette regulation and renewed policy efforts to achieve tobacco endgame in Ireland.

Funding: None.

Keywords: Dual use; E-cigarette regulation; E-cigarette use; Population health; Quit attempts; Quit intentions; Tobacco control; Tobacco use; Trends.

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Conflict of interest statement

FD has received research funding from the Health Services Executive to explore tobacco use. FD has received research funding from the Health Research Board to explore tobacco use. PK is a Member of the Organising Committee for 9th European Conference on Tobacco or Health 2023 and was supported with travel, accommodation and registration fee for this conference by the organisers incl European Cancer Leagues. PK is a Council Member, Action on Smoking and Health (ASH), Ireland (unpaid). PK is a Member, Tobacco Policy Advisory Group, Royal College of Physicians in Ireland (unpaid). All other authors (MMB, AKB, FB and AS) declare no competing interests.

Figures

Fig. 1
Fig. 1
Trends in survey-weighted prevalence and 95% confidence intervals for nicotine, tobacco, e-cigarette and dual use, 2015–2023 in the overall study population (a) and among those aged 15–24 (b).
See this image and copyright information in PMC

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