Prevalence and uptake of vaping among people who have quit smoking: a population study in England, 2013-2024

Background: Vaping prevalence has increased rapidly in England since 2021. This study estimated trends between 2013 and 2024 in vaping among ex-smokers, overall and among those who did not use e-cigarettes to support their quit attempt. Methods: Data were collected via nationally-representative, monthly cross-sectional surveys in England, October-2013 to May-2024. We analysed data from 54,251 adults (≥18y) who reported having tried to stop smoking in the past year or having stopped smoking more than a year ago. Logistic regression estimated associations between time and e-cigarette use. Findings: Across the period, there were increases in the use of e-cigarettes to support attempts to stop smoking (from 26.9% [24.0-30.0%] in October-2013 to 41.4% [37.7-45.2%] in May-2024), in current vaping among ≥1y ex-smokers (1.9% [1.5-2.5%] to 20.4% [18.7-22.2%]), and in late uptake of vaping after smoking cessation (i.e., current vaping among people who quit smoking before e-cigarettes started to become popular in 2011; 0.4% [0.2-0.8%] to 3.7% [2.8-4.9%]). These increases were non-linear, with much of the change occurring since mid-2021, and were greatest at younger ages (e.g., current vaping among ≥1y ex-smokers reached 58.9% among 18-year-olds vs. 10.7% among 65-year-olds). Interpretation: Vaping prevalence increased substantially among adult ex-smokers in England over the past decade, particularly at younger ages. While this is likely to have been largely driven by increased use of e-cigarettes in quit attempts and continued use thereafter, there was also evidence of increased uptake of vaping among those who had been abstinent from smoking for many years.