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

Abstract

AbstractBackground and aimsIn 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.DesignNationally‐representative, cross‐sectional household survey, July 2016 to January 2024.SettingGreat Britain.Participants7981 adult vapers.MeasurementsParticipants 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.FindingsThe 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.ConclusionsUse 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.