“There is an epidemic of youth vaping!” They say, showing a picture of a JUUL or pod-style device in the hands of someone too young to legally buy it.
They release ominous videos telling us that vaping “reprograms your brain” and warn of the spectre of a gateway to smoking at every opportunity.
They want parents to be scared, and they apparently don’t want teens vaping under any circumstances.
But if you take a step back from the hyperbole and raise a sceptical eyebrow instead of a pitchfork when faced with an unlikely claim, the picture becomes less clear-cut and the nuances start to seem all the more important.
If there is an “epidemic” of teen vaping in the US, what is happening to the smoking rate? Is it non-smoking teens who vape, or is it mainly confined to smokers? How do vaping rates compare to things like drinking rates or illegal drug use rates?
What we need in this debate isn’t anger and knee-jerk reactions: it’s the data and an open mind.
So we’ve put together some key statistics about vaping and smoking in the UK, US and Australia, to take a look at the issue without putting on our ideological glasses. What does the data really tell us?
Smoking Rates vs. Vaping Rates – UK
The most basic data on the topic is the most informative, because it tells us how many teens vape, how many smoke and how those percentages are changing with time.
In the UK, youth smoking rates are reported in “Smoking, Drinking and Drug Use Among Young People in England” survey, which is conducted in secondary schools and covers students in years 7 to 11 (i.e. mainly 11 to 15 years old).
In this survey, “regular” smoking is classed as once a week or more, and “occasional” smoking is classed as smoking less than once a week. The results show a decline in regular smoking and having ever smoked from 2011 to 2016 (the date of the most recent survey), while occasional smoking has remained constant.
For vaping, ASH UK’s survey looks at the data on young people’s vaping and has been updated every year since 2013, covering people aged 11 to 18.
The results show an increase in vaping as smoking has become less common. While there’s been a dramatic increase in under 18’s who have tried vaping, there’s been a much smaller increase in those who vape on a regular basis.
Smoking Rates vs. Vaping Rates – US
In the US, the National Youth Tobacco Survey tracks the same basic data, and this is undertaken every year in middle schools and high schools.
The results follow a similar trend to the UK, with vaping generally increasing from 2011 to 2015, before declining slightly through to 2017.
Again this was accompanied by a dramatic fall in smoking rates.
Smoking Rates vs. Vaping Rates – Australia
Australia is a little different to the US and UK. Nicotine-containing e-cigarettes are banned, and some localities have even more strict rules around even the possession of vaping devices.
However, the picture in Australia (based on the Australian Secondary Students Use of Tobacco, Alcohol, Over-the-Counter Drugs, and Illicit Substances survey) still roughly reflects the ones in the US and UK, with smoking declining among 12 to 17 year olds from 2011 to 2017 (regardless of intensity) and a much more modest rise in vaping from 2014 to 2017 (because the question wasn’t asked in 2011).
The Size of the Declines in Smoking
One notable difference is that the declines in smoking between Australia, the US and the UK aren’t all the same size.
“Smoking in the past week” (or the closest measure to it – more than 5 days in the past month for the US data), has seen a 58 percent decline in the US from 2011 to 2017, a 45 percent decline in the UK from 2011 to 2016, and just a 25 percent decline in Australia.
The decline in “ever having smoked” is similar between the UK and Australia (24 and 27 percent, respectively), but in the US there has been a 43 percent drop in the numbers who have ever smoked.
“Past week smoking” amongst youths is also at 5 percent in Australia, compared to 2.4 percent in the US and 3 percent in the UK, in the most recent year for the survey and the closest measure to “weekly smoking” available. Weekly vaping in Australia stands at about 1.7 percent (although this is likely dominated by nicotine-free vaping), compared to 2 percent in the UK and 3.2 percent in the US.
In short, it seems the US and the UK have bigger declines in smoking than Australia, although all three countries are seeing a reduction in youth smoking since 2011. Clearly, reductions in smoking aren’t proof by themselves that vaping is responsible (because it is still declining in Australia, where there is much less vaping), but there is still a notable difference in the speed of the decline between countries with different levels of vaping.
Are Never-Smokers Vaping Regularly?
One of the central claims of people concerned about youth vaping is that teens who’ve never smoked are picking up vaping in worrying numbers. However, data from the three countries lets us address this concern directly.
Overall, regular vaping is much more common in smokers than never-smokers. For instance, in the US, about 1 percent of never-smokers vaped regularly (more than five days in the past month), compared to 40 percent of smokers. In the UK, 0 percent (i.e. less than 0.5 percent) of never-smokers vaped weekly, compared to 16 percent of smokers. In Australia, based on data for the whole population aged 14 or older (no other data is available on this point), 0.1 percent of never-smokers vaped weekly and 0.2 percent vaped daily, making 0.3 percent on a comparable “regular vaping” measure. In contrast, 2.7 percent of smokers vaped weekly or more.
In short, regular vaping among never-smokers is uncommon in all of these countries, whereas among smokers regular vaping is much more likely.
Vaping, Smoking, Drinking and Other Drugs
It goes without saying that vaping is being presented as an epidemic in the US and elsewhere at present, but it’s important to remember that vaping and smoking aren’t the only potentially dangerous behaviours teenagers become involved in. So, bringing in the Monitoring the Future survey for some additional US data, how does the vaping “epidemic” compare to other risky behaviours, like drinking and drug use?
In a nutshell, in all three countries, vaping is less common than drug use, and in the UK and Australia especially it is much less common than drinking alcohol.
Why are children vaping?
What this data here doesn’t tell us is why children are using electronic cigarettes.
But there is a clue buried deep in the 2016 NHS report on Smoking Drinking and Drug use (table 3.24 here). That tells us that 39% of former smokers used e-cigarettes to give up, which compares to just 1% that used NHS stop smoking services.
Facts vs. Fears
Many people would love to live in a world where teens didn’t vape, didn’t smoke, didn’t drink, didn’t do drugs and didn’t do a whole bunch of things. And that’s understandable. But whatever your fears about teen vaping are – many of which are understandable – you need to look at the actual numbers to see whether they’re justified.
So this post has presented the facts and figures. How you choose to interpret them is up to you, but it seems hard to avoid the link between higher vaping rates and faster declines in smoking that jump out of the statistics, and it’s hard to argue that vaping is more of a concern than drug use or drinking, giving that both are more common.