Last updated: June 2022
Suggested citation: Greenhalgh, EM, Bain, E, Jenkins, S & Scollo, MM. 18B.3 Prevalence of e-cigarette use. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2022. Available from: http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18b-e-cigarettes
In many countries, including Australia, the use of e-cigarettes is growing, with the highest proportions of users among current smokers.1-5
18B.3.1 Trends in use of e-cigarettes in Australia
The National Drug Strategy Household Survey asked respondents about e-cigarettes for the first time in 2013, and in 2016 and 2019, asked additional questions about frequency of use. Prevalence of ever use of e-cigarettes among Australian smokers, non-smokers (including ex- and never smokers) of various age groups and totals for persons 14 years and over and 18 years and over for all three survey years is set out in Table 18B.3.1.
Lifetime e-cigarette use by smoking status and age, 2013, 2016 and 2019
Sources: National Drug Strategy Household Surveys 2016 key findings, Table 82 and 2019, Table 2.195
*Estimate has a relative standard error of 25% to 50% and should be used with caution
# Statistically significant change between 2013 and 2016, or between 2016 and 2019.
^ 2013 survey youngest age group included 12–17-year-olds however 12 & 13-years olds were not surveyed in 2019
(a) Smoked daily, weekly or less than weekly.
(b) Ex-smokers and never smokers combined; i.e., includes both those who have never smoked more than 100 cigarettes and those who have smoked more than 100 cigarettes but report no longer smoking at time of survey
Note: The question about lifetime use of electronic cigarettes was modified in 2016 and may have impacted how people responded question.
About 11% of the general population aged 14 and over reported in 2019 having ever used e-cigarettes. At 26.1%, ever use was highest among young adults aged between 18 and 24 years, with lower use among older age groups. The proportion of people who had ever used e-cigarettes significantly increased between 2013 and 2016 both among adult smokers (from about 18% to about 31%) and non-smokers (never + ex-smokers; from about 2% to about 5%), and across all age groups except for the oldest. Between 2016 and 2019, ever use increased further among adult smokers (from about 31% to 38%) and among non-smokers (from about 5% to almost 7%). In 2016, the highest rates of ever use appeared to be among 18–24-year-olds (49.1% and 13.6% of smokers and non-smokers, respectively, compared to 30.8% and 4.7% in the total adult population). In 2019 rates of ever use among 18–24-year-olds had increased to 63.9% of smokers and 19.6% of non-smokers.
Frequency of e-cigarette use by smoking status in 2019 is presented in Table 18B.3.2. The proportion of never smokers who had also never used e-cigarettes decreased between 2016 and 2019, with 94.8% of adult never smokers reporting that they had never tried e-cigarettes in 2019 (compared with 96.1% in 2016 and 98.7% in 20136 ). Among ex-smokers, 11.4% reported ever use, compared with 7.5% in 2016 and 3.1% in 2013.6
More than one-third of smokers had tried e-cigarettes in 2019, and 7.8% reported current use (daily, weekly, or monthly).
Frequency of e-cigarette use, people aged 14 years or older, 2019 (per cent)
Source: National Drug Strategy Household Survey 2019, Table 2.225
*Estimate has a relative standard error of 25% to 50% and should be used with caution
** Estimate has a high level of sampling error (relative standard error of 51% to 90%), meaning that it is unsuitable for most uses
(a) Smoked daily, weekly or less than weekly.
(b) Smoked at least 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco in their life, and reported no longer smoking.
(c) Never smoked 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco
Frequency of current use of e-cigarettes by age group and smoking status in 2016 and 2019 is set out in Table 18B3.3.
Prevalence of current use of e-cigarettes (a) by age, 2016 and 2019 (per cent)
Source: National Drug Strategy Household Survey 2019, Table 2.25
*Estimate has a relative standard error of 25% to 50% and should be used with caution.
** Estimate has a high level of sampling error (relative standard error of 51% to 90%), meaning that it is unsuitable for most uses.
# Statistically significant change between 2016 and 2019.
(a) Includes people who reported smoking electronic cigarettes daily, weekly, monthly or less than monthly.
(b) Includes people who reported smoking combustible cigarettes (manufactured and/or roll-your-own) daily, weekly or less than weekly.
(c) Includes those who have never smoked more than 100 combustible cigarettes (manufactured and/or roll-your-own), and those who have smoked this amount of combustible tobacco and report no longer smoking.
The 2020–21 ABS National Health Survey also collected data about use of e-cigarettes in Australia (noting that data collection, including response rates and sample representativeness, was impacted by COVID-19). Almost one in ten (9.3%) people aged 18+ had ever used an e-cigarette, and 2.2% reported currently vaping. In line with the National Drug Strategy Household Survey, vaping was most common among young adults aged 18–24 (see Figure 18B.3.1). Those aged 18–44 years were twice as likely as people aged 45 years and over to report current vaping (3.2% vs. 1.5%). Men were more likely than women to have ever used (11.3% vs. 7.5%) or currently used (2.9% vs. 1.6%) e-cigarettes. Among smokers, 8.9% reported current vaping, and 23.8% were former vapers.7
Figure 18B.3.1 Use of e-cigarettes by age group, Australia, 2020–21
Source: ABS National Health Survey 7
A number of studies have examined the social and demographic characteristics that predict e-cigarette use among Australians (see also Section 18B.12). Analysis of 2016 National Drug Strategy Household Survey data showed that individuals who were male, younger, had higher psychological stress and were current smokers were more likely to be e-cigarette users. Smoking status had the strongest relationship with e-cigarette use.8 Another survey, this time looking at young Australian adults (18-25-years-olds), found positive expectancies about e-cigarettes were associated with increased curiosity and intention to use e-cigarettes.9 A 2017 survey of university students in Queensland found that participants aged 25+ years were more likely than those aged <25 to report daily e-cigarette use, use of nicotine e-liquid, and use as a cessation aid, and less likely to report vaping out of curiosity. Men were more likely than women to report vaping, and to believe that e-cigarettes were less harmful than tobacco cigarettes.10
An online community survey of adults conducted in New South Wales in early 2016 found that 13% had ever used an e-cigarette and, of those, 34% had used an e-cigarette in the past month. Among ever e-cigarette users, 4.6% reported regular daily use over the previous month. Participants who were younger, as well as current and ex-smokers, were more likely to have used e-cigarettes, while women with higher levels of education and income were less likely.11
Researchers have also examined the extent of e-cigarette use and understanding among Aboriginal and Torres Islander peoples in Australia. The National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) found in 2018–19, 8.1% of Aboriginal and Torres Strait Islander adults had ever used e-cigarettes, though the majority were not current users. Men and women did not significantly differ in pattern of e-cigarette use.12 Among smokers about one in five (21%) had tried e-cigarettes in 2013–14. Forty-one per cent had never tried e-cigarettes, and the remaining 38% had not heard of the products.13 E-cigarette use was found to be concentrated in the young adult population, those aged 18–24 and 25–44 had a 2–3 fold greater prevalence of lifetime usage than adults over 45. The prevalence of e-cigarette use was also 3–4 fold higher in major city and regional areas compared to remote areas.13
18B.3.1.1 E-cigarette use among Australian teenagers
Among Australian secondary school students, in 2017, 14% reported that they had ever used an e-cigarette. Use was higher with age, from 4% of 12-year-olds to 21% of 17-year-olds, and boys (17%) were significantly more likely than girls (10%) to report ever-use. Four percent of students had used an e-cigarette in the past month, including 2% who reported using them three or more times over this period. Of those who had tried e-cigarettes, younger students were more likely to have used them recently. About 37% of 12-to-15-year-old users and 27% of 16-and-17-year-old users reported vaping at least once during the past month. Younger vapers were also more likely to have used e-cigarettes at least three times in the past month (12–15: 16%; 16–17: 10%). Two percent of students reported using e-cigarettes three or more times in the past month, with no difference by age group. Of the students who had ever used an e-cigarette, about half (48%) reported that they had never smoked a tobacco cigarette before their first vape. A quarter of these students who had vaped but never smoked, reported later trying tobacco cigarettes—see Figure 18B.3.2.14
Figure 18B.3.2 Previous tobacco smoking (before trying an e-cigarette) among ever e-cigarette users, Australia, 2017
Source: Australian Secondary Students’ Alcohol and Drug Survey 201714
In 2014, 3% of all Australian secondary students had used e-cigarettes exclusively, while 11% reported having concurrently used e-cigarettes with tobacco cigarettes and/or shisha-tobacco. Of the 14% of students who had ever used an e-cigarette, 12% used them exclusively, 55% had used shisha-tobacco, and 65% had smoked tobacco cigarettes at least once in their lifetime. Of the 20% of students who had smoked tobacco cigarettes in their lifetime, 47% had ever used e-cigarettes.15
The 2018–19 National Aboriginal and Torres Strait Islander Health Survey found that 3.8% of Aboriginal and Torres Strait Islander adolescents had ever used e-cigarettes. Though this may underestimate the prevalence of e-cigarette use as adults are often present during NATSIHS data collection.12
18B.3.2 International prevalence of e-cigarette use
International Tobacco Control (ITC) Surveys data show wide variation in the prevalence of use of e-cigarettes between countries surveyed, which may be attributable to a range of factors, including but not solely differences in regulatory approaches (see Sections 18B.8 and 18B.9).16-19 Findings from the 2016 ITC survey of adult smokers and/or e-cigarette users in the US, England, Australia and Canada showed that 11% were dual users (people who both smoke and use e-cigarettes),20 and dual use continues to be a common pattern of use (see also Section 18B.6). Current use of e-cigarettes among adult never smokers appears to be consistently less common than among smokers.
Table 18B3.4 shows results from national surveys on the prevalence of e-cigarette use among adults and, where data is available, by smoking status.
Table 18B.3.4 Prevalence of use of e-cigarettes (per cent) by country and frequency of use
^Frequency of use unless otherwise specified
18B.3.3 Prevalence of e-cigarette use among adolescents
As with adults, the prevalence of e-cigarette use among adolescents varies widely between countries, with use generally higher in high-income countries. Table 18B3.5 shows results from national surveys on the prevalence of e-cigarette use among young people. For a discussion of the predictors and correlates of e-cigarette use among young people, see Section 18B.12.
Table 18B.3.5 Prevalence of use of e-cigarettes (per cent) among young people by country and frequency of use
^Frequency of use unless otherwise specified
Relevant news and research
For recent news items and research on this topic, click here. ( Last updated June 2022)
1. Dai H and Leventhal A. Prevalence of e-cigarette use among adults in the United States, 2014-2018: Research letter. Journal of the American Medical Association, 2019. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31524940
2. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2016 key findings. 2017. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-key-findings/contents/summary
3. Centers for Disease Control and Prevention. QuickStats: Cigarette Smoking Status Among Current Adult E-cigarette Users, by Age Group—National Health Interview Survey, United States, 2015. Morbidity and Mortality Weekly Report, 2016; 65:1177. Available from: http://dx.doi.org/10.15585/mmwr.mm6542a7
4. Action on Smoking and Health. Use of e-cigarettes (vaporisers) among adults in Great Britain. ASH, 2019. Available from: https://ash.org.uk/wp-content/uploads/2019/09/Use-of-e-cigarettes-among-adults-2019.pdf
5. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 - 2. Tobacco smoking chapter, Supplementary data tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data
6. Centre for Behavioural Research in Cancer. Analysis of Australian Institute of Health and Welfare National Drug Strategy Household Survey, 2013 [computer file; Australian Data Archive, The Australian National University]. 2016.
7. Australian Bureau of Statistics. Smoking: 2020-21 financial year. 2022. Available from: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/smoking/2020-21
8. Chan G, Leung J, Gartner C, Yong HH, Borland R, et al. Correlates of electronic cigarette use in the general population and among smokers in Australia - Findings from a nationally representative survey. Addictive Behaviors, 2019; 95:6-10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30784874
9. Jongenelis MI, Brennan E, Slevin T, Kameron C, Jardine E, et al. Factors associated with intentions to use e-cigarettes among Australian young adult non-smokers. Drug Alcohol Rev, 2019; 38(5):579-87. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31317596
10. Wamamili B, Lawler S, Wallace-Bell M, Gartner C, Sellars D, et al. Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys. BMJ Open, 2021; 11(2):e041705. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33563621
11. Twyman L, Watts C, Chapman K, and Walsberger SC. Electronic cigarette use in New South Wales, Australia: reasons for use, place of purchase and use in enclosed and outdoor places. Australian and New Zealand Journal of Public Health, 2018; 42(5):491-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30152006
12. Thurber K, Walker J, Maddox R, Marmor A, Heris C, et al. A review of evidence on the prevalence of and trends in cigarette and e-cigarette use by Aboriginal and Torres Strait Islander youth and adults. The Australian National University: Aboriginal and Torres Strait Islander Health Program; National Centre for Epidemiology and Population Health; Research School of Population Health, 2020. Available from: https://openresearch-repository.anu.edu.au/bitstream/1885/210569/1/Aboriginal%20cigarette%20ecigarette%20prevalence%20trends_2020.pdf
13. Thomas DP, Lusis N, Van der Sterren AE, and Borland R. Electronic Cigarette Use and Understanding Among a National Sample of Australian Aboriginal and Torres Strait Islander Smokers. Nicotine & Tobacco Research, 2019; 21(10):1434-40. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30053109
14. Guerin N and White V. Secondary school students’ use of tobacco, alcohol and other drugs in 2017: Second Edition. Cancer Council Victoria, 2020. Available from: https://www.health.gov.au/resources/publications/secondary-school-students-use-of-tobacco-alcohol-and-other-drugs-in-2017
15. Williams T and White V. What Factors are Associated with Electronic Cigarette, Shisha-Tobacco and Conventional Cigarette Use? Findings from a Cross-Sectional Survey of Australian Adolescents? Substance Use and Misuse, 2018; 53(9):1433-43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29336657
16. Gravely S, Fong GT, Cummings KM, Yan M, Quah AC, et al. Awareness, trial, and current use of electronic cigarettes in 10 countries: findings from the ITC project. International Journal of Environmental Research and Public Health, 2014; 11(11):11691–704. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25421063
17. Gravely S, Fong GT, Cummings KM, Yan M, Quah AC, et al. Correction: Gravely, S., et al. Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project. Int. J. Environ. Res. Public Health 2014, 11, 11691-11704. International Journal of Environmental Research and Public Health, 2015; 12(5):4631–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25922990
18. Lee C, Yong HH, Borland R, McNeill A, and Hitchman SC. Acceptance and patterns of personal vaporizer use in Australia and the United Kingdom: Results from the International Tobacco Control survey. Drug and Alcohol Dependence, 2018; 185:142-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29448147
19. Li L, Borland R, Cummings KM, Gravely S, Quah ACK, et al. Patterns of non-cigarette tobacco and nicotine use among current cigarette smokers and recent quitters: Findings from the 2020 ITC Four Country Smoking and Vaping Survey. Nicotine & Tobacco Research, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33693833
20. Borland R, Murray K, Gravely S, Fong GT, Thompson ME, et al. A new classification system for describing concurrent use of nicotine vaping products alongside cigarettes (so-called 'dual use'): findings from the ITC-4 Country Smoking and Vaping wave 1 Survey. Addiction, 2019; 114 Suppl 1:24–34. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30702175
21. Ministry of Health. New Zealand Health Survey. New Zealand Government, 2019–20. Available from: https://www.health.govt.nz/nz-health-statistics/national-collections-and-surveys/surveys/new-zealand-health-survey
22. European Commission. Special Eurobarometer 506: Attitudes of Europeans towards tobacco and electronic cigarettes (S2240_506_ENG). 2021. Available from: http://data.europa.eu/88u/dataset/S2240_506_ENG
23. Organisation for Economic Co-operation and Development and Health Division, Non-medical determinants of health: use of vaping products. Paris: OECD; 2021. Available from: http://www.oecd.org/els/health-systems/health-data.htm.
24. Use of e-cigarettes among adults in Great Britain. Action on Smoking and Health (ASH), 2021. Available from: https://ash.org.uk/wp-content/uploads/2021/06/Use-of-e-cigarettes-vapes-among-adults-in-Great-Britain-2021.pdf
25. World Health Organization. Global Adult Tobacco Survey. Available from: https://www.who.int/teams/noncommunicable-diseases/surveillance/data
26. Kilibarda B, Krstev S, Milovanovic M, and Foley K. E-cigarette use in Serbia: Prevalence, reasons for trying and perceptions. Addictive Behaviors, 2019; 91:61-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30473245
27. East KA, Reid JL, and Hammond D. Smoking and vaping among Canadian youth and adults in 2017 and 2019. Tobacco Control, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34272339
28. Statistic Canada. Canadian Tobacco and Nicotine Survey, 2019. 5305. Government of Canada, 2020. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/200305/dq200305a-eng.htm
29. Cornelius ME, Wang TW, Jamal A, Loretan CG, and Neff LJ. Tobacco product use among adults—United States, 2019. Morbidity and Mortality Weekly Report, 2020; 69(46):1736.
30. Bertoni N, Szklo A, Boni R, Coutinho C, Vasconcellos M, et al. Electronic cigarettes and narghile users in Brazil: Do they differ from cigarettes smokers? Addictive Behaviors, 2019; 98:106007. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31247536
31. Cavalcante TM, Szklo AS, Perez CA, Thrasher JF, Szklo M, et al. Electronic cigarette awareness, use, and perception of harmfulness in Brazil: findings from a country that has strict regulatory requirements. Cad Saude Publica, 2017; 33Suppl 3(Suppl 3):e00074416. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28954048
32. Action on Smoking and Health UK. Use of e-cigarettes among young people in Great Britain. 2021. Available from: https://ash.org.uk/information-and-resources/fact-sheets/statistical/use-of-e-cigarettes-among-young-people-in-great-britain-2021/
33. Zavala-Arciniega L, Reynales-Shigematsu LM, Lozano P, Rodriguez-Andrade MA, Arillo-Santillan E, et al. Patterns of awareness and use of electronic cigarettes in Mexico, a middle-income country that bans them: Results from a 2016 national survey. Preventive Medicine, 2018; 116:211-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30261244
34. Zhao Z, Zhang M, Wu J, Xu X, Yin P, et al. E-cigarette use among adults in China: findings from repeated cross-sectional surveys in 2015-16 and 2018-19. Lancet Public Health, 2020; 5(12):e639-e49. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33271077
35. Tabuchi T, Gallus S, Shinozaki T, Nakaya T, Kunugita N, et al. Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol. Tobacco Control, 2018; 27(e1):e25-e33. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29248896
36. Chang Y, Cho S, Kim I, and Khang YH. Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys. International Journal of Environmental Research and Public Health, 2019; 16(22). Available from: https://www.ncbi.nlm.nih.gov/pubmed/31766232
37. Ab Rahman J, Mohd Yusoff MF, Nik Mohamed MH, Mahadir Naidu B, Lim KH, et al. The Prevalence of E-Cigarette Use Among Adults in Malaysia. Asia-Pacific Journal of Public Health, 2019; 31(7_suppl):9S–21S. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30880403
38. Ministry of Health and Welfare’s Health Promotion Administration. Adult Smoking Behavior Survey (ASBS). 2021. Available from: https://www.hpa.gov.tw/EngPages/Detail.aspx?nodeid=1077&pid=6202
39. Jordan Health Ministry and World Health Organization. Jordan smoking rates highest in world amid claims of big tobacco interference. 2020. Available from: https://www.theguardian.com/world/2020/jun/23/jordan-smoking-rates-highest-in-world-amid-claims-of-big-tobacco-interference
40. Yoong SL, Hall A, Leonard A, McCrabb S, Wiggers J, et al. Prevalence of electronic nicotine delivery systems and electronic non-nicotine delivery systems in children and adolescents: a systematic review and meta-analysis. Lancet Public Health, 2021; 6(9):e661-e73. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34274048
41. Ball J, Fleming T, Drayton B, Sutcliffe K, Lewycka S, et al. New Zealand Youth19 survey: vaping has wider appeal than smoking in secondary school students, and most use nicotine-containing e-cigarettes. Australian and New Zealand Journal of Public Health, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34648227
42. Tarasenko Y, Ciobanu A, Fayokun R, Lebedeva E, Commar A, et al. Electronic cigarette use among adolescents in 17 European study sites: findings from the Global Youth Tobacco Survey. European Journal of Public Health, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34694383
43. Health Canada. Canadian Student Tobacco, Alcohol and Drugs Survey 2018-19. 2019. Available from: https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey/2018-2019-summary.html
44. Park-Lee E, Ren C, Sawdey MD, Gentzke AS, Cornelius M, et al. Notes from the Field: E-Cigarette Use Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021. Morbidity and Mortality Weekly Report, 2021; 70(39):1387-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34591834