18B.3 Prevalence of e-cigarette use

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.

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).

Table 18B.3.2 
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

Table 18B.3.3 
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)

     

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