Global Youth Smoking Trends: E-cigarette Use Surpasses Cigarettes

Global Youth Smoking Trends E-cigarette Use

The World Health Organization (WHO) and global tobacco industry watchdog “STOP” have recently released a report titled “Hooking the Next Generation,” urging governments worldwide to protect youth from the harms of the tobacco and nicotine industries. This report comes in light of the upcoming World No Tobacco Day on May 31, as governments, health organizations, and monitoring groups release data on youth smoking in their respective countries. Ecigator, a leading authority on e-cigarette trends and research, has compiled and analyzed youth smoking data from various countries, revealing a notable decline in youth smoking rates but a concerning rise in e-cigarette use.

The HBSC (Health Behaviour in School-aged Children) study, initiated by the WHO and conducted every four years in collaboration with the WHO European Regional Office, is the largest and most comprehensive school survey to date. Covering 280,000 youths aged 11, 13, and 15 from 44 countries, the study aims to ascertain the current status of substance use among young people, including smoking, e-cigarette use, drinking, drunkenness, and cannabis use, as well as the role of gender, age, and social inequalities in these behaviors.

The latest 2021/2022 HBSC survey data reveals that approximately 37 million children aged 13 to 15 globally use tobacco, with the smoking rate among youths aged 11 to 15 decreasing by 2% from four years earlier to 13% in 2022. While this decline in traditional cigarette use is encouraging, the study also highlights the increasing popularity of e-cigarettes and other new tobacco and nicotine products among young people.

In most countries surveyed, the rate of e-cigarette use has now surpassed that of rolled cigarettes, with youth e-cigarette use even exceeding that of adults in some cases. The study shows that the smoking rate among 15-year-olds stands at 15%, while the e-cigarette usage rate is 19.5%, with 15-year-old boys using e-cigarettes at a rate of 26% and girls at an alarming 40%. Among 13-year-olds, the smoking rate is 5.5%, and e-cigarette usage is 9%, while nearly 10% of 11-year-olds report having used an e-cigarette at least once.

Country-Specific Youth Smoking Situations

To gain a more comprehensive understanding of the global youth smoking landscape, it is essential to examine country-specific data and trends. Ecigator has analyzed youth smoking data from several countries, including the United States, United Kingdom, Southeast Asian nations, Australia, Switzerland, and Germany, to provide a more nuanced picture of the situation.

Country-Specific Youth Smoking Situations

United States: Girls’ E-cigarette Use Rate Approaching Adult Levels

In the United States, data from a risk behavior survey of 57,006 students in grades 9 through 12 from 2015 to 2021 indicates that the e-cigarette usage rate among American students declined to 5% in 2021, more than doubling since 2015. Notably, the proportion of girls using e-cigarettes (5.6%) was higher than that of boys (4.5%) in 2021, increasing by 125% since 2015. Perhaps most concerning is that the girls’ rate of e-cigarette use in 2021 (5.6%) was only slightly lower than the adult usage rate of 6% in 2022, suggesting that young girls are rapidly catching up to adult levels of e-cigarette consumption.

United Kingdom: Tripling of Young People’s E-cigarette Use Rate Within Two Years

In the United Kingdom, a youth smoking situation survey conducted by the UK’s Action on Smoking and Health (ASH) from February to March 2024 found that the number of e-cigarette users aged 11 to 17 has significantly increased since before the pandemic, rising from 4.4% in 2019 to 7.6% in 2024. This trend is further supported by a University College London (UCL) study, which surveyed 132,252 Britons about their e-cigarette and smoking behaviors from July 2016 to May 2023. The UCL study revealed that from May 2021 to May 2023, the smoking rate among British young people aged 18 to 24 decreased from 25% to 21%, while the overall nicotine usage rate increased from 28% to 35%. Most alarmingly, the proportion using e-cigarettes tripled within two years, rising from 9% to 29%, driven largely by the popularity of disposable e-cigarettes in the country.

Southeast Asia: Steady Rise in Youth E-cigarette Use Despite Declining Cigarette Use

Southeast Asian countries, such as Malaysia, Thailand, the Philippines, and Vietnam, have also witnessed a decline in cigarette use among 13 to 15-year-olds, according to the WHO’s Global Youth Tobacco Survey (GYTS). However, this decline has been accompanied by a steady increase in e-cigarette use. In 2022, the e-cigarette usage rate among Malaysian boys was 23.5%, and girls 6.2%; in Thailand, 20.2% of boys and 15% of girls used e-cigarettes; and in the Philippines, in 2019, 20.9% of boys and 7.5% of girls used e-cigarettes.

The results of the Global Adult Tobacco Survey released in 2023 showed that over the past 12 years, the number of e-cigarette users in Malaysia has significantly increased by 600%, rising from 0.8% in 2011 to 5.8% in 2023. Among the 15 to 24 age group, e-cigarette usage increased from 1.1% in 2011 to 8.6% in 2023.

In Vietnam, a report from the Ministry of Health indicated that while the smoking rate among the 13-17 age group decreased from 5.36% in 2013 to 2.78% in 2019, and among the 13-15 age group decreased from 2.5% to 1.9%, the proportion of youths using e-cigarettes and heated tobacco products is on the rise. Among the 13-17 age group, the e-cigarette usage rate increased from 2.6% in 2019 to 8.1% in 2023; and among the 13-15 age group, from 3.5% in 2022 to 8% in 2023.

Australia: Sharp Increase in Usage Rates Among 18-24 Age Group

The latest report from the Australian Institute of Health and Welfare (AIHW) shows a significant increase in e-cigarette use among young Australians aged 18 to 24. Over two years, the number of 18-24 year-old Australians who used an e-cigarette more than 3000 times increased from 18.5% to 36.5%. This sharp increase in usage rates among young adults highlights the need for targeted interventions and policies to address the growing popularity of e-cigarettes in this age group.

Switzerland: Rising Snus Consumption Among Swiss Youths, Both Genders Affected

In Switzerland, research data released by the Swiss Addiction Research Foundation (Sucht Schweiz) shows that snus consumption among Swiss youths is also on the rise. The proportion of 15-year-old boys using snus at least once a month doubled from 2018 to 2022, reaching 13%, while among girls of the same age, the proportion increased from 1% to 6%. This trend suggests that both genders are increasingly turning to alternative tobacco products, such as snus, which may be perceived as less harmful than traditional cigarettes.

Germany: Significant Decline in Youth Smoking Rates, but Increase in Disposable E-cigarette Use

Germany has seen a significant decline in youth smoking rates since 2001, according to the latest survey data released by the German Federal Centre for Health Education (BZgA). The proportion of 12 to 17-year-olds who have never smoked reached 83%, and among 18 to 25-year-olds, 47%. The proportion of male youth smokers decreased from 27.2% in 2001 to 9.3% in 2015, and further to 7.2% in 2023; among 12 to 17-year-old females, the smoking rate decreased from 27.9% in 2001 to 6.1% in 2016, stabilizing at 6.4% in 2023. The smoking rate among the 18 to 25 age group is also decreasing, with 33.6% of young men and 18.4% of young women being smokers.

Despite these positive trends in traditional cigarette use, the survey also revealed that regardless of age group, both 12 to 17-year-olds and 18 to 25-year-olds prefer disposable e-cigarettes. Over the past 30 days, about 7% of 12 to 17-year-olds and 12% of 18 to 25-year-olds used a disposable e-cigarette, indicating a shift in preferences towards these more convenient and potentially appealing products.

Conclusion: Urgent Need for Action to Protect Youth from Tobacco and Nicotine Harms

The global youth smoking trends analyzed by Ecigator, based on data from the WHO, national health organizations, and research institutions, paint a complex picture of the current landscape. While the decline in traditional cigarette use among young people is a positive development, the rising popularity of e-cigarettes and other new tobacco and nicotine products is a cause for concern.

As e-cigarette use surpasses that of rolled cigarettes in most countries, and youth usage rates approach or even exceed adult levels in some cases, it is clear that urgent action is needed to protect the next generation from the harms associated with these products. Governments and health organizations must continue to monitor these trends closely and implement evidence-based policies and interventions to prevent youth from becoming addicted to tobacco and nicotine.

The upcoming World No Tobacco Day serves as a timely reminder of the importance of this issue and the need for concerted efforts to safeguard the health and well-being of young people worldwide. By working together to address the challenges posed by the evolving tobacco and nicotine landscape, we can create a healthier, smoke-free future for all.

Matthew Ma