e-cigarettes and shisha – gateways to regular smoking among british youth? martin dockrell frsph...
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E-cigarettes and Shisha – Gateways to regular smoking among British youth?
Martin Dockrell FRSPHDirector of Policy & ResearchAction on Smoking & Health
E-cigarette use among adults has increased rapidly
9%3% 7%
22%
34%
11%
0%
20%
40%
Currently use e-cigarettes Have ever tried e-cigarettes
2010 2012 2013
E-cigarette use among adult smokers in Great Britain
…but current use remains confined largely to current and ex-smokers
11%
24%
67%69%
57%
29%21%
7%3% 2% 2%
1% 5%0%
25%
50%
75%
100%
Never smoked(5972)
Ex-smoker (4303) Smoker (2009)
Don’t know
I have never heard ofe-cigarettes and havenever tried them
I have heard of e-cigarettes but havenever tried them
I have tried e-cigarettes but do notuse them (anymore)
I have tried e-cigarettes and still usethem
E-cigarette use in Britain, 2013(All adults)
Children who have never smoked rarely use e-cigarettes
E-cigarette use among children in Britain, 2013(All children, by smoking status N=12,171)
37%21%
14% 9% 12% 10%
62%
72%71%
68%53%
35%
6% 17%33%
44%
5%3%
7%4%5%4%6%
1%
0%
25%
50%
75%
100%
Neversmoked
Triedsmoking
once
Used tosmoke
Smoke <1 aweek
Smoke 1-6 a week
Smoke 6+ aweek
Don't want to say
I use them often(more than once aweek)
I use themsometimes (morethan once a month)
I have tried themonce or twice
I have never usedthem
Never heard of them
N=1680 N=235 N=74 N=79 N=26 N=60
43%
17%
54%
74%
2%
6%
1%
1%
1%
0%
0%
0%
0% 20% 40% 60% 80%
11 to
15
(N=
1328
)16
to 1
8 (N
=85
0) Wont say
I use them often (morethan once a week)
I use them sometimes(more than once amonth)
I have tried them onceor twice
I have never used them
Not heard of them
E-cigarette use in Britain, 2013(All children, by age)
Weekly use is rare and confined to older children
2 out of 3 children who had used e-cigarettes had not used them in the last month
64%
28%
0%
20%
40%
60%
80%
100%
Yes No
Have you used an e-cigarette in the last month? (Children who have ever used e-cigarettes N=97)
Children who have never used e-cigarettes don’t expect to try soon
93%
1% 6%0%
20%
40%
60%
80%
100%
All children who have never tried e-cigarettes
Yes Don’t know No
Do you expect you will try e-cigarettes soon? (Children who have never used e-cigarettes N=2075)
Shisha use is rare but more common among younger adults
6%2% 1% 1%
20% 18%
10%
57%61%
72%76% 76%
2% 3% 1% 1% 1%
12% 13% 15% 16%19%
5%3%
0%
20%
40%
60%
80%
18-24 25-34 35-44 45-54 55+
More than 3 to 4times a month
Once or twice amonth
Once or twiceevery 2 to 3monthsOnce every 6 to 12months
Less often
Never
Don’t know/ can’tremember
Not applicable – donot know what ashisha pipe is
Shisha use among adults in Britain, 2013 (N=12,171)
N=1324 N=1180 N=1758 N=2351 N=5558
58%
33%
33%
62%
7%
4%
1%
0%
0%
0%
0%
0%
0 0.25 0.5 0.75 1
Shi
sha
e-ci
gare
ttes
Wont say
I use them often(more than once aweek)I use them sometimes(more than once amonth)I have tried them onceor twice
I have never usedthem
Never heard of them
Shisha and e-cigarette use and awareness byChildren (N=2178)
Shisha use is more common than e-cigarette use among children
Awareness if shisha is lower among younger children
27%
67%
70%
30%
4%
3%
0% 25% 50% 75% 100%
11 to
15
(N=
1382
)16
to 1
8 (N
=85
0)
Don’t know
Not heard ofshisa
Heard ofshisha
Heard of shisha (All children by age)
Awareness of shisha is lower among never smokers
42%
67%
54%
30%
3%
3%
0% 25% 50% 75% 100%
All
(217
8)N
ever
sm
oked
(170
0) Don’t know
Not heard of shisah
Heard of shisha
All Children (N=2178)
1 in 5 older children have tried shisha
73%
33%
24%
48%
2%
15%
0%
3%
0%
0%
0% 25% 50% 75% 100%
11 to
15
(N=
379)
16 to
18
(N=
509)
Don't want to say
I use shisha often(more than once aweek)I use shishasometimes (morethan once a month)I have tried shishaonce or twice
I have never usedshisha
Never heard ofshisha
Shisha use and awareness(All children, by age)
Never smokers rarely try shisha
66%
32%36%
13%
23% 23%
31%
47%
37%
18%23%
32%
39%38%
21%
3%
14%9%
2%2%
9%
2%4%
0%
25%
50%
75%
never smokednot even a puff
or two
only ever triedsmoking once
used to smokesometimes
<1 a week 1-6 cigarettesa week
>6 cigarettes aweek
Never heard ofshisha
I have never usedshisha
I have tried shishaonce or twice
I use shishasometimes (morethan once a month)
I use shisha often(more than once aweek)
Don't want to say
Shisha use and awareness (All children, by smoking status)
N=573 N=159 N=47 N=69 N=20 N=46
Children who have never used shisha don’t expect to try soon
91%
2% 7%0%
20%
40%
60%
80%
100%
All children who have never tried shisha
Yes Don’t know No
Do you expect you will try shisha soon? (Children who have never used shisha N=1988)
7% of 18 year olds who have not yet tried shisha expect to try soon
Conclusions• e-cigarette use is a growing phenomenon
• but current use among children remains relatively rare and confined to older children and smokers
• Shisha use is almost twice as common but is also confined almost entirely to older children and smokers. However, more expect to start soon.
• We found negligible shisha smoking or e-cigarettes use among children who have never smoked so far
• When a young person smokes cigarettes every day and shisha once a month, tackle the cigarette smoking with the shisha use
• We need bigger, better, faster evidence to inform policy