The second found that, when used in conjunction with nicotine patches, tank e-cigarettes increased abstinence when compared to nicotine patches used alone or with placebo e-cigarettes 12. The first found that they almost doubled the rate of successfully quitting smoking after 12 months when compared with nicotine replacement therapy 5. Two recent randomised controlled trials demonstrated the effectiveness of tank e-cigarettes for smoking cessation. They can deliver a similar amount of nicotine to cigarettes and satisfy cravings to smoke 14. These refillable tank devices tend to have a fixed power output, so the temperature to which e-liquid is heated remains relatively constant. They come in a variety of shapes, but most are the size of a fountain pen. Tank e-cigarettes have a rechargeable battery and a tank that can be replenished with bottled e-liquid. Compared with newer devices, these deliver less nicotine 4 and, as a result, may be less effective at helping people quit smoking 6. But their effectiveness for smoking cessation may depend on the specific device used.ĭisposable cigarette shaped devices, also known as cigalikes, were the first type of e-cigarette to enter the market in England. Evidence from randomised controlled trials 5, 7, 12 and observational studies 1, 13 indicates that nicotine e-cigarettes can increase the likelihood that people will succeed in their attempts to stop smoking cigarettes. The UK has taken a policy approach that attempts to benefit from the use of e-cigarettes for smoking cessation, while minimising risks from youth use 11.
However, public health bodies have differing attitudes towards the overall impact of e-cigarettes on public health, with some emphasising their potential use for smoking cessation while others highlighting risks to young non-smokers 10. e-Cigarette use is widely recognised as less harmful to health than cigarette smoking, since users are exposed to much lower levels of toxicants and carcinogens 2, 8, 9. e-Liquid usually contains nicotine alongside propylene glycol, glycerol and flavourings. The most commonly used form of HANDS in England are e-cigarettes: hand-held electronic devices that heat a liquid, called an e-liquid, in order to produce an aerosol for inhalation. In this paper, we explore trends in the use of different e-cigarette device types and heated tobacco products in England, from 2016 to 2020. It is therefore important to explore how the number of people using different device types and nicotine concentrations is changing, alongside a regulatory environment that may incentivise or discourage use of certain products. These can vary considerably in their potential to produce toxicants and carcinogens 2, delivery of nicotine 3, 4, and effectiveness in helping people stop smoking combustible cigarettes 5, 6, 7.
e-Cigarettes encompass a variety of different products, from bulky mod e-cigarettes to small cigarette shaped cigalikes. Over the past decade, HANDS-principally e-cigarettes-have eclipsed nicotine replacement therapy as the most widely used aids for stopping smoking in England 1. These include electronic cigarettes (“e-cigarettes”) and heated tobacco products (HTPs). Heated aerosolized nicotine delivery systems (HANDS) are handheld devices that heat either nicotine-infused liquid or tobacco sticks, producing an aerosol that can be inhaled. In conclusion, despite growing popularity of pods and HTPs worldwide, refillable tank e-cigarettes remain the most widely used device type in England. Among e-cigarette/HTP users, ex-smokers were more likely than current smokers to use mod and tank e-cigarettes, but less likely to use pods, disposables, JUUL and HTPs. Among all e-cigarette/HTP users, prevalence of HTP use remains rare (3.4% in 2016 versus 4.2% in 2020), whereas JUUL use has risen from 3.4% in 2018 to 11.8% in 2020.
Mods were second until 2020, when pods overtook them. Tanks were the most widely used device type throughout 2016–2020. Of 75,355 participants, 5.3% (weighted = 5.5%) were currently using e-cigarettes or HTPs, with the majority (98.7%) using e-cigarettes. Bayesian logistic regression was used to estimate proportions and 95% credible intervals (CrIs).
Data were from a representative repeat cross-sectional survey of adults aged 16 or older. This study examined use trends of e-cigarette devices types, heated tobacco products (HTPs) and e-liquid nicotine concentrations in England from 2016 to 2020.