ArticleThe International journal on drug policy2020
Young people's use of e-cigarettes in Wales, England and Scotland before and after introduction of EU Tobacco Products Directive regulations: a mixed-method natural experimental evaluation.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- A systematic review and network meta-analysis of population-level interventions to tackle smoking behaviour.Nature human behaviour · 2024Pooled it
- A systematic review for the impacts of global approaches to regulating electronic nicotine products.Journal of global health · 2023Pooled it
- An International Systematic Review of Prevalence, Risk, and Protective Factors Associated with Young People's E-Cigarette Use.International journal of environmental research and public health · 2022Pooled it
- Association between household secondhand tobacco smoke exposure and regular e-cigarette use among adolescents: evidence from a national school-based survey.European journal of public health · 2025Article
- The Role of e-Cigarette Packaging as a Health Communications Tool: A Focus Group Study With Adolescents and Adults in England and Scotland.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Young people's experiences of vaping in their community: a co-created study between embedded researchers and local authority public health practitioners.Perspectives in public health · 2025Review
- Bigger, stronger and cheaper: growth in e-cigarette market driven by disposable devices with more e-liquid, higher nicotine concentration and declining prices.Tobacco control · 2025Article
- Scoping of Policy Impacts for Regulating E-cigarettes (SPIRE): findings from a data and decision analytic model mapping project.NIHR open research · 2025Article
- Data Resource Profile: The School Health Research Network (SHRN) Student Health and Well-being (SHW) survey of 11-16-year-olds (2017-2023).International journal of epidemiology · 2024Article
- Impact of e-cigarette retail displays on attitudes to smoking and vaping in children: an online experimental study.Tobacco control · 2023Review
- 'Give 'em the vape, sell 'em the pods': razor-and-blades methods of pod e-cigarette pricing.Tobacco control · 2022Article
- Implementation of e-cigarette regulation through the EU Tobacco Products Directive (2016) in Wales, Scotland and England from the perspectives of stakeholders involved in policy introduction and enforcement.Tobacco prevention & cessation · 2021Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundYoung people's experimentation with e-cigarettes has increased in recent years, although regular use remains limited. EU Tobacco Products Directive (TPD) regulations introduced packet warnings, advertising restrictions, and regulated nicotine strength from 2016, in part due to concerns regarding use by young people. This paper examines e-cigarette use trajectories before and after TPD.
methodsE-cigarette use data were obtained from School Health Research Network/Health Behaviour in School-aged Children surveys in Wales and Smoking Drinking and Drug Use surveys in England. Data from Wales were analysed using segmented logistic regression, with before and after regression analyses of English data. Semi-structured group interviews included young people aged 14-16 years in Wales, England and Scotland in 2017 and 2018.
resultsIn Wales, ever use of e-cigarettes increased over time, but under a range of assumptions, growth did not appear to continue post-TPD. A small and non-significant change in trend was observed post-implementation (OR=0.96; 95%CI=0.91 to 1.01), which increased in size and significance after adjusting for ever smoking (OR=0.93; 95%CI=0.88 to 0.98). There was little increase in regular e-cigarette use from 2015 to 2017 in Wales. However, ever and regular use increased from 2014 to 2016 in England. Young people in all nations described limited interactions with components of TPD, while describing e-cigarette use as a 'fad', which had begun to run its course.
conclusionsThis study provides preliminary evidence that young people's e-cigarette experimentation may be plateauing in UK nations. The extent to which this arises from regulatory changes, or due to a fad having begun to lose its appeal among young people in the UK countries, remains unclear. These trends contrast to those observed in North America, where newer products whose EU market entry and marketing have been impacted by TPD, have gained traction among young people. Long-term monitoring of e-cigarette use trends and perceptions among young people remain vital.
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