E-cigarettes and Shisha – Gateways to regular smoking among British youth? Martin Dockrell FRSPH Director of Policy & Research Action on Smoking & Health

E-cigarette use among adults has increased rapidly E-cigarette use among adult smokers in Great Britain

…but current use remains confined largely to current and ex-smokers 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) N=1680N=235N=74N=79N=26N=60

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 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 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 Shisha use among adults in Britain, 2013 (N=12,171) N=1324N=1180N=1758N=2351N=5558

Shisha and e-cigarette use and awareness by Children (N=2178) Shisha use is more common than e-cigarette use among children

Awareness if shisha is lower among younger children Heard of shisha (All children by age)

Awareness of shisha is lower among never smokers All Children (N=2178)

1 in 5 older children have tried shisha Shisha use and awareness (All children, by age)

Never smokers rarely try shisha Shisha use and awareness (All children, by smoking status) N=573N=159N=47N=69N=20N=46

Children who have never used shisha don’t expect to try soon 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