Prevalence and Characteristics of Ever Regular Use of Non-combustible Nicotine for One-year or More: A Population Survey in England

Abstract

Introduction: Up-to-date monitoring of non-combustible nicotine products (NNP) is important to assess their impact. To date, there is little evidence on the association between long-term regular use (defined here as one-year or more) of NNP and current smoking status. Aims/methods: The purpose of this study was to examine the prevalence, and sociodemographic, alcohol and smoking status correlates, of ever regular use of NNP in England in 2020.A cross sectional survey of adults in England between February and June 2020. Results: 8,486 adults were surveyed, 94.9% (8,055) were complete cases. The weighted prevalence of ever regular NNP use was 5.4% (n=436; 95%CI 5.0-6.0), of which 82% (n=360; 95%CI 78.7-85.8) was single, and 18% (n=79; 95%CI 14.8-22) multiple product use. Amongst ever regular NNP users, the prevalence of ever regular nicotine replacement therapies (NRT), e-cigarette and heated tobacco product use was 64.7% (95% CI 60.1-69), 43.4% (95%CI 38.8-48) and 2.5% (95% CI 1.4-4.5), respectively. In regression analysis, ever regular NNP use was independently associated with smoking status, being significantly higher among current (22.3%; Adjusted OR (aOR) 34.9, 95%CI 24.0-50.8) and ex-smokers (12.7%, aOR 19.8, 95%CI 11.1-14.4) than among never smokers (0.6%). More advantaged occupational grade (aOR, 1.27 95% CI 1.02-1.57) and at least hazardous alcohol use (aOR, 1.38 95%CI 1.06-1.78) were independently associated with greater prevalence of ever regular NNP use.Conclusions: Ever regularly using NNP was highest among smokers and ex-smokers and rare among never smokers. Among people who have ever regularly used NNP, NRT is the most popular.