Children are increasingly exposed to e-cigarettes on display in shops

New research has examined changes in exposure to and sources of nicotine products in UK adolescents.

Children are being increasingly exposed to e-cigarettes on display in shops, according to new analysis from Imperial College London of data collected in the annual ASH survey of youth vaping.

Comparing 12,445 responses to an online survey over the five years from 2018 to 2022, researchers from Imperial College London found increases in the proportion of children reporting that they had seen e-cigarettes on display in shops. By contrast, the children reported seeing fewer tobacco cigarettes for sale, although over half of respondents had still noticed these. The survey respondents were aged between 11 and 18.

In 2022, 66% of children reported seeing e-cigarettes in supermarkets compared with 57% in 2018. For tobacco products, the likelihood of noticing these fell from 81% to 66% for small shops and from 67% to 59% in supermarkets.

There needs to be greater enforcement of existing laws on the display of tobacco, as well as action to stem e-cigarette advertising and put vapes out of sight and reach of children." Dr Anthony Laverty School of Public Health

Researchers also examined where children were buying these products from and whether that changed over time. Sources of tobacco did not change over time for children who smoked tobacco; approximately 50% of children bought tobacco products from small shops and 25% from supermarkets.

They also found 57% of 11-13-year-olds who smoked tobacco reported buying this from small shops and 55% of 11-13-year-olds reported buying e-cigarettes in small shops. Children who vaped were more likely to buy e-cigarettes in small shops in 2022 than they were in 2019, with 51% buying them from small shops in 2022 vs. 34% in 2019.

Promotion and sale

The researchers say their findings, published in the journal Tobacco Control, show that greater attention needs to be paid to promotion and sale of tobacco and e-cigarette products to children.

Dr Anthony Laverty, from the School of Public Health at Imperial College London, who led the research, said: "These results highlight high levels of exposure to tobacco and e-cigarettes among children as well as the ease of accessing these products.

"This is despite legislation prohibiting sales to minors. There needs to be greater enforcement of existing laws on the display of tobacco, as well as action to stem e-cigarette advertising and put vapes out of sight and reach of children."

Hazel Cheeseman, Deputy Chief Executive of Action on Smoking and Health said, "Quantifying the impact on children of the growing promotion of vapes is crucial to determine the scale of the problem and how best it can be addressed. This analysis shows that instore promotion has the biggest impact, which is why ASH is advocating that promotion and display of e-cigarettes in shops should be prohibited, as should the child friendly packaging and labelling of vapes."

They focused on self-reported answers over time to questions such as "When you go into supermarkets, how often, if at all do you notice tobacco on display?". Questions on children noticing e-cigarettes and where these were purchased were only available from 2019 to 2022.

Dr Laverty explained: "This data from online surveys is designed to represent the whole population. While there is always some possible error, the results fit with other evidence on what we know about promotion and sale of these products."

Study co-author Professor Nicholas Hopkinson, from the National Heart and Lung Institute at Imperial, added: "In 2021, the UK government rejected amendments to the Health and Social Care Bill which would have given it power to control types of e-cigarette marketing that promote youth uptake. Since then, youth vaping has increased dramatically. It is well past time for the government to take steps to deal with this.

"As well as display bans and standardised packaging, an excise tax on disposable vapes would stop them being available at pocket money prices and bring them into the excise control regime, giving HMRC and Border Force powers to deal with illegal imports."

The research was funded by Cancer Research UK (CRUK)