We can’t be complacent in stubbing out smoking among young people

The overall rates of smoking among UK adults and young people have declined in recent decades. Legislation around the consumption, sale and advertisement of cigarettes has become tighter, and wide-reaching public health campaigns have taken effect.

Nonetheless, smoking remains the UK’s single biggest cause of preventable illness and avoidable death—100,000 people die each year from smoking-related diseases. That it remains a notable risk to public health is the reason for including smoking in young people as an indicator in our latest State of Child Health report

Most adult smokers had their first cigarette, or were addicted to nicotine, by the age of 18. And 90% of lifetime smoking starts between the ages of 10 and 20. That’s why it’s important to provide information about the dangers of cigarette smoking to young people, as well as monitoring overall smoking rates. 

smoking remains the UK’s single biggest cause of preventable illness and avoidable death—100,000 people die each year from smoking-related diseases

Our indicator aims to do just that by examining the latest tobacco use data. We also included e-cigarettes because, while we cannot yet confirm the long-term effects, we know that vaping is not without risks. Young people who have never smoked tobacco should not be encouraged to begin smoking e-cigarettes, and those who smoke tobacco should be supported to quit altogether.

Regular smoking among young people, defined as smoking at least one tobacco cigarette per week, has fallen steadily since at least 2011 in every UK country. But, worryingly, this pattern of decline has come to an end among certain groups. Young males in Scotland and Wales, for instance, have shown slight increases in their rates of regular smoking. And the reasons for this uptick are unclear. 

We know that young people are more likely to smoke due to a variety of factors, including having a parent or friend that smokes, seeing smoking in the media, and socioeconomic status. But untangling these factors is tricky. For instance, higher rates in lower socioeconomic groups may be less about income and more about simply being in the same room as a smoker.

In other words, it might be useful to think about the influence of, say, socioeconomic status, but stop-smoking initiatives should also provide support for parents and caregivers that smoke. Programmes that think about these wider factors are, perhaps, more likely to curb smoking rates.

E-cigarettes are a relatively new contraption, so we still have limited data to track their use among young people. The data that we do have suggests that e-cigarette use is more common among boys than girls across all UK countries, with the exception of Scotland, where rates are similar. 

In survey data, ‘ever use’ tells us the number of young people that have ever tried a substance, including electronic or tobacco cigarettes. The ‘ever use’ value for e-cigarettes is at least as high as the value for tobacco cigarettes in the 3 UK countries where comparable data is available. 

There isn’t sufficient historical data to tell us whether these findings are part of a wider trend towards rising e-cigarette usage—although, anecdotally, e-cigarettes do appear to be common among young people. 

Smoking is detrimental to the health of young people throughout their lives. The younger they start, the more likely they are to become dependent, and the less likely they are to quit. Smoking must remain a public health priority to avoid a reversal of the positive, downwards trend we have achieved in recent decades. We cannot afford to be complacent.