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State of Child Health 2026: Vaping and smoking

Health Policy team
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This indicator reports primarily on youth vaping trends by examining the proportion of children aged 15 who are e-cigarette users, including those who have ever tried an e-cigarette and those who currently vape, across the UK.
Last updated
Post date
14 July 2026
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Contents

This is one of 12 indicators in our State of Child Health resource.

What is the problem?

Vaping is a relatively new phenomenon in the UK; however, there has been a marked rise in the number of young people vaping in recent years. In 2023, over a quarter (27%) of females and 22% of males aged 11–15 in England reported having ever used e cigarettes, which has increased from 25% in 2021 for females and 19% for males.

See chart in full

In Scotland, two-fifths (40%) of 15-year-old females reported having ever used e-cigarettes and over a third (37%) in Wales in 2022. For males, this was around a third in Wales (30%) and Scotland (33%). In Northern Ireland, nearly half (44%) of all 15-year-olds had ever used e-cigarettes. The number of current users decreases to 30% of 15-year-old females in Scotland, and 27% in Wales. For males, 19% were current users in Wales and 20% in Scotland. In Northern Ireland, 23% of all 15-year-olds reported to be current users. This is a significant increase since the 2020 State of Child Health report, when only 2-3% of young people were reported to be regular users.

There is limited data on health inequalities; however, in Northern Ireland, children aged 11-15 living in the most deprived areas were more likely to report having ever used e-cigarettes (25.7%) compared to the least deprived (19.5%).

See chart in full

While regular smoking among 15-year-olds has steadily decreased across the UK, the impact of vaping as a gateway to smoking needs to be closely monitored. The latest available data show that 1% of females in England in 2023, 13% in Wales in 2022, and 6% in Scotland in 2018 were regular smokers. For males, 2% were regular smokers in England in 2023, 9% in Wales in 2022, and 8% in Scotland in 2018. In Northern Ireland, 6.6% of 15-year-olds were regular smokers in 2022.

See chart in full

Why does it matter?

The long-term health impacts of vaping are not known, as vapes are a relatively new product. Nevertheless, current evidence indicates that vaping has significant adverse health consequences for children and young people in the short and medium term.1 The above figures also highlight the normalisation of nicotine vaping among young people and the need for targeted prevention strategies across the UK.

Nicotine is a key component in many vapes and is known for its addictive properties and its impact on children and young people’s brain development. Young people who used nicotine vapes reported to have higher rates of poor mental health, including depression and anxiety.2 Vaping is also associated with negative respiratory health outcomes, such as asthma and dry cough, and a higher risk of poor oral health, such as ulcers.3 Emerging surveillance data has shown that vapes seized from secondary schools in England contain significant quantities of toxins and unregulated substances, including synthetic cannabinoids,4 which suggests that vaping may act as a gateway to illicit drug use. 

Drivers of poor outcomes

Vapes were originally introduced to the market as a smoking cessation aid for adults; however, its promotion of this role has led to an underestimation of the unknown harms associated with their use, especially in young people.

It is illegal to sell nicotine vapes to under 18s, and advertising of vapes is prohibited on a number of media platforms. However, the marketing tactics adopted by the vape industry have driven its appeal through the creation of enticing vape flavours and colourful packaging designs to attract and increase their popularity amongst young people. Coupled with the easy availability of vapes on the high street and the poorly enforced age restrictions on purchases, young people have readily accessed vapes, driving increased use among this group.5

Emerging evidence has also highlighted the strong role of social context in shaping vaping uptake. Exposure to second-hand vapour in public places is associated with increased young people’s susceptibility, curiosity, and willingness to try vapes, as well as reinforce current vaping habits.6

Why we need to act now

Nicotine vapes have been found to be a significant gateway to subsequent smoking. Users were three times more likely to start smoking than non-vapers and, in those with no smoking history, are more likely to be future daily smokers.7

Although our analysis has focused on vaping and smoking, we recognise that children and young people are engaging with a broader range of nicotine products. Areas such as nicotine pouches have not been analysed in depth, and data gaps limit our understanding of their use among this group. Addressing these gaps is important to ensure a more complete picture of nicotine consumption among children and young people.

A paediatrician's insight

From Dr Sarah Brown, Consultant in Paediatric Respiratory Medicine

Your experience of supporting and/or treating children and young people who vape - any specific trends or has anything changed over time?

"I have looked after several children and young people who vape. Two recently had acute hospital admissions with respiratory complications likely directly influenced by vaping. The youngest child I have looked after was a 6-year-old with severe bronchiectasis found using their parents vape on the ward.

"Our dental colleagues report a rise in periodontal disease associated with vaping in children and young people. There are ongoing problems with vaping in school toilets, and children with asthma report that this causes chest tightness and breathing difficulties.

"Although disposable vapes are now banned, young people are instead buying rechargeable vapes. They also alter their vapes to inhale illicit drugs such as Spice/cannabinoids and, in my experience, have taken single-use vapes and modified the electrics to make them rechargeable, with resulting fire risks."

What have been the challenges to supporting children and young people who vape - what contributes to this or keeps them returning to NHS for support? 

"Nationally, there are huge variations in vaping cessation resources to support children and young people. There is a specialist vaping cessation service at Alder Hey Children’s Hospital in Liverpool, but in many areas, at best it is taken on by respiratory nurses (alongside their usual workload) and, at worst, there are no services at all. There is a need for properly funded vaping cessation services for CYP."

Any examples of good practice to tackle the growing number of children and young people vaping that you have been part of or aware of?

"The Young People’s Stop Smoking and Vaping Advisory Board: This board brings together young Londoners aged 16–25 and empowers them to shape the future of public health by tackling the growing challenges of youth smoking and vaping.  This includes influencing local and national policy, co-designing campaigns and research, developing resources for schools and youth services, and engaging with public health teams and decision-makers.

"The initiative is delivered in partnership with the London Tobacco Alliance and NHS London and supports the wider goal of making London Smoke Free by 2030."

Any advice you'd give to paediatricians that would help prevent vaping uptake?

"Use every consultation as an opportunity to ask about vaping, in the same way that we ask about smoking and immunisations.  This ensures that children and young people get the message that it is of concern if they vape, even if they are not willing to divulge that they do so.  Not asking may inadvertently reinforce the perception that it is of no concern to health.

"Understanding the risks of vaping – and the advantages of quitting – can be a powerful motivator for young people.  Access to reliable, youth-focused resources is important, and websites such as Health for Teens and Talk to Frank offer clear, age-appropriate information and practical support."

Recommendations

England
  • Limit vape flavours to tobacco, mint, and menthol only by restricting flavours to an approved list of descriptors and permitted ingredients. 
  • Prohibit the use of all imagery, colouring, and branding for both vape packaging and devices. As smoking cessation aids, vape packaging should resemble medicinal products to align with other aids and include public health information on health harms.
  • Restrict access to vapes by keeping them behind the counter and ensuring they are not on display in retail settings, similar to tobacco products, as they can contain nicotine.
  • Expand indoor smokefree legislation to cover outdoor public areas where children frequent, and extend these to also be vape-free. 
  • Ensure there is a dedicated smoking and vaping cessation service for children and young people, with additional support for nicotine dependence related to vaping.
Scotland
  • Use devolved powers under the Tobacco and Vapes Bill to restrict vape flavours to tobacco, mint, and menthol, and require standardised, non‑branded packaging and devices with clear public health information, to reduce youth appeal and prevent industry exploitation.
  • Require vaping products to be kept behind the counter and out of sight in retail settings, restricting their display in line with tobacco products.
  • Expand smokefree legislation to include additional outdoor public spaces and extend these protections to make those areas vape‑free to protect public health and reduce youth exposure to nicotine.
  • Establish dedicated smoking and vaping cessation services for young people, ensuring early intervention and support for those struggling with addiction.
Wales
  • Implement the control measures as set out by the Public Health Wales Vaping amongst Children and Young People in Wales Incident Response Group, to curb the rise in vaping among children and young people.  
  • Use devolved powers under the Tobacco and Vapes Act 2026 to prohibit promotional imagery, colours, and branding on both vape packaging and devices, requiring standardised, non‑branded presentation that reflects vapes’ role as smoking cessation products, with packaging that resembles medicinal nicotine products and includes clear public health information on nicotine addiction and health harms. 
  • Ensure there is a dedicated smoking and vaping cessation service for children and young people, with additional support for nicotine dependence related to vaping.
Northern Ireland
  • Ensure the effective implementation of the Tobacco and Vapes Act and examine areas where devolved powers should be used to ensure there are no gaps in the marketing and sale of vape products in NI, particularly where products are designed or promoted in ways that appeal to young people. This should include prohibiting flavoured vaping products and be consistent with the wider public health emphasis on harm prevention and concerns raised in early intervention frameworks.
  • Fund and effectively deliver evidence-based smoking prevention programmes and initiatives within education settings, youth provision and community programmes. For example, by utilising the role of school nursing teams and wellbeing education as strengthened through the refreshed Healthy Child, Healthy Future framework.

This is one of 12 indicators in our State of Child Health resource.