Adult cigarette smoking has fallen for three decades. E-cigarette use has filled the space, most sharply among young women. Among 13 to 15 year-olds, e-cigarette experimentation is now four times more common than cigarette experimentation.
One of five short reports in our Health Survey for England 2024 series, drawing on data published by NHS England in early 2026. The other four are linked at the foot of this page.
The Health Survey for England 2024 makes one of the largest behavioural shifts of the last three decades unmistakable. Cigarette smoking has collapsed among adults, and even more sharply among children. E-cigarette use has filled the space, fastest among young women, and is now an established behaviour among 13 to 15 year-olds.
What the numbers say
Current cigarette smoking among adults in England, by gender, selected survey years:
Year | Men | Women |
|---|---|---|
1993 | 28% | 26% |
2003 | 27% | 25% |
2013 | 22% | 17% |
2018 | 17% | 13% |
2024 | 13% | 10% |
Children's cigarette smoking has fallen even faster. Share of 13 to 15 year-olds who have ever smoked, selected survey years:
Year | Boys 13–15, ever smoked | Girls 13–15, ever smoked |
|---|---|---|
1997 | 38% | 41% |
2008 | 29% | 33% |
2018 | 11% | 11% |
2024 | 5% | 6% |
E-cigarette use among young women in England (currently using), the steepest rise in the dataset:
Year | Current e-cigarette use |
|---|---|
2016 | 3% |
2019 | 5% |
2022 | 14% |
2024 | 19% |
Children's e-cigarette experimentation, 2024:
Group | Ever used an e-cigarette |
|---|---|
Boys 13–15 | 17% |
Girls 13–15 | 20% |
All 13–15 | 19% |
What that means
The substitution story is the spine of the piece. Adult cigarette smoking has fallen from 28% / 26% (men / women, 1993) to 13% / 10% (2024). Children who have ever smoked has collapsed from around 40% in the late 1990s to 5%–6% in 2024. E-cigarette use among 16 to 24 year-old women has risen sixfold in eight survey years, from 3% to 19%. And 19% of 13 to 15 year-olds have already tried an e-cigarette, against 5%–6% who have tried a cigarette.
The two halves of the story do not cancel out. Cigarette smoking is the largest preventable cause of disease in England, and its decline is a public health win on the scale of seatbelts. But the displacement is not benign: e-cigarettes have not been on the market long enough to know their long-run health profile, and the steepest rises are in young women and in children. Anyone reading this dataset as "the smoking problem is solved" is reading half of it.
The age structure matters. Cigarette smoking among 13 to 15 year-olds is now rare. E-cigarette experimentation among 13 to 15 year-olds is roughly four times more common. The cohort growing up now is the first one for whom the question is not whether to smoke but whether to vape.
Related reports in this NHS England Health Survey 2024 series
Chronic pain in England has a clear shape, and women carry more of it
Inactive adults are more than twice as likely to feel lonely often
Source: Health Survey for England 2024, NHS England (Tables 1, 2, 4, 5 and Table 7 for e-cigarette use). Adults aged 16 and over for adult-smoking measures; ages 13 to 15 for the child measures. Unweighted bases vary by table. Figures are age-standardised where applicable.
