Jackson Sarah E, Shahab Lion, Brown Jamie
Department of Behavioural Science and Health, University College London, London, UK.
SPECTRUM Consortium, Edinburgh, UK.
Nicotine Tob Res. 2025 Jan 22;27(2):342-350. doi: 10.1093/ntr/ntae021.
The UK Government intends to implement a "smokefree generation" policy prohibiting the sale of all tobacco products to people born after 2008. National surveys provide comprehensive data on cigarette smoking, but little is known about patterns of non-cigarette tobacco smoking across key population groups.
Using data from a nationally representative cross-sectional survey of adults in England, collected monthly between September 2013 and September 2023 (n = 196 721), we estimated time trends in exclusive non-cigarette tobacco (eg, cigar/pipe/shisha) smoking prevalence, overall and by age, gender, occupational social grade, region, ethnicity, and vaping status. Interviews were conducted face-to-face until March 2020 and via telephone thereafter.
From September 2013 to September 2023, there was a non-linear increase in exclusive non-cigarette tobacco smoking prevalence (from 0.36% to 1.68%; prevalence ratio = 4.72 [95% CI = 3.43-6.48]). Prevalence was relatively stable up to February 2020 (at an average of 0.46%), then increased sharply at the start of the COVID-19 pandemic (at the same time as survey methods changed), to 0.90% (0.82%-0.99%) in March 2020. This was followed by a steadier rise, peaking at 1.97% in May 2022, before falling slightly to 1.68% by September 2023. In 2022/2023, 1 in 10 smokers (10.8% [9.64%-12.0%]) exclusively used non-cigarette tobacco. The rise in prevalence was observed across all subgroups but was most pronounced among younger adults (eg, reaching 3.21% of 18-year-olds vs. 1.09% of 65-year-olds). Prevalence was consistently higher among men and current vapers.
Although exclusive use of non-cigarette combustible tobacco remains rare among adults in England, it has increased in recent years, particularly among younger ages. As of September 2023, there were approximately 772 800 adult exclusive non-cigarette tobacco smokers in England; around five times more than a decade earlier.
The proportion of adults in England who do not use cigarettes at all but smoke other combustible tobacco products has increased substantially in recent years, with a particularly pronounced rise among young people. The inclusion of non-cigarette combustible tobacco products under the proposed "smokefree generation" policy is therefore likely to be important for achieving the greatest reduction in youth uptake of tobacco smoking, as it would ensure young people who are unable to legally buy cigarettes do not buy other combustible tobacco products that are similarly harmful to health.
英国政府打算实施一项“无烟一代”政策，禁止向2008年以后出生的人销售所有烟草制品。全国性调查提供了关于吸烟的全面数据，但对于关键人群中非卷烟类烟草使用模式却知之甚少。
利用2013年9月至2023年9月期间每月收集的、具有全国代表性的英格兰成年人横断面调查数据（n = 196721），我们估算了仅吸非卷烟类烟草（如雪茄/烟斗/水烟）的流行率随时间的变化趋势，总体情况以及按年龄、性别、职业社会阶层、地区、种族和是否使用电子烟状态划分的情况。2020年3月之前采用面对面访谈，之后通过电话访谈。
从2013年9月到2023年9月，仅吸非卷烟类烟草的流行率呈非线性上升（从0.36%升至1.68%；流行率比值 = 4.72 [95%置信区间 = 3.43 - 6.48]）。到2020年2月流行率相对稳定（平均为0.46%），然后在新冠疫情开始时急剧上升（与调查方法改变同时发生），到2020年3月达到0.90%（0.82% - 0.99%）。随后是较为平稳的上升，在2022年5月达到峰值1.97%，到2023年9月略有下降至1.68%。在2022/2023年，十分之一的吸烟者（10.8% [9.64% - 12.0%]）仅使用非卷烟类烟草。各亚组均观察到流行率上升，但在年轻人中最为明显（例如，18岁人群中达到3.21%，而65岁人群中为1.09%）。男性和当前使用电子烟者的流行率一直较高。
尽管在英格兰成年人中仅使用非卷烟类可燃烟草的情况仍然很少见，但近年来有所增加，尤其是在年轻人中。截至2023年9月，英格兰约有772800名成年纯非卷烟类烟草吸烟者；比十年前大约多五倍。
近年来，英格兰完全不吸卷烟但吸其他可燃烟草制品的成年人比例大幅增加，在年轻人中上升尤为明显。因此，将非卷烟类可燃烟草制品纳入拟议的“无烟一代”政策，对于最大程度减少年轻人吸烟率可能至关重要，因为这将确保无法合法购买卷烟的年轻人不会购买其他对健康同样有害的可燃烟草制品。
