There has been a sharp increase in the use of high-strength nicotine amongst vape smokers in England, a study has revealed.

Researchers at University College London (UCL) found that the proportion of adults using high-strength e-liquids has increased to 32.5%, compared to an average of 3.8% between July 2016 and June 2021.

The increase is most pronounced amongst young people aged 19-24, where 53.1% now use high-strength vapes which contain up to 20 mg/ml of nicotine, the legal limit for nicotine in e-liquids in the UK.

This comes as the UK Government announced in this year’s spring budget that it would tax e-liquid from October 2026. The proposals suggest three tax categories for e-liquid, with the lowest being applied to nicotine-free liquid and the highest to e-liquid containing 11 mg/ml or more of nicotine.

The findings are published in the journal Addiction.

Despite the ‘sharp increase’ in high nicotine users, the researchers warn against taxing high-strength nicotine since such a move could undermine smokers’ attempts to quit through vaping.

Using data from the Smoking Toolkit Study, an ongoing monthly survey documenting the smoking habits of the population of England, Scotland and Wales, the researchers analysed survey responses of 7,314 adult vapers in England between 2016 and 2024. They also examined data from Wales and Scotland between 2022 and 2024. Participants were asked whether the e-cigarette they mainly use contains nicotine and what strength the e-liquid was (no nicotine, between 0- 6, 7–11, 12–19 and 20 or more mg/ml). E-liquids containing 20mg/ml or more of nicotine were classified as high strength.

The most significant increase was seen in young people, where 53.1% of 18 to 24-year-olds use high-strength nicotine vapes compared to 3.9% between 2016 and 2021. In people over 25, the use of high-strength nicotine vapes went from 9.4% to 25.1% over the study period.

Significant rises were also seen in people who used disposable vapes (2.6% to 49.0%) compared to pods and refillable devices, with 16.3% and 11.5% using high-strength nicotine, respectively. The pattern of increase was seen in all current smokers as well as people who had never smoked but was not observed in long-term ex-smokers (those who have quit smoking for one year or more).

Lead author Dr Sarah Jackson of the UCL Institute of Epidemiology and Health Care said: ‘Our study shows a sharp increase in the use of high-strength nicotine e-liquids in England since 2021.’

She explained that whilst nicotine may be addictive, it is not what causes the majority of harm from smoking. For smokers trying to quit, vaping with higher-strength nicotine is often more effective because it satisfies cravings more quickly and provides better relief from withdrawal symptoms.

Dr Jackson added: ‘Taxing higher-strength nicotine products at higher rates will make the most effective way to quit less affordable, which may drive vapers towards lower-strength e-liquids and potentially undermine smoking cessation attempts.’

The researchers suggest that the tax may also result in people using a lower, cheaper strength and vaping more to get the nicotine they need, which could result in increased exposure to toxicants in the e-liquids.

Deborah Arnott, CEO of Action on Smoking and Health (ASH) and a co-author of the study, said: ‘Curbing underage vaping can best be achieved by making all vapes less appealing and increasing the price at point of sale, whatever their nicotine content. Those are the policies which will be most effective in stopping children from starting to vape in the first place.’

This article was first published by our sister title Nursing in Practice.