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Loneliness and E-cigarette Use Among Adolescents in England: Evidence From the Smoking, Drinking and Drug Use Survey 2023

Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Adolescent e-cigarette use is an increasing public health concern in England, yet the psychosocial drivers of this trend remain poorly understood. This study examines the association between loneliness and current e-cigarette use among secondary school students aged 11-15. METHODS: We analysed data from 13 725 pupils who participated in the 2023 wave of the nationally representative Smoking, Drinking and Drug Use among Young People in England survey. Loneliness was assessed using a validated composite score derived from 3 indirect questions on social isolation, categorised as low, medium, and high. Current e-cigarette use was defined as self-reported use "sometimes" or "every week." Logistic regression models estimated crude and adjusted odds ratios (ORs) for the association between loneliness and vaping, adjusting for age, gender, current smoking, ethnicity, family affluence, and alcohol use. RESULTS: Overall, 8.0% of adolescents (n=1104) reported current e-cigarette use. Compared with those reporting low loneliness, adolescents with medium and high loneliness had significantly greater odds of vaping, with adjusted ORs of 1.48 (95% confidence interval [CI], 1.24 to 1.76; p<0.001) and 2.46 (95% CI, 2.00 to 3.04; p<0.001), respectively. Findings were consistent in sensitivity analyses using weekly e-cigarette use as the outcome. Adolescents with medium and high loneliness had significantly higher adjusted odds of weekly use (adjusted ORs, 1.39; 95% CI, 1.11 to 1.75; p=0.005; and 2.04; 95% CI, 1.55 to 2.71; p<0.001, respectively) compared with those reporting low loneliness. CONCLUSIONS: Loneliness is a strong and graded correlate of adolescent e-cigarette use.
Language: English
Subfield: Physiology
Field: Medicine
Open Access status: gold
Estimated APC paid: $214
OpenAlex ID: W4415283133
FWCI:
Cites: 25
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