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E-cigarette use remains a controversial topic, with questions over how people transition between e-cigarette use and cigarette smoking. This paper examined transitions into and out of nicotine product use in a representative sample of UK youth.

We used Markov multistate transition probability models on data from 10 229 participants (10–25 years old) in the UK Household Longitudinal Study (2015–2021). We used four product use states (‘never’, ‘non-current use’, ‘e-cigarette only’ and ‘smoking and dual use’) and estimated likelihood of transitions according to sociodemographic characteristics.

Among participants who had never used nicotine products, most were still non-users a year later (92.9% probability; 95% CI 92.6%, 93.2%); a small proportion transitioned to using e-cigarettes only (4.0%; 95% CI 3.7%, 4.2%) and cigarettes (2.2%; 95% CI 2.0%, 2.4%). Those aged 14–17 years …