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Purpose <p>E-cigarette use has increased substantially in the general population, yet evidence on use among older adults remains limited. Older adults bear a disproportionate burden of smoking-related morbidity and, in some populations, have shown persistently high smoking prevalence relative to younger age groups. Understanding the prevalence and correlates of e-cigarette use in this population is essential to inform targeted tobacco control and harm reduction strategies.</p> Methods <p>We conducted a pooled cross-sectional analysis of 13,297 adults aged 60&#xa0;years and over (mean age 71.4&#xa0;years; 54.3% female) from seven waves (2017–2024, excluding 2020) of the Scottish Health Survey (SHeS), a nationally representative household survey. Current e-cigarette use was the primary outcome. Survey-weighted logistic regression was used to estimate crude and adjusted odds ratios for the association between current e-cigarette use and sociodemographic, behavioural, and health-related covariates, accounting for the complex survey design.</p> Results <p>The weighted prevalence of current e-cigarette use among older adults was 4.5% (95% CI: 4.1–4.9). Prevalence remained broadly stable across survey years, ranging from 2.16% (95% CI: 1.43–3.25) in 2021 to 5.55% (95% CI: 4.43–6.93) in 2023. E-cigarette use was overwhelmingly concentrated among those with a smoking history: current smokers (adjusted OR 18.78, 95% CI: 11.79–29.92, <i>p</i> &lt; 0.001) and ex-smokers (adjusted OR 20.17, 95% CI: 13.10–31.06, <i>p</i> &lt; 0.001) had markedly elevated odds compared with never smokers. E-cigarette use declined sharply with advancing age: compared with the 60–64 reference group, adjusted odds were lower at ages 65–69 (OR 0.61, 95% CI: 0.47–0.79, <i>p</i> &lt; 0.001), 70–74 (OR 0.44, 95% CI: 0.33–0.58, <i>p</i> &lt; 0.001), 75–79 (OR 0.19, 95% CI: 0.13–0.29, <i>p</i> &lt; 0.001), and 80 and over (OR 0.11, 95% CI: 0.06–0.19, <i>p</i> &lt; 0.001). Residence in less deprived areas was associated with lower odds of use compared with the most deprived quintile: fourth quintile (OR 0.49, 95% CI: 0.34–0.70, <i>p</i> &lt; 0.001) and least deprived (OR 0.41, 95% CI: 0.27–0.61, <i>p</i> &lt; 0.001). Respondents reporting fair (OR 1.32, 95% CI: 1.03–1.70, <i>p</i> = 0.028) or bad/very bad self-rated health (OR 1.73, 95% CI: 1.31–2.27, <i>p</i> &lt; 0.001) had higher odds than those in very good or good health. Being divorced was independently associated with current use (OR 1.65, 95% CI: 1.22–2.23, <i>p</i> = 0.001). Sex and alcohol consumption were not significant correlates.</p> Conclusions <p>E-cigarette use among Scottish older adults was low but non-trivial and was strongly patterned by smoking history. The concentration of use among current and former smokers suggests that e-cigarette use in this age group occurs mainly among people with prior exposure to combustible tobacco, although the cross-sectional design cannot determine whether use reflects cessation, substitution, experimentation, or persistent dual use. The steep age gradient, deprivation patterning, and association with poorer self-rated health highlight the need for age-sensitive clinical counselling and balanced risk communication in older adults.</p>

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Prevalence and correlates of e-cigarette use among older adults aged 60 years and over

  • 期刊论文

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  • 发表日期：

    2026年6月29日

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  • Yusuff Adebayo Adebisi,
  • Anas Ali Alhur,
  • Isaac Olushola Ogunkola,
  • Najim Z. Alshahrani,
  • Don Eliseo Lucero-Prisno III,
  • Usman A. Adeniran,
  • Giulio Geraci,
  • Venera Tomaselli,
  • Riccardo Polosa

摘要

Purpose

E-cigarette use has increased substantially in the general population, yet evidence on use among older adults remains limited. Older adults bear a disproportionate burden of smoking-related morbidity and, in some populations, have shown persistently high smoking prevalence relative to younger age groups. Understanding the prevalence and correlates of e-cigarette use in this population is essential to inform targeted tobacco control and harm reduction strategies.

Methods

We conducted a pooled cross-sectional analysis of 13,297 adults aged 60 years and over (mean age 71.4 years; 54.3% female) from seven waves (2017–2024, excluding 2020) of the Scottish Health Survey (SHeS), a nationally representative household survey. Current e-cigarette use was the primary outcome. Survey-weighted logistic regression was used to estimate crude and adjusted odds ratios for the association between current e-cigarette use and sociodemographic, behavioural, and health-related covariates, accounting for the complex survey design.

Results

The weighted prevalence of current e-cigarette use among older adults was 4.5% (95% CI: 4.1–4.9). Prevalence remained broadly stable across survey years, ranging from 2.16% (95% CI: 1.43–3.25) in 2021 to 5.55% (95% CI: 4.43–6.93) in 2023. E-cigarette use was overwhelmingly concentrated among those with a smoking history: current smokers (adjusted OR 18.78, 95% CI: 11.79–29.92, p < 0.001) and ex-smokers (adjusted OR 20.17, 95% CI: 13.10–31.06, p < 0.001) had markedly elevated odds compared with never smokers. E-cigarette use declined sharply with advancing age: compared with the 60–64 reference group, adjusted odds were lower at ages 65–69 (OR 0.61, 95% CI: 0.47–0.79, p < 0.001), 70–74 (OR 0.44, 95% CI: 0.33–0.58, p < 0.001), 75–79 (OR 0.19, 95% CI: 0.13–0.29, p < 0.001), and 80 and over (OR 0.11, 95% CI: 0.06–0.19, p < 0.001). Residence in less deprived areas was associated with lower odds of use compared with the most deprived quintile: fourth quintile (OR 0.49, 95% CI: 0.34–0.70, p < 0.001) and least deprived (OR 0.41, 95% CI: 0.27–0.61, p < 0.001). Respondents reporting fair (OR 1.32, 95% CI: 1.03–1.70, p = 0.028) or bad/very bad self-rated health (OR 1.73, 95% CI: 1.31–2.27, p < 0.001) had higher odds than those in very good or good health. Being divorced was independently associated with current use (OR 1.65, 95% CI: 1.22–2.23, p = 0.001). Sex and alcohol consumption were not significant correlates.

Conclusions

E-cigarette use among Scottish older adults was low but non-trivial and was strongly patterned by smoking history. The concentration of use among current and former smokers suggests that e-cigarette use in this age group occurs mainly among people with prior exposure to combustible tobacco, although the cross-sectional design cannot determine whether use reflects cessation, substitution, experimentation, or persistent dual use. The steep age gradient, deprivation patterning, and association with poorer self-rated health highlight the need for age-sensitive clinical counselling and balanced risk communication in older adults.