Disposable e-cigarettes: Prevalence of use in Germany from 2016 to 2023 and associated user characteristics.

Aims: To provide data on prevalence and trends in the use of different types of e-cigarettes (disposable, pod, tank) in Germany (a country with high smoking prevalence of approximately 30%) from 2016 to 2023, and to analyse the characteristics and smoking behaviours of users of these types.

Design: A series of nationally representative cross-sectional face-to-face household surveys.

Setting: General population of Germany, 2016-2023.

Participants: A total of 92 327 people (aged ≥14 years) of which 1398 reported current use of e-cigarettes.

Measurements: Type of e-cigarette usually used (single choice: disposable, pod, or tank), person characteristics, and smoking/vaping behaviour.

Findings: E-cigarette use in the population of Germany has increased from 1.6% (95% confidence interval [CI] = 1.1,2.2) in 2016 to 2.2% (95% CI = 1.6,3.0) at the end of 2023. Disposable e-cigarette use has increased in this period from 0.1% (95% CI = 0.0,0.3) to 0.8% (95% CI = 0.4,1.8). Pod type use exhibited the most stable trend, with a steady rise to 0.6% (95% CI = 0.4,0.9) in 2023. Tank e-cigarette use peaked at 1.6% (95% CI = 1.3,1.9) in November 2017, declined to 0.7% (95% CI = 0.6,0.9) in December 2020, and has since remained constant at 0.8% (95% CI = 0.6,1.0). Disposable e-cigarette users were on average 3.5 and 4.1 years younger than tank and pod users, respectively. They were more likely than tank users to be female, non-daily users, and dual users of tobacco. In the subgroup of dual users, there were no significant differences with regard to urges to smoke, cigarettes smoked per day, motivation to stop, and attempts to stop smoking between users of disposables and other types.

Conclusions: The use of e-cigarettes has increased in Germany from 2016 to 2023, especially that of disposable e-cigarettes, which are now the most commonly used type with a prevalence rate of 0.8%. However, the use of e-cigarettes is still much lower compared with tobacco smoking.