The rise of E-cigarette use in Belgium: a growing concern among adolescents

Abstract Background E-cigarettes have been promoted for smoking cessation and are considered less harmful than traditional cigarettes. However, research shows they strongly appeal to young people and are not risk-free. Monitoring their use is thus essential. This study examines changes in e-cigarette use in Belgium between 2018 and 2024. Methods Cross-sectional data on e-cigarette use in the general population were collected from the Belgian health interview surveys of 2018 and 2023-2024. A total of 5695 and 3315 individuals aged 15-64 years responded to the e-cigarette module, respectively. Weighted percentages with 95% confidence intervals were calculated. Results The percentage of the population that ever tried an e-cigarette increased significantly from 18.6% (CI: 17.0%-20.2%) in 2018 to 26.6% (CI: 24.5%-28.7%) in 2024. This increase was most pronounced among young people aged 15-24, rising from 25.4% to 45.1%. Current e-cigarette use also rose from 5.1% (CI: 4.2%-5.9%) to 7.7% (CI: 6.5%-9.0%), with the highest prevalence in the youngest age group (17.3% compared to 10.1% or less in those aged 25+). While disposable and prefilled e-cigarettes were only used by a minority in 2018 (12.5% of current users, CI: 7.2%-17.9%), their share increased sharply by 2024 (57.5%, CI: 49.0%-66.0%). Among vapers aged 15-24, 61.6% mainly used disposable e-cigarettes and 79.2% used e-cigarettes that contain nicotine. Notably, 46.1% of them indicated that they had never smoked tobacco before trying an e-cigarette. Conclusions E-cigarette use has increased in Belgium between 2018 and 2024, largely driven by its consumption among adolescents. The widespread use of nicotine-containing vapes among young people is particularly concerning, as nicotine is addictive and can severely impact brain development. The ban on disposable vapes, implemented in January 2025 in Belgium, may help curb this trend and also offer environmental benefits, though enforcement and tackling the illegal market will be crucial. Key messages • E-cigarette use in Belgium has risen sharply between 2018 and 2024, mostly driven by an increase among 15-24-year-olds. The popularity of disposable e-cigarettes also surged. • Strong enforcement of Belgium’s ban on disposable e-cigarettes will be needed to prevent illegal sales and curb the trend of use among adolescents.