Trends in Non-Daily Cigarette Smoking in England, 2006-2024

Background: Cigarette smoking is incredibly harmful, even for people who do not smoke every day. This study aimed to estimate trends in non-daily smoking in England between 2006 and 2024, how these differed across population subgroups, and to explore changes in the profile of non-daily smokers in terms of their sociodemographic and smoking characteristics and vaping and alcohol consumption. Methods: Data were collected monthly between November-2006 and April-2024 as part of a nationally-representative, repeat cross-sectional survey of adults (≥18y; n=353,711). We used logistic regression to estimate associations between survey wave and non-daily smoking and used descriptive statistics to characterise the profile of non-daily smokers across 3-year periods. Results: The proportion of cigarette smokers who smoked non-daily was relatively stable between November-2006 and November-2013, at an average of 10.5% \[10.1-10.9%], then increased to 27.2% [26.0-28.4%\] (4.0% [3.7-4.2%] of adults) by April-2024. This increase was particularly pronounced among younger adults (e.g., reaching 52.8%, 20.4%, and 14.4% of 18-, 45-, and 65-year-old cigarette smokers by April-2024) and those who vape (reaching 34.2% vs. 23.1% among non-vapers). Over time, there were reductions in non-daily smokers' mean weekly cigarette consumption (from 34.3 in 2006-09 to 21.1 in 2021-24), urges to smoke (e.g., the proportion reporting no urges increased from 29.2% to 38.0%), and motivation to stop smoking (e.g., the proportion highly motivated to quit within the next three months decreased from 30.8% to 21.0%). Conclusions: An increasing proportion of adults in England who smoke cigarettes do not smoke every day, particularly younger adults. Although non-daily smokers report smoking fewer cigarettes and weaker urges to smoke than they used to, which may make it easier for them to stop smoking, they appear to be decreasingly motivated to quit. ### Competing Interest Statement JB has received unrestricted research funding from Pfizer and J&J, who manufacture smoking cessation medications. LS has received honoraria for talks, unrestricted research grants and travel expenses to attend meetings and workshops from manufactures of smoking cessation medications (Pfizer; J&J), and has acted as paid reviewer for grant awarding bodies and as a paid consultant for health care companies. All authors declare no financial links with tobacco companies, e-cigarette manufacturers, or their representatives. ### Clinical Protocols ### Funding Statement Cancer Research UK (PRCRPG-Nov21\100002) funded the Smoking Toolkit Study data collection and salary for SJ and SC. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for the STS was granted originally by the UCL Ethics Committee (ID 0498/001). The data are not collected by UCL and are anonymized when received by UCL. All participants provided verbal consent which was recorded on computers by trained interviewers. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.