The number of younger middle-class women who smoke has jumped 25% over the past decade, according to research. Smoking is the leading cause of preventable death and illness in the UK and accounts for 76,000 deaths annually. Experts from UCL examined data from nearly 200,000 adult participants in the Smoking Toolkit Study, a monthly survey of adults in England. Just over 44,000 were women aged 18-45. The study, funded by Cancer Research UK and published in BMC Medicine, found that while overall smoking rates declined between 2013 and 2023, the proportion of women aged 18-45 from higher socioeconomic backgrounds who smoked rose from 12% to 15%. In contrast, there was a drop in the proportion of less advantaged women of the same age who smoked, from 29% to 22%, while smoking rates among men of all backgrounds remained stable. Dr Sarah Jackson, the lead author of the research, said: “We don’t know why younger affluent women are smoking more. Future studies could explore whether social media may be increasing uptake in this cohort, or whether they are less able to use strategies or support to avoid long-term relapse … We need to do a lot more research to find out.” Most smokers now predominantly use rollups, the authors found, with 54% of adults of all ages mainly or exclusively using hand-rolled cigarettes, up from 42% in 2013. The trend was particularly marked among female smokers aged 18 to 45, where the proportion who said they mainly or exclusively smoked hand-rolled cigarettes increased from 41% to 61%. The report said financial pressures may have hit women harder, with higher rates of job loss during the pandemic and a greater burden of housework and childcare. This probably contributed to the reduction in smoking prevalence among women from less advantaged social grades and encouraged those who did not stop to switch to hand-rolled products as a way to afford to continue to smoke, the authors concluded. Vaping among all adults aged 18 to 45 more than tripled in the decade to 2023, with the bulk of the increase occurring after 2021. By 2023, one in five adults under 45 were vaping, the study calculated. A new report from the Royal College of Physicians (RCP) has called for more action to prevent vaping among children. The RCP study proposed restrictions on the promotion of e-cigarettes on social media, making e-cigarettes less affordable for young people and less appealing through plain packaging. John Waldron, policy and public affairs manager at Action on Smoking and Health, said UCL’s study demonstrated that there could be no complacency about continued declines in smoking rates. He said: “It is of particular concern that the increases have been seen in women of child-bearing age, as smoking in pregnancy doesn’t just threaten the lives of women but also their unborn children.” Ann McNeill, a professor of tobacco addiction at King’s College London, said: “Researchers and clinicians have worked tirelessly over the last few decades to educate people on the harms of smoking tobacco, and to a large extent we have been successful. It’s worrying therefore that we should see any increases in smoking in any social demographic.” She added: “Smoking, in any form, is uniquely deadly. We need to move quickly to understand why this group of women in particular are risking their health, despite all of the evidence.” On Tuesday MPs voted by 383 to 67 in favour of the prime minister’s bill to make it illegal for anyone born in 2009 or later to buy tobacco products in the UK. Dr Claire Fuller, the national primary care medical director, said: “Smoking is the biggest cause of preventable illness and deaths in the UK, and we know that smoking reduces fertility in women and increases the risk of complications in pregnancy. “With NHS staff across the country seeing increasing numbers of young people needing treatment for the effects of vaping, the recent action to crack down on child-friendly marketing and illegal sales is much needed.” A Department of Health and Social Care spokesperson said: “We are taking bold action to create the world’s first smoke-free generation, with MPs voting the tobacco and vapes bill through to committee stage. We have also doubled funding for stop smoking services to nearly £140m a year.”