Background: Public health bodies in the UK, and elsewhere, have expressed concern over the wider social and economic impact of crack cocaine use on society. Objective: The aim of the study was to use English substance misuse treatment data to estimate the incidence of crack cocaine use in the population who are expected to present to treatment with crack cocaine as the primary substance. Method: Known year of first crack-related treatment demand and age of first use of crack were combined to provide the distribution of lag to treatment for each year of onset. The resulting combined lag distribution was used to estimate the proportion of incident crack cocaine users who will have presented in a given year and, from that, the total number who will have started in that year. Results: Our estimates identified an approximate doubling in incidence between 2012 and 2016, following a decrease up to 2012. Conclusion: This represents an increase in treatment demand that is likely to continue for a number of years.