e-cigarette CDC image

E-Cigarette Use Increased in Young Adult Never Smokers

MedicalResearch.com Interview with:

Priti Bandi PhD Principal Scientist, Risk Factors Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303

Dr. Bandi

Priti Bandi PhD
Principal Scientist, Risk Factors Surveillance Research
American Cancer Society, Inc.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Trends in e-cigarette prevalence and population count of users according to cigarette smoking histories are unknown. These data are needed to inform public health actions against a rapidly changing U.S. e-cigarette market.

MedicalResearch.com: What should readers take away from your report?

e-cigarette CDC imageResponse: Our study assessed trends between 2014 and 2018 in the prevalence of e-cigarette use and population count of e-cigarette users, according to combustible cigarette smoking histories, in younger (18–29 years), middle-aged (30–49 years), and older (≥50 years.) U.S. adults.

The most notable finding was an increase in e-cigarette use among younger adult never smokers of combustible cigarettes, whose use nearly tripled (1.3% to 3.3%) between 2014-2018, potentially suggesting increasing primary nicotine initiation with e-cigarettes. While this two-percentage point increase appears modest, when combined with a large and growing prevalence and population of never-smokers nationally, this increase represented the largest absolute increase in e-cigarette users – an estimated 0.87 million more never smoking younger adults users in 2018 (1.35 million) than in 2014 (0.49 million). We also note substantial increases in e-cigarette use among near-term quitters (i.e. those that quit combustible cigarettes 1-8 years ago, when e-cigarettes proliferated the US retail market) across all age groups. This trend suggests continued use of e-cigarette devices among those who may have switched from cigarettes previously, potentially for nicotine maintenance.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: This study’s cross-sectional nature precludes any causal implications between e-cigarette use and cigarette smoking status. For example, we could not causally relate e-cigarette use in cigarette quitters and the likelihood of quitting. Also, prevalence trends do not imply transitions within individuals; for example, the increase in e-cigarette use in cigarette quitters could not be temporally related to either e-cigarettes or cessation aids’ use. Future longitudinal research exploring the reasons for and trajectories of e-cigarette use is needed. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Urgent efforts are needed to address the potential rise in primary nicotine initiation with e-cigarettes among younger adults. It is also important to aid the transition of e-cigarette users—particularly among younger adults—to non-use of all tobacco or nicotine products given that the long-term consequences of e-cigarette use are mostly unknown.

No disclosures to report. 


Trends in E-Cigarette Use by Age Group and Combustible Cigarette Smoking Histories, U.S. Adults, 2014–2018

Bandi, Priti et al.
American Journal of Preventive Medicine, Volume 0, Issue 0




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Last Updated on October 5, 2020 by Marie Benz MD FAAD