28 Jul Vaping in 2026: How Research, Regulation, and Consumer Demand Are Converging
Notice: Vaping and e-cigarette products contain nicotine, which is highly addictive. They are not approved by the FDA as cessation devices and are not recommended for non-smokers, pregnant individuals, or anyone under 21. If you do not currently smoke, do not start vaping. If you smoke and are considering switching or quitting, speak with a qualified healthcare provider about all available options, including FDA-approved cessation aids. This article is for informational purposes only.
The conversation about vaping has, for most of the last decade, run on a research track and a consumer track that didn't quite meet. The research track measured what specific devices did to specific populations under specific conditions. The consumer track evolved faster than the research could keep up with. What's changing in 2026 is that a third track — what vape users themselves are demanding — has started to shape the market in ways that research and regulation, on their slower clocks, haven't. The result is a faster pull toward transparency, third-party testing, and ingredient disclosure than either evidence-based or rule-making alone had produced.
What follows is a look at where those three tracks are converging: what the research has actually established, what the consumer market looks like now, what vape users themselves are asking for, and what the answer to all three together means for the conversation a clinician or current adult smoker is most likely to be having.
[caption id="attachment_75310" align="aligncenter" width="500"] Photo by Aleksander Dumała[/caption]
![Cannabis and CBD Product Notice: Cannabis and CBD products are not FDA-monitored or approved for the treatment of anxiety, depression, or any other mental health condition and are not legal in all locations. Effects vary significantly between individuals. Do not use if you are pregnant, nursing, or may become pregnant. Keep out of reach of children. Children and pets should not be exposed to these products. Cannabis and CBD products may interact with alcohol and other drugs including prescription medications. Always consult your physician or qualified healthcare provider before using any cannabinoid product, especially if you have an existing health condition or take other medications. MedicalResearch.com Interview with: Ryan M. Sullivan, PhD Postdoctoral Research Fellow, UC San Diego School of Medicine [IMAGE GOES HERE] Study: Sullivan RM, Wallace AL, Shankula CA, et al. Substance use patterns from late childhood to mid-adolescence: Updates on the Adolescent Brain Cognitive Development Study. Drug and Alcohol Dependence Reports. 2026;20:100463. https://doi.org/10.1016/j.dadr.2026.100463 MedicalResearch.com: What is the background for this study? Dr. Sullivan: Adolescence is a critical period for brain development and a time when many young people begin experimenting with alcohol, cannabis, nicotine and other substances. Understanding when substance use begins, how it changes as young people get older, and which substances are most commonly used together can help researchers identify opportunities for prevention and better understand how early substance use may relate to later health outcomes. This study used data from the Adolescent Brain Cognitive Development (ABCD) Study, one of the largest longitudinal studies of youth in the United States, to provide an updated picture of substance use patterns from late childhood through mid-adolescence. Related MedicalResearch.com research has also found that cognitive brain circuits are altered in youth with significant cannabis use — underlining why tracking when and how adolescents begin using substances matters for understanding long-term neurodevelopmental outcomes. MedicalResearch.com: What are the main findings? Dr. Sullivan: The study found that substance use increased steadily as participants moved through adolescence. By age 16, 38% of participants reported having used at least one substance during their lifetime. Alcohol, cannabis and nicotine were the substances most commonly reported. The researchers also identified differences by sex. Boys reported higher rates of substance use before age 12, but beginning around age 13, girls reported higher rates of alcohol, cannabis and nicotine use, with the largest differences seen for nicotine. Polysubstance use — using two or more substances — was also relatively common, with nearly 15% of participants reporting it during the study. The most common combination was nicotine and cannabis, and girls reported higher rates of polysubstance use after age 13, particularly combinations involving nicotine. Importantly, estimates adjusted to better reflect the U.S. population were very similar to the study's unadjusted estimates, suggesting that the ABCD cohort provides a useful representation of national patterns of adolescent substance use. MedicalResearch.com: What should readers take away from your report? Dr. Sullivan: The key takeaway is that substance use becomes increasingly common as young people move through adolescence, highlighting the importance of prevention and early intervention before or during the early teen years. The findings also show that substance use does not follow the same pattern for everyone. In particular, the shift toward higher rates of use among girls beginning around age 13 and the prevalence of nicotine-cannabis co-use point to the need for prevention strategies that account for differences in age, sex and patterns of substance use. These findings also provide an important national benchmark for future research. By establishing when substance use emerges and how patterns evolve during adolescence, researchers can better investigate how substance use may intersect with brain development, mental health and other long-term outcomes. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Dr. Sullivan: It will be important to investigate why substance use patterns diverge between boys and girls around age 13 and to identify the factors that contribute to higher rates of use among girls during later adolescence. Additional research should examine the factors associated with polysubstance use, particularly nicotine and cannabis co-use, and determine whether using multiple substances is associated with different developmental or health outcomes than using a single substance. Future studies could also explore how family environment, peer relationships, mental health, social conditions and changing perceptions of substance-related risks influence when and how adolescents begin using substances. MedicalResearch.com: Is there anything else you would like to add? Any disclosures? Dr. Sullivan: One important point is that these findings should not be interpreted to mean that most adolescents use substances. The study found that substance use increases with age, but the majority of young people in the cohort had not reported using substances by age 16. The value of this research is in identifying when use becomes more common and the specific patterns that emerge, so that prevention efforts can be targeted at the times and populations when they may have the greatest impact. Disclosures: The study was funded by the National Institute on Drug Abuse (NIDA) through National Institutes of Health awards DA064409, DA062011, DA050779, DA054980 and DA062432. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Disclaimer: The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Some links are sponsored. Products, services and providers are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc. Always seek the advice of your physician or other qualified health provider and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.](https://medicalresearch.com/wp-content/uploads/2026/07/dr-ryan-sullivan.jpg)
Dr. Lazarus[/caption]
Philip Lazarus, PhD
Boeing Distinguished Professor, Pharmaceutical Sciences
Professor, Dept of Pharmaceutical Sciences
College of Pharmacy and Pharmaceutical Sciences
Washington State University
Spokane, WA 99210
MedicalResearch.com: What is the background for this study?
Response: Smoking and tobacco use remains a major health issue. Smokers use cigarette over the course of the day because the levels of nicotine, the addictive agent in cigarettes and other forms of tobacco, dimmish with time in the bloodstream due to the breakdown of nicotine by enzymes in the body. By inhibiting the breakdown of nicotine in smokers, one would expect that the levels of nicotine would remain higher after smoking a single cigarette, and that these individuals may not require lighting up another cigarette so quickly, reducing the number of cigarettes smoked over the course of a day. This could have a profound effect on reducing the overall harm incurred from smoking or from using other forms of tobacco.
In a single previous study, smokers who used a CBD inhaler exhibited a 40% reduction in cigarette use. In addition, while cannabis users are often smokers, previous studies have indicated that they smoke less cigarettes than non-cannabis-using cigarette smokers. In previous studies published in 2021, we found that major cannabinoids present in cannabis like THC and CBD inhibit major metabolizing enzymes in our body, including several that are important in drug metabolism. We hypothesized that CBD and its major active metabolite, 7-hydroxy (OH)-CBD, may also be inhibiting one or more of the enzymes important in the metabolism (or breakdown) of nicotine.
Dr. Dai[/caption]
Dr. Hongying Daisy Dai, PhD
Professor and Associate Dean of Research
The College of Public Health
University of Nebraska Medical Center.
MedicalResearch.com: What is the background for this study?
Response: Tobacco use landscape has been changing in the United States with fewer combustible cigarette smokers and more e-cigarette and other emerging tobacco users. Nicotine concentration level is a key product characteristic of modern e-cigarette products and high-nicotine vaping devices have recently become available. This study seeks to examine whether biomarkers of exposure to tobacco-related toxicants have changed since 2013 among adult nicotine e-cigarette users, non-nicotine e-cigarette users, and cigarette smokers.
Dr. Han[/caption]
Meilan K Han MD, MS
Henry Sewall Professor of Medicine
Professor of Internal Medicine and Section Head
Division of Pulmonary and Critical Care Medicine, Medical School
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the NIH sponsored SPIROMICS study we demonstrated that symptomatic, tobacco exposed individuals have frequent exacerbations. Many of these individuals are treated with the same inhaled medications that have shown benefit in COPD, but we don’t have any evidence basis for this practice.
Response: Cigarette smoking is one of the well-established causes of periodontitis, but the effect of using electronic cigarettes (e-cig), especially its long-term impact on periodontal health, is not yet clearly understood. Considering the increased popularity of e-cig use, especially among teenagers and young adults, and the known effect of high nicotine concentration in e-cigarette products, we conducted this clinical research to see if there were differences in periodontal health between e-cig users, traditional smokers, and nonsmokers. The study consisted of two visits, 6 months apart, where measures of oral and periodontal health were obtained.
Our data showed significantly greater clinical attachment loss in the e-cigarette users and cigarette smokers than in the non-smokers at both study visits. In only e-cigarette users, we observed an over 0.2 mm average increase in the clinical attachment loss after 6 months. 
Dr. Pierce[/caption]
John Pierce, PhD
Professor Emeritus
Department of Family Medicine and Public Health
Moores Cancer Center Director for Population Sciences
Co-leader of the Cancer Prevention program
UC San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Graphic Warning Labels are to be implemented in the US in July 2022, depending on litigation. This will be about 10 years after they were first proposed. Meanwhile, 120 other countries have implemented them already.
The FDA states that their purpose for the warnings is to provide a constant reminder to smokers about the health consequences of smoking, not to force them to quit.
In our study, 3 months of having cigarettes repackaged into graphic warning packs was associated with smokers thinking more about quitting and not getting as much pleasure out of their cigarettes. However, thinking about quitting is only the first step to conquering a nicotine addiction. 
Dr. Lee[/caption]
Brian P. Lee, MD, MAS
Assistant Professor Clinical Medicine
University of Southern Californi
Keck School of Medicine
Los Angeles, California
MedicalResearch.com: What is the background for this study?
Response: The COVID-19 pandemic has been associated with mental health stressors, including anxiety, loneliness, and social instability. We hypothesized the pandemic may have led to increased alcohol and tobacco use as a coping mechanism for these stressors. National retrospective questionnaires had suggested higher reports of substance use, but these are limited by selection and recall biases, in addition to subjective report – we sought to address this knowledge gap by using a nationally-representative longitudinal cohort (Nielsen National Consumer Panel) tracking real-time purchases of households across the US. 
Dr. Silverstein[/caption]
Dr. Michael Silverstein M.D., M.P.H
Professor of Pediatrics
Director of the Division of General Academic Pediatrics
Vice Chair of Research, Department of Pediatrics
Boston University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Tobacco use is the leading preventable cause of disease, disability, and death in the United States and quitting is one of the best things people can do for their health. Additionally, smoking during pregnancy can cause serious harms to both the pregnant person and the baby.
The Task Force continues to recommend that clinicians ask all adults and pregnant people about their tobacco use, advise those who use tobacco to quit, and connect them to proven, safe methods to help them quit. 
Dongmei Li, Ph.D.[/caption]
Dongmei Li, Ph.D., Associate Professor
Clinical and Translational Science Institute
University of Rochester Medical Center
MedicalResearch.com: What is the background for this study?
Response: Previous animal and human studies have found that nicotine exposure could harm adolescents’ brain development and impact their cognitive functions. Electronic cigarettes, which have become very popular among youth in the US in recent years, usually contain nicotine at equivalent or possibly higher levels than traditional tobacco cigarettes. Thus, it is reasonable to assume that vaping might be associated with self-reported cognitive complaints.
MedicalResearch.com: What are the main findings?
Response: Main findings from our study are:
Dr. Halpern-Felsher[/caption]
Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her)
Professor of Pediatrics
Taube Endowed Research Faculty Scholar
Professor (by courtesy), Epidemiology and Population Health
Professor (by courtesy), Psychiatry and Behavioral Sciences
Director of Fellows’ Scholarship, Department of Pediatrics
Director of Research, Division of Adolescent Medicine
Co-leader, Scholarly Concentrations, Pediatrics Residency Program
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic.
There were 4 main findings:
Dr. Al Rifai[/caption]
Mahmoud Al Rifai, MD, MPH
Cardiovascular Disease Fellow
Baylor College of Medicine Houston, TX
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Dr. Virani[/caption]
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center
Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: E-cigarettes have gained popularity since their introduction in the U.S. market nearly 20 years ago and their use has increased especially among younger adults. On the other hand, public health efforts aimed at curbing tobacco use over the past few decades have resulted in a decrease in cigarette use. However, state-specific laws and regional cultural differences with regards to perception of these products may result in variability in tobacco use patterns. We therefore evaluate temporal changes in e-cigarette and cigarette use in each U.S. state between the years 2016 to 2018. 
Dr. Al Rafai[/caption]
Mahmoud Al Rifai MD MPH
Section of Cardiology, Department of Medicine
Baylor College of Medicine Houston
[caption id="attachment_55680" align="alignleft" width="150"]
Response: The background for this study involves the associations of household rules and parental awareness with youth tobacco use using data from the Population Assessment Tobacco and Health Study. Health concerns regarding non-cigarette tobacco products, specifically e-cigarettes, have been on the rise. We wanted to explore whether parents are up to date with the trends of popular tobacco products today and what role they may play in youth tobacco cessation and prevention.
The main findings of the study revealed that parents less often suspected their children’s tobacco use if their children reported using only e-cigarettes, and other non-cigarette tobacco products, when compared with cigarettes. Additionally, we found that youth who agreed with their parents that their home has strict rules for tobacco use were less likely to initiate of tobacco use compared to youth who had different understanding of the rules from their parents or youth from households with more permissive household rules. 
Dr. Lanza[/caption]
Isabella Lanza, PhD
Associate Professor of Human Development
California State University, Long Beach
MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is the first study to examine both nicotine vaping and cannabis vaping trajectories across adolescence and young adulthood, which allowed us to assess whether poly-substance vaping is common among adolescents and young adults. Poly-substance vaping (nicotine and cannabis vaping) was reported among a significant proportion of participants in the study (25% were identified as poly-substance vapers). For those that either escalated to frequent nicotine vaping use in adolescence or initiated frequent nicotine vaping use in young adulthood, the probability of engaging in cannabis vaping was very high (85%+).
Dr. Bandi[/caption]
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.
Dr. Obisesan[/caption]
Funmi (Abiru) Obisesan, MD, MPH
Postdoctoral Fellow
Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease
Postdoctoral Fellow
Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease
MedicalResearch.com: What is the background for this study?
Response: E-cigarettes are conceived by many individuals to be less harmful than combustible cigarettes, resulting in their use among young individuals and other vulnerable subpopulations. The recent outbreak of EVALI (e-cigarette, or vaping, product-use associated lung injuries) which was directly associated with e-cigarette use, and the rapidly evolving e-cigarette market, as well as regulations concerning them necessitates the need for up-to-date analyses of e-cigarette use trends. 
Dr. Hongying (Daisy) Dai[/caption]
Hongying (Daisy) Dai, PhD
Associate Professor
Department of Biostatistics | College of Public Health
University of Nebraska Medical Center
Omaha, NE
MedicalResearch.com: What is the background for this study?
Response: E-cigarette use increased dramatically from 11.7% to 27.5% for high school students and from 3.3% to 10.5% for middle school students during the periods of 2017 - 2019. In September 2018, the Food and Drug Administration (FDA) warned that youth e-cigarette use is reaching an epidemic proportion.
Exposure to secondhand aerosol (SHA) from e-cigarettes is not harmless as e-cigarettes aerosol contains nicotine and potentially harmful substances, including carbonyl compounds, TSNAs, heavy metals, and glycols. This study analyzed the 2015-2018 National Youth Tobacco Survey (NYTS) and the main findings are:
Dr. Villanti[/caption]
Andrea Villanti, PhD, MPH
Associate Professor
Department of Psychiatry
Vermont Center on Behavior and Health
University of Vermont
MedicalResearch.com: What is the background for this study?
Response: Our earlier work documented a significant association between first use of a flavored tobacco product and current tobacco use (