Changes in E-Cigarette Use Among U.S. Adults, 2019-2021

Area of Science:

• Public Health
• Tobacco Control
• Epidemiology

Background:

• E-cigarette use increased among young US adults who never smoked combustible cigarettes between 2014-2018.
• The impact of the E-cigarette, or vaping, product use-associated lung injury (EVALI) epidemic and the COVID-19 pandemic on E-cigarette prevalence was unknown.

Purpose of the Study:

• To examine trends in E-cigarette use among US adults from 2019 to 2021.
• To analyze these trends by age group and combustible cigarette smoking status.

Main Methods:

• Utilized data from the 2019, 2020, and 2021 National Health Interview Surveys (NHIS).
• Estimated current E-cigarette use prevalence and population counts.
• Analyzed data stratified by age groups (18-29, 30-44, 45-59, ≥60 years) and smoking status (current, former, never).

Main Results:

• E-cigarette use prevalence increased among younger adults (18-29 years) from 8.8% in 2019 to 10.2% in 2021.
• This increase was primarily driven by young adults who never smoked cigarettes (4.9% to 6.4%).
• In contrast, E-cigarette use prevalence remained stable among middle-aged and older adults, with former smokers constituting the largest proportion of users.

Conclusions:

• Targeted public health efforts are needed to address the rising E-cigarette use among young adults, particularly those who have never smoked combustible cigarettes.
• Support is also required for individuals who have transitioned to E-cigarettes from combustible tobacco to help them achieve complete cessation.