Trends in Electronic Nicotine Delivery Systems and Cigarette Use Among Texas College Students, 2015-2024

We examined trends in past 30-day electronic nicotine delivery systems (ENDS) and past 30-day cigarette use among Texas college students from 2015 to 2024. We hypothesized that ENDS use would a) decline from 2015 to 2017 similar to national surveillance research, b) increase from 2017 to 2019 after the surging popularity of JUUL and similar pod-vapes, and then c) decline again from 2019 to 2024 after the enactment of federal tobacco policies and the onset of the COVID-19 pandemic. We also hypothesized that cigarette smoking would decline steadily over the 10 years.

Participants were 45,129 18-25-year-old Texas college students who participated in at least one of ten repeated cross-sectional surveys from 2015 to 2024. Discontinuous growth curve models were used to analyze trends in past 30-day ENDS use and cigarette smoking across the 10 years.

Results indicated that ENDS use decreased from 2015 to 2017 (AOR = 0.88, 95% CI: 0.81, 0.96), increased from 2017 to 2019 (AOR = 2.08, 95% CI: 1.96, 2.20), and then decreased from 2019 to 2024 (AOR = 0.95, 95% CI: 0.93, 0.97). Past 30-day cigarette smoking decreased steadily across the 10-year study period (AOR = 0.82, 95% CI: 0.80, 0.83).

Findings suggest that while cigarette use has declined over the past decade among Texas college students, there have been inconsistent changes in ENDS use. Although the present study cannot infer causality, these changes align with the timing of tobacco legislation and FDA regulations. The sharp increase in ENDS between 2017 and 2019 highlights the need to remain vigilant about new products and marketing strategies from tobacco companies, as they may undermine the effectiveness of tobacco control efforts.