Prevalence of ENDS and JUUL Use, by Smoking Status, in National Samples of Young adults and Older adults in the U.S.

Introduction:
This text provides an analysis of the prevalence of electronic nicotine delivery systems (ENDS) and JUUL brand ENDS use among adults in the US, overall and by smoking history. The study utilizes 2019 cross-sectional online surveys assessing smoking, use of any ENDS, and JUUL specifically, in a national probability sample of 11,833 US adults. The data is analyzed for young adults (18-24) and older adults (25+).

Key Points:

* Past 30-day ENDS use was 8.0% among young adults and 4.7% in older adults.
* Most (> 98%) ENDS and JUUL users were current or former smokers.
* among those who had ever used both ENDS and other tobacco, strong majorities reported using other tobacco first.
* among JUUL users who also had used other tobacco, 95% had used other tobacco first.
* Prevalence of ENDS use was highest among current smokers (30.1% of Ya; 16.3% of Oa), and lowest among never smokers (2.0% of Ya; 0.4% of Oa).
* Prevalence of JUUL use was highest among current smokers (18.6% of Ya; 5.2% of Oa), and lowest among never smokers (0.9% of Ya; 0.1% of Oa).
* The figures for former smokers, by time since quitting, also parallel the figures for the overall ENDS category, although the sample sizes were smaller.

Main Message:
The study highlights the importance of understanding both the potential beneficial uses of ENDS products, such as by adult current smokers who would have otherwise continued smoking, and adult former smokers who may use ENDS as a means to prevent resumption of smoking, as well as potentially harmful use by non-smokers or non-users of tobacco products who would not otherwise have used tobacco products. The analysis of ENDS use in this age cohort is significant as young adulthood is now the prime period for smoking initiation and progression, and is associated with high levels of risk-taking.

Prakash S, hatcher C, Shiffman S. Prevalence of ENDS and JUUL Use, by Smoking Status, in National Samples of Young adults and Older adults in the U.S. american journal of health behavior. 2021;45(3):402-418. doi:10.5993/aJhB.45.3.2