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

Introduction: This article provides an analysis of trends in e-cigarette use among U.S. adults between 2014 and 2018, differentiated by age group and cigarette smoking histories. The study's findings offer valuable insights into the real-world trends of e-cigarette use and their implications for public health.

Key Points:

* The study uses data from the National Health Interview Surveys, a nationally representative survey, to estimate current e-cigarette prevalence, adjusted prevalence differences, and population counts of users.
* The analysis is stratified by age group (younger adults, middle-aged adults, and older adults) and cigarette smoking histories (current smokers, recent quitters, near-term quitters, long-term quitters, and never smokers).
* Among younger adults, e-cigarette use increased in all groups of smokers, with notable increases between 2014 and 2018 among never smokers (1.3% - 3.3%, adjusted prevalence difference=2%, p<0.001) and near-term quitters (9.1% - 19.2%, adjusted prevalence difference=8.8%, p=0.024).
* The largest absolute population increase in e-cigarette users between 2014 and 2018 was among younger-adult never smokers (0.49 - 1.35 million).
* Among middle-aged and older adults, the only substantial increase in e-cigarette use between 2014 and 2018 was among near-term quitters.
* The continuous increase among younger-adult never smokers suggests a rise in primary nicotine initiation with e-cigarettes. The concomitant increase among near-term quitters of all age groups suggests continuing e-cigarette use among smokers who may have switched from cigarettes previously.

Main Message: The study highlights the significant increase in e-cigarette use among younger-adult never smokers, which raises concerns about primary nicotine initiation. This trend, combined with the increase in e-cigarette use among near-term quitters, underscores the importance of addressing the potential risks associated with e-cigarette use, particularly among younger age groups. Public health actions should be informed by these findings to mitigate the potential negative consequences of e-cigarette use.

Bandi P, Cahn Z, Goding Sauer A, et al. Trends in E-Cigarette Use by Age Group and Combustible Cigarette Smoking Histories, U.S. Adults, 2014-2018. American journal of preventive medicine. 2021;60(2):151-158. doi:10.1016/j.amepre.2020.07.026