E-cigarette Use Among Young Adults in the U.S.

Abstract

Introduction: Use of e-cigarettes is increasing among young adults in the U.S. Whether ecigarette use serves as an aid to smoking reduction or cessation among young adults remains a matter of contention. This analysis examines patterns of e-cigarette use in relation to cigarette smoking in a nationally representative sample of U.S. young adults. Methods: Data were analyzed from nationally representative U.S. adults, aged 18 to 35 years (n=12,415), in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Logistic regression assessed associations between e-cigarette use and smoking intensity, continuity, and reduction while controlling for several potential confounding factors. Data were analyzed in 2018. Results: Among cigarette smokers, e-cigarette use was associated with higher odds of tobacco use disorder (AOR=2.58, 95% CI=1.73, 3.83) and daily cigarette smoking (AOR=1.67, 95% CI=1.73, 3.83). Among adults aged 26-35 years, e-cigarette use was also associated with heavy cigarette smoking (AOR=2.01, 95% CI=1.09, 3.74). Among lifetime smokers, e-cigarette use was associated with lower odds of stopping smoking (AOR=0.14, 95% CI=0.08, 0.23) and lower odds of a 50% reduction in cigarettes smoked per day (AOR=0.63, 95% CI=0.43, 0.93). Only 13.1% of young adults who ever used e-cigarettes reported using them to help stop or quit smoking. Conclusions: Use of e-cigarettes by U.S. young adults, most of which is not to help reduce smoking, is related to more rather than less frequent and intensive cigarette smoking.

Type of e-liquid vaped, poly-nicotine use and nicotine dependence symptoms in young adult e-cigarette users: a descriptive study

“…Extant evidence on the efficacy of e-cigarettes is equivocal [4,13,14,24,55]. A US report using nationally representative data found that only 13% of young adult lifetime e-cigarette users reported using e-cigarettes as a cessation aid and these individuals were less likely to report cessation in the pastyear [56]. It is possible that, because of nicotine in ecigarettes (even in e-cigarettes labelled nicotine-free [53]), young adults who try to quit using nicotinecontaining e-cigarettes in fact contribute to or increase their ND level [25] leaving them craving nicotine.…”

“…One hypothesis posits that e-cigarette users could decrease the number of cigarettes smoked because e-cigarettes deliver nicotine at similar rates, making them as or more satisfying than traditional nicotine replacement therapies, but contributing more to ND and sustained smoking [25]. Olfson et al (2019) [56] reported that e-cigarette users were 2.3 times more likely to be daily cigarette smokers than non-e-cigarette users, and 3.6 times more likely to report a tobacco use disorder. Recent longitudinal findings concur that dual use (cigarettes and e-cigarettes) was associated with an increase in e-cigarette frequency, nicotine exposure and ND in adolescent e-cigarette users with minimal cessation benefits [58].…”

“…The rising popularity of e-cigarettes among youth [1,4,56,59] and increased availability of e-liquid with nicotine [2,60], threatens tobacco control achievements [5]. Up to 2018, there were no regulations governing vaping products in Canada.…”

Labelling accuracy in low nicotine e-cigarette liquids from a sampling of US manufacturers

“…The labelled nicotine ‘strength’ is available in a wide range, most commonly 0–24 mg/ml . Popularity of EC has increased dramatically in recent years, especially among adolescents . For new EC users who smoke tobacco, recent US evidence suggests that their use could pose a higher risk for the development of tobacco use disorder than daily cigarette smoking alone .…”

“…Popularity of EC has increased dramatically in recent years, especially among adolescents . For new EC users who smoke tobacco, recent US evidence suggests that their use could pose a higher risk for the development of tobacco use disorder than daily cigarette smoking alone . There has also been an increased interest globally in the safety of EC versus traditional cigarettes, and many agree that ECs can provide a harm reduction strategy versus actual tobacco exposure .…”