Ever Use of E-Cigarettes Among Adults in the United States: A Cross-Sectional Study of Sociodemographic Factors

Abstract

E-cigarette use among adolescents is well-documented, but less is known about adult users of e-cigarettes. The purpose of this study was to examine associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use among 5989 adults aged ≥18 years. Multivariable logistic regression was conducted to examine associations between the sociodemographic exposures of age, sex, race, marital status, education level, employment status, and poverty-income ratio and the outcome of e-cigarette use. The weighted prevalence of ever use of e-cigarettes was 20%. Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times (95% confidence interval [CI] = 3.63-6.27) higher among ages 18 to 34 years and 2.16 times (95% CI = 1.49-3.14) higher among ages 35 to 54 years. Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school (odds ratio [OR] = 1.47; 95% CI = 1.08-2.00) or high school/general educational development (GED) education (OR=1.41; 95% CI = 1.12-1.77) compared with those with college degrees/some college, and among those with incomes below the poverty level (OR=1.31; 95% CI = 1.01-1.69) compared with above the poverty level. For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working. Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are likely to report ever use of e-cigarettes. As increasing evidence demonstrates negative health consequences, e-cigarette initiation may ultimately contribute to additional smoking-related health inequalities even among non-smokers of conventional cigarettes.

Factors Associated with E-Cigarette Use in U.S. Young Adult Never Smokers of Conventional Cigarettes: A Machine Learning Approach

“…Multivariable logistic regression was used to examine the association between e-cigarette use and the variables selected from either Boruta or LASSO, after controlling for gender, age and race/ethnicity, which are considered to be non-modifiable demographic exposures [ 69 ]. There were no statistical adjustments for the association between these non-modifiable demographic exposures and e-cigarette use [ 69 ]. Creating multivariable logistic regression models for each selected feature and adjusting for only the non-modifiable demographic exposures (gender, age, and race/ethnicity) will independently identify the factors associated with e-cigarette use.…”

“…Multivariable logistic regression was used to examine the association between e-cigarette use and the variables selected from either Boruta or LASSO, after controlling for gender, age and race/ethnicity, which are considered to be non-modifiable demographic exposures [69]. There were no statistical adjustments for the association between these non-modifiable demographic exposures and e-cigarette use [69].…”

Neuroinflammatory and Behavioral Outcomes Measured in Adult Offspring of Mice Exposed Prenatally to E-Cigarette Aerosols

“…Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems purported by some to be a safer alternative to tobacco cigarettes for pregnant women (Mark et al 2015;Wagner et al 2017) despite the lack of information on their toxicological effects on the developing fetus. Alarmingly, up to 15% of pregnant women use e-cigarettes based on survey data collected between 2007 and 2017 (Wagner et al 2017;Whittington et al 2018), with the highest prevalence of overall e-cigarette use among people of childbearing age (18-34 years of age) (Kasza et al 2014;Parker and Villanti 2019;Stallings-Smith and Ballantyne 2019). In addition to the known detrimental effects of nicotine on the developing brain, potential health risks are being raised for the added flavors and vehicle [propylene glycol and vegetable glycerin (PG/VG)] used in most e-cigarettes due to their under-investigated toxicology (Burstyn 2014).…”

Are electronic cigarettes and vaping effective tools for smoking cessation? Limited evidence on surgical outcomes: a narrative review

“…of ever e-cigarette use was also found in individuals with a lower education level attained, incomes below the poverty level, and with individuals that are separated, widowed, or divorced (16). The increasing popularity of these devices among youth was also exemplified by a 10% increase in amount of 12 th grade youth vaping observed between 2017 and 2018 in the U.S. (17).…”

“…Much larger than a cigarette with a higher-capacity battery and typically contains a large, refillable cartridge.Often contains manual switches and a battery casing for customizing battery capacity.Can be easily modified. (16). A higher likelihood…”