Report: More Than One in Ten Young Adults Uses E-cigarettes

The latest research, published in a July National Center for Health Statistics data brief, shows that in 2021, e-cigarette use was highest among adults 18 to 24 years old. Young adults also were more likely to use both e-cigarettes and combustible cigarettes compared with adults 45 and older.

These figures coincide with additional research that indicates an overall increase in e-cigarette use. Estimates of annual National Health Interview Survey data suggest that 6% of U.S. adults aged 18 and over used e-cigarettes in 2022 compared with 3.7% in 2020, and another study found that e-cigarette unit sales jumped by more than 46% between January 2020 and December 2022 — an increase from 15.5 million products per month to 22.7 million.

Analysis

The NCHS brief found that 4.5% of all adults use e-cigarettes. More adults 18 to 24 years old used e-cigarettes (11.0%, or roughly 3.4 million people) compared with adults 25 to 44 (6.5%) or 45 and older (2.0%).

Among young adults, men were slightly more likely to use e-cigarettes than women, while those who are white were more likely to use e-cigarettes than young Black adults and significantly more likely than young Asian or Hispanic/Latino adults.

Young adults with family incomes of less than 200% of the federal poverty level also were more likely to use e-cigarettes than those with greater family income.

In addition, young adults were significantly more likely to use both cigarettes and e-cigarettes than adults 45 and older.

The brief’s authors noted that e-cigarette use in young adults is a concern because most e-cigarettes contain nicotine, which is highly addictive and may cause long-term adverse consequences for brain development. They also said dual use of cigarettes and e-cigarettes “may result in greater exposure to toxins and worse respiratory outcomes than using either product alone.”

A scientific statement published by the American Heart Association earlier this summer carried a similar warning about the effects of e-cigarettes, and noted that nicotine and other agents regularly used in these products may pose “dangerous health risks.”

Use Academy Tools to Help Patients Stop, Prevent E-Cigarette Use

As a longstanding proponent of prevention and cessation programs and tobacco product regulation, the AAFP has a wealth of resources available to guide family physicians in their efforts to help patients stop using e-cigarettes. These include

• a treating tobacco dependence practice manual,
• a guide of FDA-approved pharmacologic medications for smoking cessation and
• a tobacco cessation telehealth guide developed by the Academy in collaboration with Pfizer Inc.

These resources and others are on the AAFP’s Tobacco and Nicotine Prevention and Control webpage. Familydoctor.org, the Academy’s patient-facing web resource, has additional materials on tobacco addiction, the harms of vaping and several related topics.