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

  • Mark Olfson
    Address correspondence to: Mark Olfson, MD, MPH, New York State Psychiatric Institute/Department of Psychiatry, Vagelos College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York NY 10032.
    Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

    New York State Psychiatric Institute, New York, New York
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  • Melanie M. Wall
    Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

    New York State Psychiatric Institute, New York, New York
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  • Shang-Min Liu
    Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

    New York State Psychiatric Institute, New York, New York
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  • Ryan S. Sultan
    Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

    New York State Psychiatric Institute, New York, New York
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  • Carlos Blanco
    National Institute on Drug Abuse, Division of Epidemiology, Services, and Prevention Research, Rockville, Maryland
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      Use of e-cigarettes is increasing among young adults in the U.S. Whether e-cigarette 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.


      Data were analyzed from nationally representative U.S. adults, aged 18 to 35years (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.


      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 26–35years, 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.


      Use of e-cigarettes by U.S. young adults, most of which is not intended to help reduce smoking, is related to more rather than less frequent and intensive cigarette smoking.
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