Action Needed: E-Cigarettes


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Following years of successful tobacco control efforts that achieved record low youth smoking, e-cigarettes have driven total youth tobacco use to rates unseen in decades. Current, or past 30-day, use of e-cigarettes among high school students increased from 11.7% to 27.5% between 2017 and 2019, driving overall tobacco use among high school students to 31.2%. The most recent data from 2020 show that high school students continue to use e-cigarettes at epidemic levels, with 1 in 5 (19.6%) vaping in the past 30 days, and that the intensity of use has increased with 38.9% of current users reporting vaping on 20 or more days per month.

The Food and Drug Administration has taken only tentative steps to remove some youth-appealing products and flavors. In the absence of comprehensive federal regulation, many flavored e-cigarettes remain on the market and sales data indicate that young people simply switch to products that are still available. Meanwhile, evidence is mounting that links e-cigarette use among young people with subsequent cigarette use. A 2020 Truth Initiative study shows that young Americans who had ever used e-cigarettes had seven times higher odds of becoming smokers one year later compared with those who had never vaped.

Despite the tobacco industry’s insistence to regulators that e-cigarettes are intended for and marketed to adult smokers, the data show that youth and young adults continue to vape at the highest rates. While youth use of e-cigarettes reached 20.8% in 2018, the National Health Interview Survey found in the same year that only 3.2% of adults use e-cigarettes – much of that driven by young adults, who use at 7.6%. A recent Truth Initiative study also found that very few adult smokers are using e-cigarettes to try to quit. Among adult smokers who tried to quit in the last year, just 1.1% used JUUL alone and only 5.6% used other e-cigarettes alone. The study found that among former smokers who had quit in the past four years, just 2.2% reported using only JUUL and 6.9% used other e-cigarettes. While some adults have used e-cigarettes to switch completely from combustible cigarettes, the FDA has not approved any e-cigarette as a cessation intervention, and nearly half of adults who use e-cigarettes also use cigarettes. This “dual use” provides no reduction in the harms associated with smoking.

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Format: Reports/Handout
Publisher: Truth Initiative
Downloadable: Yes

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