Data from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) demonstrated that the prevalence of electronic cigarette (e-cigarette) use in the United States is more common in younger individuals, those at a low socioeconomic status, and current and former smokers.

The current analysis, with results published in the Journal of the American Heart Association, used tobacco information from NHANES to examine the prevalence and patterns of recent e-cigarette use in a nationally representative sample of US adolescents and adults.

A total of 5423 adults and 895 adolescents (age 13-17 years) were included in the current analysis. Tobacco use, demographic, and drug use information were all self-reported by the participants. In addition, recent e-cigarette use (ie, within the prior 5 days) was stratified according to smoking status.

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Among 125 users of e-cigarettes, 116 individuals were ≥18 years of age, which corresponded with a 2.6% prevalence (95% CI, 2.0%-3.1%) of e-cigarette use in US adults and a 1.21% prevalence (95% CI, 0.3%-2.1%) in US adolescents.

Overall, 68.1% of adult e-cigarette users were current smokers, 23.7% were former smokers, and 8.2% were never smokers. The highest prevalence of e-cigarette use was reported in current smokers (8.2%; 95% CI, 6.3%-10.1%), which was followed by former smokers (2.7%; 95% CI, 1.4%-4.1%), then by never smokers (0.4%; 95% CI, 0.2-0.6).

Following adjustments for age, gender, and ethnicity, users of e-cigarettes had significantly higher odds of exposure to second-hand smoke (odds ratio, 6.3; 95% CI, 3.6-11.1; P <.001) and of consuming alcohol (odds ratio, 4.2; 95% CI, 1.8-10.0; P <.01), along with lower odds of having at least a college education or a higher income compared with tobacco nonusers.

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The investigators concluded that the findings from this study should help to inform future research as well as public policy and tobacco regulatory agencies about the prevalence of e-cigarette use compared with other methods of tobacco use. These results should also assist in the prioritization and implementation of group-based interventions.    


Jaber RM, Mirbolouk M, DeFilippis AP, et al. Electronic cigarette use prevalence, associated factors, and pattern by cigarette smoking status in the United States from NHANES (National Health and Nutrition Examination Survey) 2013-2014. J Am Heart Assoc. 2018;7(14). doi:10.1161/JAHA.117.008178