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. 2018 Oct 2;169(7):429-438.
doi: 10.7326/M17-3440. Epub 2018 Aug 28.

Prevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016

Mohammadhassan Mirbolouk  1 , Paniz Charkhchi  2 , Sina Kianoush  3 , S M Iftekhar Uddin  1 , Olusola A Orimoloye  1 , Rana Jaber  4 , Aruni Bhatnagar  5 , Emelia J Benjamin  6 , Michael E Hall  7 , Andrew P DeFilippis  5 , Wasim Maziak  8 , Khurram Nasir  9 , Michael J Blaha  1
Affiliations

Prevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016

Mohammadhassan Mirbolouk et al. Ann Intern Med. .

Abstract

Background: Contemporary data on the prevalence of e-cigarette use in the United States are limited.

Objective: To report the prevalence and distribution of current e-cigarette use among U.S. adults in 2016.

Design: Cross-sectional.

Setting: Behavioral Risk Factor Surveillance System, 2016.

Participants: Adults aged 18 years and older.

Measurements: Prevalence of current e-cigarette use by sociodemographic groups, comorbid medical conditions, and states of residence.

Results: Of participants with information on e-cigarette use (n = 466 842), 15 240 were current e-cigarette users, representing a prevalence of 4.5%, which corresponds to 10.8 million adult e-cigarette users in the United States. Of the e-cigarette users, 15% were never-cigarette smokers. The prevalence of current e-cigarette use was highest among persons aged 18 to 24 years (9.2% [95% CI, 8.6% to 9.8%]), translating to approximately 2.8 million users in this age range. More than half the current e-cigarette users (51.2%) were younger than 35 years. In addition, the age-standardized prevalence of e-cigarette use was high among men; lesbian, gay, bisexual, and transgender (LGBT) persons; current combustible cigarette smokers; and those with chronic health conditions. The prevalence of e-cigarette use varied widely among states, with estimates ranging from 3.1% (CI, 2.3% to 4.1%) in South Dakota to 7.0% (CI, 6.0% to 8.2%) in Oklahoma.

Limitation: Data were self-reported, and no biochemical confirmation of tobacco use was available.

Conclusion: E-cigarette use is common, especially in younger adults, LGBT persons, current cigarette smokers, and persons with comorbid conditions. The prevalence of use differs across states. These contemporary estimates may inform researchers, health care policymakers, and tobacco regulators about demographic and geographic distributions of e-cigarette use.

Primary funding source: American Heart Association Tobacco Regulation and Addiction Center, which is funded by the U.S. Food and Drug Administration and National Heart, Lung, and Blood Institute.

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Conflict of interest statement

Disclosures: Drs. Mirbolouk, Uddin, and Orimoloye report grants from A-TRAC during the conduct of the study. Dr. Benjamin reports grants from the National Institutes of Health (NIH) and American Heart Association, served as associate editor for the journal Circulation, and was a member of the NIH/National Center for Biotechnology Information Observational Study Monitoring Board for the CARDIA (Coronary Artery Risk Development in Young Adults) trial outside the submitted work. Dr. DeFilippis reports grants from the National Institute of General Medical Sciences and NIH during the conduct of the study. Dr. Blaha reports grants from the FDA during the conduct of the study and grants from the NIH, FDA, Amgen Foundation, and Aetna Foundation and personal fees from the FDA, American College of Cardiology, Amgen Foundation, Aetna Foundation, MedImmune, Novartis, Sanofi/Regeneron, and Akcea outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3440.

Figures

Figure 1.
Figure 1.. Prevalence of e-cigarette use among U.S. adults, according to age group, 2016 Behavioral Risk Factor Surveillance System survey.
P values for trends <0.001. Error bars represent 95% CIs.
Figure 2.
Figure 2.. Prevalence of current (top) and daily (bottom) e-cigarette use among former and current combustible cigarette smokers, stratified by age, 2016 Behavioral Risk Factor Surveillance System survey.
Error bars represent 95% CIs.
Figure 3.
Figure 3.. State-specific, age-standardized prevalence of current e-cigarette use among U.S. adults: results of the 2016 Behavioral Risk Factor Surveillance System survey.
See this image and copyright information in PMC

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