The social patterning of electronic nicotine delivery system use among US adults

Prev Med. 2018 Nov:116:27-31. doi: 10.1016/j.ypmed.2018.08.038. Epub 2018 Aug 29.


There is little research examining the social patterning of electronic nicotine delivery system (ENDS) use. This study investigated the association between socioeconomic status (SES) (education, income, and employment status) and current and former ENDS use. Data were collected from 2561 participants from the American Heart Association Tobacco Regulatory and Addiction Center (A-TRAC) online survey. Participants were 18-64 years old and reported demographic, SES, and ENDS use. Poisson regression was used to estimate prevalence ratios (PR 95% confidence interval-CI) of participants' current and former (vs. never) ENDS use. Models were adjusted for age, sex, sexual orientation, race/ethnicity, marital status, and reasons for ENDS use. In the unadjusted analysis, ENDS use was primarily patterned by education and employment status. College educated persons (vs. those with less than a high school diploma) had a 37% greater prevalence of current ENDS use (PR 1.37, 95% CI 1.20-1.55), and a 16% greater prevalence of former ENDS use (PR 1.16, 95% CI 1.06-1.28) in the fully-adjusted model. Persons with household incomes above $90 K (vs. less than $20,000) had a greater prevalence of current (PR 1.30, 95% CI 1.19-1.41) and former (PR 1.17, 95% CI 1.05-1.30) ENDS use. Those who were employed (vs. not employed) had a 13% greater prevalence of current ENDS use (PR 1.13, 95% CI 1.07-1.19) after full adjustment. Higher SES (vs. lower SES) persons were more likely to use ENDS.

Keywords: A-TRAC; E-cigarettes; ENDS; Social patterning; Socioeconomic status; Vaping.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Prevalence
  • Smoking / epidemiology
  • Smoking Cessation / statistics & numerical data*
  • Social Class
  • Surveys and Questionnaires
  • United States / epidemiology
  • Vaping / epidemiology*
  • Young Adult