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E-cigarette use up sharply among younger adults, ACS study finds

new study by American Cancer Society researchers shows almost three-quarters of a million more adults in the United States, ages 18-29 years, used e-cigarettes between 2019-2021 during the period that spanned the EVALI outbreak (E-cigarette or vaping product use–associated lung injury) and COVID-19 pandemic. Scientists report the year-on-year increase was primarily among adults who never smoked cigarettes. The study was published in the American Journal of Preventive Medicine (AJPM) and shared on Twitter.

"Unfortunately, these numbers show we're moving in the wrong direction concerning e-cigarette use in this vulnerable population,” said Dr. Priti Bandi, ACS scientific director, cancer risk factors and screening surveillance research at and lead author of the study. “Our research finding is concerning as it may point to an increase in nicotine addiction risk for young adults, potentially contributing to progression to combustible tobacco products, and may also increase exposure to unknown toxicants, carcinogens, and the risk of respiratory diseases.”

A few key facts:

  • The study results showed between 2019 and 2021, e-cigarette use prevalence increased from 8.8% in 2019 to 10.2% in 2021 among younger U.S. adults ages 18-29 years. 
  • Of note, among those young adults who never smoked cigarettes, e-cigarette use jumped from 4.9% in 2019 to 5.2% in 2020 to 6.4% in 2021. This group of young adults constituted 53% (2.68 million) of younger adults who used e-cigarettes in 2021, increasing by 0.71 million persons from 2019. 
  • The study also showed among middle-aged and older U.S. adults, e-cigarette prevalence was similar in 2019 and 2021 irrespective of combustible cigarette smoking status. People who formerly smoked cigarettes constituted the largest population proportion of people who use e-cigarettes among adults older than 30 years in 2021 (51.1%, 3.1 million).

Dr. Ahmedin Jemal is senior author of the study. Other ACS authors include: Jessica StarAdair K. MinihanDr. Minal Patel, and Dr. Nigar Nargis.

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