SAFE Glen Cove Coalition: The Truth About Who is Using E-Cigarettes

E-cigarettes have been the most commonly used tobacco product among U.S. youth since 2014. E-cigarette use among middle and high school students steadily increased from 2011, reaching its zenith at 27.5% of high school students using e-cigarettes in 2019. Current e-cigarette use among middle and high school students declined significantly between 2023 and 2024 (7.7% to 5.9%, or 2.13 million to 1.63 million) but e-cigarette use remains a serious public health threat: among students who currently used e-cigarettes in 2024, 38.4% reported frequent use and 26.3% reported daily use.

• In 2024, 3.5% of middle school students and 7.8% of high school students – roughly 1.63 million students – reported current (i.e., past 30-day) e-cigarette use.
• Among current e-cigarette users:
  • 38.4% reported frequent use, and 26.3% reported daily use.
  • 87.6% used a flavored e-cigarette
  • Disposable e-cigarettes (55.6%), prefilled or refillable pods or cartridges (15.6%), and tanks or mod systems (7.0%) were the most commonly used device types. 21.8% of students were unsure of the device type used.
• In 2022, young people most acquired e-cigarettes through social sources (56.9%) followed by retail sources (43.1%).

While e-cigarette use among young people has declined in recent years, it remains a serious public health threat: 10% of high school students used e-cigarettes in 2023, many of whom were not smokers in the first place.

In terms of adult users, E-cigarette use has remained relatively low and stable among adult users since around 2012, although use has gone up slightly among adults recently, from 4.5% in 2021 to 6% in 2022. In 2022, the greatest e-cigarette use among adults was among 23- to 24-year-olds, 22.8% of whom were current users, according to Monitoring the Future (MTF), one of the nation’s most relied upon scientific sources of valid information on trends in use of licit and illicit psychoactive drugs by U.S. adolescents, college students, young adults, and adults up to age 60. MTF is conducted each year by researchers at the University of Michigan, Ann Arbor, and funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health..

While some e-cigarette brands have recently begun to offer nicotine-free products, most e-cigarettes products sold in the U.S. contain nicotine. Nicotine is harmful to developing brains and its use during adolescence can disrupt the formation of brain circuits that control attention, learning, and susceptibility to addiction. Exposure to nicotine among youth is particularly dangerous since it affects key brain receptors, making young people more susceptible to nicotine addiction.

When evaluating the risks of e-cigarette use, it is important to note that exposure to harmful chemicals inhaled by e-cigarette users can vary greatly depending on e-cigarette device characteristics (voltage, flavor, nicotine) and how the device is used. Below is a list of the potential health risks associated with e-cigarette use, based on recent findings from the National Academies of Sciences, Engineering, and Medicine as well as other major reviews on the topic. Researchers note it is important that additional data is needed on the health effects of e-cigarettes.

• Asthma There is moderate evidence for increased coughing and wheezing in adolescents who use e-cigarettes. E-cigarette use is associated with an increase in asthma exacerbations. Two meta-analyses have identified an association between current and ever e-cigarette use and asthma. However, significant inconsistencies across studies suggest the need for additional research.
• Cancer Some chemicals present in e-cigarette aerosols, such as formaldehyde and acrolein, can cause DNA damage and mutagenesis that can lead to cancer. Long-term exposure to e-cigarette aerosols could increase the risk of cancer and adverse reproductive outcomes; however, given that studies varied, additional research is needed.
• Heart Disease

A meta-analysis found an association between e-cigarette use and heart attack, although the risk of e-cigarettes causing a heart attack was lower than the risk of heart attack from cigarette smoking. A 2023 meta-analysis concluded that inhalation of e-cigarette aerosol leads to impaired functioning of the lining of blood vessels. To date, there is no available evidence to suggest that e-cigarette use is associated with clinical cardiovascular outcomes such as coronary heart disease, stroke, peripheral artery disease, and early stages of atherosclerosis.

• Stroke, Lung Function and Other Conditions The role of e-cigarette use in the development of stroke remains inconclusive. Short-term e-cigarette inhalation has a similar effect on lung function as cigarettes and vaping may increase airway resistance in lungs. However, given the limited size and follow-up duration of existing studies, more research is needed.

Youth e-cigarette use is also linked to future cigarette use. Young people in the U.S. who had ever used e-cigarettes in 2018 had 7x higher odds of ever using cigarettes and 8x higher odds of currently using cigarettes one year later, compared with those who had never used an e-cigarette, according to Truth Initiative research.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention, and education agency in the City of Glen Cove. Its Coalition is concerned with all combustible and electronic products with tobacco. The Agency employs environmental strategies to educate and update the community regarding the negative consequences of smoking and vaping. To learn more about the SAFE Glen Cove Coalition please follow www.facebook.com/safeglencove or to learn more about electronic products visit the Youth and Tobacco Use and Vaping Facts and Myths Pages of SAFE’s website to learn more about how vaping is detrimental to your health at www.safeglencove.org.

The Truth Initiative is the nation’s largest nonprofit public health organization dedicated to preventing youth and young adult nicotine addiction and empowering quitting. For more information, please visit www.truthinitiative.org.