Concern about the use of e-cigarettes, particularly by youth, long preceded the COVID-19 pandemic. After entering the U.S. market in the mid-2000s, e-cigarettes were the most commonly used tobacco product among U.S. youth by 2014. According to the National Youth Tobacco Survey, in 2021 more than 2 million U.S. youth in grades six through 12 were currently using e-cigarettes (11.3% of youth in grades nine through 12; 2.8% of youth in grades six through eight). Almost 85% of those reported using flavored e-cigarettes. Most e-cigarettes contain addictive nicotine and substances that are harmful for users of any age.
Monitoring youth’s e-cigarette use as they become young adults and learning about adults’ attitudes regarding e-cigarettes are critical to understand the growth and evolution of this tobacco product. The region's most recent survey of adult tobacco use asked adults about their e-cigarette use and perceptions.
Over 1 in 10 Greater Cincinnati adults (12%) currently use e-cigarettes. Younger adults and those who are high school graduates or have some college education are more likely to use e-cigarettes. More information about the demographics of adults who use e-cigarettes can be found in the "Tobacco Use in Greater Cincinnati" report.
4 in 10 young adults currently use e-cigarettes
In Greater Cincinnati, almost 7 in 10 adults between the ages of 18 and 29 (67%) have used an e-cigarette at least one time. Almost 4 in 10 (36%) report that they currently use e-cigarettes. This percentage is higher than for other age groups and all adults in the region (12%). Click on the graphic to open a larger version.
Half of adults who use e-cigarettes have smoked cigarettes, half have never smoked
Among adults who currently use e-cigarettes, 1 in 4 also currently smoke cigarettes (25%), and 1 in 4 formerly smoked cigarettes (24%). Some adults begin using e-cigarettes in an attempt to quit smoking. However, many continue using both products. In addition, half of adults who currently use e-cigarettes (51%) have never smoked cigarettes. Among young adults ages 18 to 29, 6 in 10 have never smoked cigarettes (63%).
Main reasons for use
Adults who currently use e-cigarettes shared the main reason they use e-cigarettes.
Social situations or to do it with friends is the top reason for e-cigarette use. Not surprisingly, a large majority of adults who use e-cigarettes (83%) report that they have at least one friend or acquaintance who currently uses any kind of tobacco.
The role of flavors
Flavors are often used to attract younger users and those who have never used other tobacco products. The survey found that 9 in 10 adults who currently use e-cigarettes (85%) report their e-cigarettes usually contain flavors such as mint, fruit, candy or spice. Similarly, 9 in 10 adults ages 18 to 29 (91%) report using flavored e-cigarettes.
In 2020, the Food and Drug Administration took action to remove some flavored e-cigarette products from the market. However, menthol flavoring in all e-cigarette products and all flavors in disposable and refillable e-cigarette cartridges remain on the market, continuing to appeal to youth and young adults.
In 2021, the FDA announced it would begin working on regulations to eliminate menthol in cigarettes and all flavors, including menthol, in cigars. This action did not address menthol flavoring in e-cigarettes.
Perceptions of harm and addictiveness of e-cigarettes
The perception that e-cigarettes are less harmful or addictive leads some to consider them a better alternative to traditional cigarettes. The survey found that adults who currently use e-cigarettes (56%) are more likely than those who don’t currently use (25%) to think that e-cigarettes are less harmful than regular cigarettes. Adults who currently use e-cigarettes (37%) are less likely than those who don’t currently use (55%) to think that e-cigarettes are very addictive.
However, almost all e-cigarettes contain nicotine, the addictive substance in tobacco products. Exposure to nicotine by youth and young adults can lead to addiction and harm the developing brain, which develops until about age 25. While e-cigarettes generally contain fewer toxic chemicals than regular cigarettes, e-cigarettes still contain harmful substances. Adults that do not use tobacco products, pregnant women, youth and young adults should not start using e-cigarettes.
Everyone has a role to play in reducing e-cigarettes in our communities. Here are some local strategies we know work:
The 2018 Greater Cincinnati Adult Tobacco Survey is sponsored by Interact for Health. GCATS was conducted Aug. 11, 2018-Jan. 31, 2019, by the Institute for Policy Research at the University of Cincinnati. A random sample of 2,300 adults from a 22-county region surrounding Cincinnati was interviewed by telephone. This included 847 landline telephone interviews and 1,453 cell phone interviews. In 95 out of 100 cases, estimates will be accurate to ±2.0%. There are other sources of variation inherent in public opinion studies, such as non-response, question wording or context effects that can introduce error or bias. For more information and previously released data visit our Greater Cincinnati Adult Tobacco Survey page.
Interact for Health regularly conducts research and collects data in order to monitor and evaluate our region’s health status and to measure public opinions about health policy.
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