# Vaping and smoking trajectories among youth and adults in the United States across the period 2014–2022

## TL;DR

This study tracks how vaping and smoking habits changed among youth and adults in the U.S. from 2014 to 2022, showing increased vaping use and shifts in smoking behavior.

## Contribution

The study provides new insights into how ENDS use and cigarette smoking trajectories evolved during key periods influenced by market changes and public health events.

## Key findings

- Youth ENDS use progression increased from 23% to 35% between the two periods.
- Adult cigarette smokers who also used ENDS had higher discontinuation rates (42%) in the later period.
- 1.6 million youths and 1.6 million adults showed notable shifts in ENDS and cigarette use by 2022.

## Abstract

Multiple occurrences in the United States may have impacted trajectories (i.e., transitions over time) in the use of electronic nicotine delivery systems (ENDS) and cigarette smoking in the population over time. We examine youths' trajectories in ENDS use and adults' trajectories in cigarette smoking across two periods: 2014–2016–2017; 2019–2021–2022.

We analyzed longitudinal Population Assessment of Tobacco and Health (PATH) Study data from youth ages 12–17 in 2014 (N = 9,582), youth ages 12–17 in 2019 (N = 7,325), adults who smoked cigarettes in 2014 (N = 8,999), and adults who smoked cigarettes in 2019 (N = 5,800). We evaluated trajectories in ENDS use among youth and trajectories in cigarette smoking among adults, each across two periods: 2014–2016–2017; 2019–2021–2022.

Among youth, rates of progression from less frequent to frequent ENDS use were 23 and 35% across two periods: 2014–2016–2017; 2019–2021–2022, respectively; rates of maintaining frequent ENDS use were 13 and 51% across two periods: 2014–2016–2017; 2019–2021–2022, respectively. Among adults who smoked cigarettes and used ENDS frequently, 23 and 42% discontinued smoking across two periods: 2014–2016–2017; 2019–2021–2022, respectively.

Across the period 2019–2021–2022, the number of youths in 2019 who used ENDS frequently in 2022 was 1.6 million, while the number of adults who smoked cigarettes in 2019 who used ENDS frequently in 2019, and stopped smoking cigarettes in 2022, was 1.6 million. The population-level impact of ENDS in the US appears greater since the significant evolution in the ENDS market, including the rise in popularity of salt-based nicotine ENDS, the coronavirus disease 2019 (COVID-19) pandemic, and various tobacco control policies.