The latest research, published in a July National Center for Health Statistics data brief, shows that in 2021, e-cigarette use was highest among adults 18 to 24 years old. Young adults also were more likely to use both e-cigarettes and combustible cigarettes compared with adults 45 and older.

These figures coincide with additional research that indicates an overall increase in e-cigarette use. Estimates of annual National Health Interview Survey data suggest that 6% of U.S. adults aged 18 and over used e-cigarettes in 2022 compared with 3.7% in 2020, and another study found that e-cigarette unit sales jumped by more than 46% between January 2020 and December 2022 — an increase from 15.5 million products per month to 22.7 million.


The NCHS brief found that 4.5% of all adults use e-cigarettes. More adults 18 to 24 years old used e-cigarettes (11.0%, or roughly 3.4 million people) compared with adults 25 to 44 (6.5%) or 45 and older (2.0%).

Among young adults, men were slightly more likely to use e-cigarettes than women, while those who are white were more likely to use e-cigarettes than young Black adults and significantly more likely than young Asian or Hispanic/Latino adults.

Young adults with family incomes of less than 200% of the federal poverty level also were more likely to use e-cigarettes than those with greater family income.

In addition, young adults were significantly more likely to use both cigarettes and e-cigarettes than adults 45 and older.

The brief’s authors noted that e-cigarette use in young adults is a concern because most e-cigarettes contain nicotine, which is highly addictive and may cause long-term adverse consequences for brain development. They also said dual use of cigarettes and e-cigarettes “may result in greater exposure to toxins and worse respiratory outcomes than using either product alone.”

A scientific statement published by the American Heart Association earlier this summer carried a similar warning about the effects of e-cigarettes, and noted that nicotine and other agents regularly used in these products may pose “dangerous health risks.”

Use Academy Tools to Help Patients Stop, Prevent E-Cigarette Use

As a longstanding proponent of prevention and cessation programs and tobacco product regulation, the AAFP has a wealth of resources available to guide family physicians in their efforts to help patients stop using e-cigarettes. These include

These resources and others are on the AAFP’s Tobacco and Nicotine Prevention and Control webpage., the Academy’s patient-facing web resource, has additional materials on tobacco addiction, the harms of vaping and several related topics.