A selection of the popular Juul brand vaping supplies and third-party replacement pods for sale. (Photo/Richard B. Levine, Alamy)

E-cigarette use among young adults in the U.S. jumped 46% between 2017 and 2018, suggesting that the vaping industry is making inroads among 18- to 24-year-olds as it has among teens.

Co-led by scientists at USC, the research provides one of the first published looks at young adult e-cigarette use prevalence in 2018 and could inform the movement for stricter rules regarding e-cigarettes. Skyrocketing teen vaping rates and a spate of vaping-related lung-injury deaths have prompted calls for a federal ban on flavored e-cigarettes, among other proposed regulations.

The study appears in JAMA, the Journal of the American Medical Association.

Fruity and minty ‘pod-mod’ products preferred

“Sales of ‘pod-mod’ style e-cigarette products, such as JUUL, with high nicotine concentrations in fruity and minty flavors, are climbing,” said Adam Leventhal, professor of preventive medicine and psychology and director of the USC Institute for Addiction Science at the Keck School of Medicine of USC. “Young adults overwhelmingly prefer e-cigarette flavors not present in regular cigarettes.”

E-cigarette use didn’t significantly change among adults 25-44 years old and decreased in people aged 45 to 64 years and 65 years and older from 2014 to 2018.

Young adults overwhelmingly prefer e-cigarette flavors not present in regular cigarettes. Adam Leventhal

Data for the study came from interviews of 115,556 people — including 13,452 young adults aged 18-24 — who were part of the 2014-2018 National Health Interview Surveys conducted by the Centers for Disease Control and Prevention.

The increase in current e-cigarette use from 5.2% in 2017 to 7.6% in 2018 in young adults translates to about 700,000 new young adult e-cigarette users in the U.S. The researchers found that increases in e-cigarette use from 2014 to 2018 were not more pronounced in any subgroup of young adults: E-cigarette use increased in both men and women, every income level, most racial groups, and non-smokers and smokers.

“Our results are noteworthy, given that the recent reports of vaping-related lung injuries and deaths have primarily been seen in adolescents and young adults,” Leventhal said.

Is e-cig use helping anyone?

Leventhal says the numbers don’t prove or disprove e-cig makers’ claims that their products are important smoking cessation tools.

“We found that vaping increased in young adults who had never smoked, and never smokers get no health benefit whatsoever from vaping,” Leventhal said. “Vaping also increased in young adult former smokers; some of them might have been people who used e-cigarettes to quit smoking and continued to vape afterward.

“Others may be people who had quit smoking for a while and saw new nicotine products that enticed them to get back into using nicotine. Resolving this question is an important area for future research.”

In addition to Leventhal, the study’s corresponding author is Hongying Dai of the University of Nebraska. The study was supported with funds from the National Cancer Institute and the U.S. Food and Drug Administration Center for Tobacco Products (R03CA228909 and U54CA180905).

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