Intentions to Use FDA-authorized E-cigarettes among Adults Who Smoke Cigarettes in the United States

Chen-Sankey J, La Capria K, Meng S, Liu H, Ling F, Jensen JK, Wackowski OA, Villanti AC.
Intentions to Use FDA-authorized E-cigarettes among Adults Who Smoke Cigarettes in the United States
Nicotine Tob Res. 2026 Apr 27:ntag091. doi: 10.1093/ntr/ntag091. Epub ahead of print. PMID: 42041117; PMCID: PMC13179831.

Introduction: Little is known about intentions to use Food and Drug Administration-authorized e-cigarettes (FAEs) among U.S. adults who smoke cigarettes despite initial product authorizations and ongoing reviews. This study examined such intentions in this population.

Methods: We conducted an online survey in 2024 with adults who smoke cigarettes (n=2,612; ages 21-70) in the U.S. using a national panel. Participants read a description of FAEs and then answered related questions. We assessed the weighted prevalence of intentions to use FAEs (in general and for quitting) and used bivariate and multivariable ordinal logistic regressions to examine associations between sociodemographic, tobacco use behaviors, and FAE use intentions.

Results: Over half of the participants reported being "somewhat," "very," or "extremely" interested in using FAEs in general (53%) and to quit smoking (53%). The multivariable regressions showed participants who reported their subjective financial situation as "do not meet basic needs" or had a high school degree or less had lower FAE use intentions than those who reported they "live comfortably" or had higher education, respectively. Those with plans to quit smoking or who had used e-cigarettes and FAEs before reported increased FAE use intentions than those who had no plans to quit and had never used those products before, respectively.

Conclusions: FAEs may appeal to more than half of adults who smoke cigarettes, though people with lower socioeconomic statuses or no plans to quit reported lower FAE use intentions. This study can inform policy and communication strategies related to e-cigarette authorization in the U.S.

Implications: This study is among the first nationally representative surveys among U.S. adults who smoke cigarettes to examine the prevalence of intentions to use FDA-authorized e-cigarettes (FAEs), both in general and for smoking cessation, and the socioeconomic and tobacco use-related factors associated with these intentions. The study found that FAEs may appeal to more than half of adults who smoke, though people with lower socioeconomic statuses or no plans to quit smoking reported reduced FAE use intentions. This study can inform policy and communication strategies related to e-cigarette authorization in the U.S.