Demographic Characteristics, Cigarette Smoking, and e-Cigarette Use Among US Adults.
Thursday, November 19, 2020
Posted by: Natalia Gromov
Mayer
M, Reyes-Guzman C, Grana R, Choi K, Freedman ND.
Demographic
Characteristics, Cigarette Smoking, and e-Cigarette Use Among US Adults.
JAMA Netw Open. 2020;3(10):e2020694. doi:10.1001/jamanetworkopen.2020.20694
Introduction
Understanding how electronic cigarettes (e-cigarettes) are used by current,
former, and never cigarette smokers may inform public health actions and
tobacco regulations. Therefore, we examined the distribution of e-cigarette
use, also called vaping, in the 2018-2019 Tobacco Use Supplement to the Current
Population Survey, the largest nationally representative tobacco use survey of
US adults.
Methods This
cross-sectional study was determined to be exempt from review by an
institutional review board at the National Institutes of Health because it was
not human subjects research and used deidentified public use data. Informed
consent was obtained prior to interviews by the US Census Bureau, which conducted
the field work. In this study, adults aged 18 years and older were interviewed
by phone (two-thirds of respondents) or in-home (one-third of respondents) once
between July 2018 and May 2019 using probability-based multistage sampling.1
Among 137 471 self-respondents (self-response rate = 57.6%), we examined
current e-cigarette use by demographic characteristics and cigarette smoking
status. We also assessed whether former and current cigarette smokers who vape
reported using e-cigarettes to help them quit smoking. This study followed the
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)
reporting guideline. Weighted frequencies and proportions for statistical
analysis were estimated with SAS-Callable SUDAAN (SAS version 9.4 [SAS Institute];
SUDAAN version 11.0.3 [RTI International]) using self-response survey weights.
Data analysis was performed from October 2019 to July 2020.
Results The
2018-2019 Tobacco Use Supplement to the Current Population Survey was weighted
to reflect the demographic characteristics of the US adult population. Our
analytic sample included an unweighted total of 135 211 individuals with
information on both cigarette and e-cigarette use (73 853 women [weighted
percentage, 51.9%], weighted mean [SE] age 47.5 years [0.0]), of which 16 570
were current smokers (11.4% [95% CI, 11.2%-11.6%]), 29 189 were former smokers
(18.2% [95% CI, 18.0%-18.5%]), and 90 906 were never cigarette smokers (70.3%
[95% CI, 70.0%-70.7%]).
Overall, we estimate that more than 5.66 million adults in the US population
reported current vaping (2.3% [95% CI, 2.2%-2.4%]). Among e-cigarette users,
more than 2.21 million were current cigarette smokers (39.1% [95% CI,
36.8%-41.4%]), more than 2.14 million were former smokers (37.9% [95% CI: 35.6%-40.1%]),
and more than 1.30 million were never smokers (23.1% [95% CI, 20.8%-25.4%])
(Table 1).
The prevalence of vaping was higher among men (2.8%; 95% CI, 2.7%-3.0%) and
among non-Hispanic White (2.8% [95% CI, 2.6%-2.9%]), American Indian/Alaskan
Native (4.2% [95% CI, 2.8%-6.4%]), and multiracial (4.5% [95% CI, 3.3%-6.2%])
individuals. There was higher prevalence with increasing education level (less
than high school: 2.2% [95% CI, 1.8%-2.6%]; high school degree: 3.0% [95% CI,
2.7%-3.2%]; and some college: 3.1% [95% CI, 2.8%-3.3%]), except for individuals
with a college degree (1.2% [95% CI, 1.1%-1.4%]), who had the lowest
prevalence. Across all categories of sex, race/ethnicity, and education, the
majority of vapers were current or former smokers. There were, however,
differences by age. Among never smokers who vaped, 63.4% (95% CI, 58.2%-68.7%)
were between 18 and 24 years old, and 23.8% (95% CI, 19.6%-28.1%) were between
25 and 34 years old. In contrast, e-cigarette users who were current or former smokers
tended to be older (Table 1).
Among current dual users of cigarettes and e-cigarettes, 69.3% (95% CI,
65.7%-72.7%) reported using e-cigarettes to try to quit smoking. However, among
former smokers who currently vape, 80.7% (95% CI, 77.4%-83.5%) reported that
they had used e-cigarettes to help them quit smoking (Table 2).
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