Prevalence and Distribution of E-Cigarette Use Among US Adults: Behavioral Risk Factor Surveillance System, 2016

Background: Contemporary data on the prevalence of e-cigarette use in the United States are limited. Objective: To report the prevalence and distribution of current e-cigarette use among U.S. adults in 2016. Design: Cross-sectional. Setting: Behavioral Risk Factor Surveillance System, 2016. Participants: Adults aged 18 years and older. Measurements: Prevalence of current e-cigarette use by sociodemographic groups, comorbid medical conditions, and states of residence. Results: Of participants with information on e-cigarette use (n = 466 842), 15 240 were current e-cigarette users, representing a prevalence of 4.5%, which corresponds to 10.8 million adult e-cigarette users in the United States. Of the e-cigarette users, 15% were never-cigarette smokers. The prevalence of current e-cigarette use was highest among persons aged 18 to 24 years (9.2% [95% CI, 8.6% to 9.8%]), translating to approximately 2.8 million users in this age range. More than half the current e-cigarette users (51.2%) were younger than 35 years. In addition, the age-standardized prevalence of e-cigarette use was high among men; lesbian, gay, bisexual, and transgender (LGBT) persons; current combustible cigarette smokers; and those with chronic health conditions. The prevalence of e-cigarette use varied widely among states, with estimates ranging from 3.1% (CI, 2.3% to 4.1%) in South Dakota to 7.0% (CI, 6.0% to 8.2%) in Oklahoma. Limitation: Data were self-reported, and no biochemical confirmation of tobacco use was available. Conclusion: E-cigarette use is common, especially in younger adults, LGBT persons, current cigarette smokers, and persons with comorbid conditions. The prevalence of use differs across states. These contemporary estimates may inform researchers, health care policymakers, and tobacco regulators about demographic and geographic distributions of e-cigarette use. Primary Funding Source: American Heart Association Tobacco Regulation and Addiction Center, which is funded by the U.S. Food and Drug Administration and National Heart, Lung, and Blood Institute.