US vaping became more frequent and widespread from 2013 to 2023

Vaping in the United States became both more widespread and more frequent between 2013–14 and 2022–23, according to an observational analysis of national survey data. The estimated number of population-level vaping days rose by 183% over the decade, while the proportion of survey respondents who reported vaping in the previous 30 days increased by 45%. Among people who vaped, the proportion doing so every day increased by 230%. The largest increases occurred among people younger than 21, including a 337% rise in vaping days among under-21 vapers over the study period.

Researchers used data from the Population Assessment of Tobacco and Health (PATH) Study to compare its first survey wave in 2013–14 with its seventh wave in 2022–23. The analysis estimated changes in total vaping days, which combine the number of people vaping with how often they vape, and calculated the share of vaping days occurring among two age groups: 12- to 17-year-olds and people aged 18 or older. In 2022–23, people under the minimum legal age of 21 who had vaped in the past 30 days accounted for 16% of all estimated vaping days. Within that group, vaping days increased by 337%, with the rise among 12- to 17-year-olds reaching 278%.

The largest changes followed a period in which vaping increased sharply: the researchers said the most significant rises in prevalence and frequency occurred after 2016–18, corresponding with the emergence of JUUL and a market shift toward e-liquids containing nicotine salts. The study notes that nicotine salts change the chemistry of vaping aerosol and facilitate inhalation and nicotine intake, but the observational analysis cannot determine whether either product or formulation caused the changes. Researchers also reported that adult vaping days continued to increase after the onset of the COVID-19 pandemic, with the increase attributed primarily to greater vaping frequency among adults rather than population growth. Across age groups, the authors said increases in vaping days were especially pronounced among youth and younger adults; they suggested that industry marketing directed at young people and growth in the youth population may have contributed, while emphasizing that these are potential influences rather than established causes.

The findings illustrate why the intensity of vaping matters in addition to the percentage of the population that uses e-cigarettes. A prevalence measure can capture whether more people vape, but it does not fully capture how often they do. By combining these dimensions, the researchers argued that vaping days may provide a more informative indicator of patterns of use. They also raised dual use, in which people smoke and vape without fully stopping cigarette use, as a growing concern, along with possible re-initiation of nicotine use among former smokers who were otherwise at low risk of relapse. The analysis does not establish clinical outcomes, however, and the source material provides no evidence that the measured increases directly produced changes in disease, addiction, or cessation.

Several limitations restrict the conclusions. PATH relies on survey responses, which can be affected by recall error and may not always accurately reflect vaping behavior. As an observational study, the analysis cannot establish cause and effect despite identifying possible marketing, product, and population trends associated with the increases. The results also estimate population-level patterns from repeated survey waves rather than directly counting every act of vaping. Even with those qualifications, the data show a marked shift across the decade: by 2022–23, more people reported vaping, those who vaped appeared to vape more often, and the daily-vaping proportion had risen substantially since 2013–14.

Subject of Research: US trends in vaping prevalence and frequency among youth and adults from 2013–14 to 2022–23

Article Title: Substantially more people likely vaping, and more frequently, in US since 2013-14

Article References: Substantially more people likely vaping, and more frequently, in US since 2013-14. Original publication (Bibliographic details unavailable.)

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Keywords: vaping, e-cigarettes, youth vaping, nicotine salts, PATH Study, public health, US population, daily vaping, dual use, Substantially, people, likely