A Clear Perspective on Nicotine Use in the U.S. Over the Last Decade

It is now possible to understand the evolution of nicotine use in the U.S. over the past decade. While the Centers for Disease Control and Prevention (CDC) regularly publishes data on smoking and vaping, these are typically presented separately. A recent study combines both categories, providing a more comprehensive and detailed perspective on trends and their interplay in nicotine consumption.

The article “Joint Smoking–Vaping Prevalence Rates Among American Youth and Young Adults (2011–2022),” authored by Dr. Brad Rodu and Nantaporn Plurphanswat, researchers at the Department of Medicine and the James Graham Brown Cancer Center at the University of Louisville, were published in January 2024 in the prestigious Harm Reduction Journal.

This work provides an innovative and necessary perspective on nicotine use in the United States, addressing a key issue in public health.

The study is based on two essential national surveys: the National Youth Tobacco Survey (NYTS), which annually collects data on tobacco use among middle and high school students and has included an expanded section on electronic cigarette use since 2014, and the National Health Interview Survey (NHIS), which analyzes health habits in adults over 18 years old and began recording vaping data in the same year.

The analyses focus on four main indicators: smoking prevalence, exclusive electronic cigarette use, combined tobacco, and vaping consumption, and smoking cessation rates, defined as the percentage of former smokers out of the total who have ever smoked.

The objective is to examine how the dynamics of substance use have evolved over the past decade, with particular attention to two central questions: whether vaping has contributed to the decline in smoking by facilitating cessation or, conversely, whether it has served as a gateway to nicotine consumption among young people.

The authors address a significant gap in historical data on nicotine use by integrating, for the first time, figures on smoking and vaping, which have traditionally been reported separately.

This approach not only allows for the identification of more precise trends but also explores the implications of vaping for smoking reduction and the design of public health strategies that balance harm reduction and risk prevention, particularly among the most vulnerable groups.

As such, the article is a crucial contribution to the scientific and social debate on the future of tobacco control policies.

Key Findings

The study highlights that the decline in smoking coincided with an increase in e-cigarette use, suggesting that vaping has played a significant role in reducing traditional tobacco consumption.

This finding aligns with previous research identifying vaping as an effective harm-reduction tool.

Although vaping has largely replaced smoking among young people, its prevalence raises concerns about nicotine exposure and potential long-term risks.

The surveys relied on self-reports, which are prone to errors. Moreover, changes in question wording (notably in 2015 and 2020) and the COVID-19 pandemic may have influenced the results.

This study is a key contribution to understanding the landscape of nicotine consumption in the U.S. over the past decade. It demonstrates that:

• Vaping has not only replaced smoking among youth but has also facilitated higher cessation rates among young adults.

• While vaping carries risks, its net impact appears positive from a public health perspective, particularly in aiding smokers’ transition to less harmful alternatives.

Despite its limitations, this research provides crucial insights into nicotine use trends in the U.S. over the last decade.

It reveals how vaping has supplanted smoking among young people and contributed to increased cessation rates among young adults.

Although not without risks, its net effect seems favorable from a public health standpoint, especially in helping smokers transition to less harmful options.

The findings underscore the need for balanced public policies that minimize vaping-related risks among youth without undermining its potential as a harm-reduction tool for adult smokers.

This evidence-based approach is essential for crafting strategies that protect future generations while leveraging vaping’s benefits in the fight against smoking.

• Rodu, B., & Plurphanswat, N. (2024). Joint smoking–vaping prevalence rates among American youth and young adults 2011–2022. Harm Reduction Journal, 21(1), Article 209. https://doi.org/10.1186/s12954-024-01125-4