An Examination of the Variation in Estimates of E-Cigarette Prevalence among U.S. Adults

Abstract

Introduction: Accurate estimates of e-cigarette use are needed to gauge its impact on public health. We compared the results of online and traditional, large scale surveys and provide additional estimates from the Population Assessment of Tobacco and Health (PATH) survey, with the aim of assessing the extent of variation in prevalence estimates. Materials and Methods: We searched the peer-reviewed literature for nationally representative estimates of U.S. adult e-cigarette prevalence, and developed our own estimates from waves one, two, and three of the PATH survey. We compared estimates by age, gender, cigarette smoking status, and e-cigarette use intensity both between online and traditional surveys and among the traditional surveys. Results: For specific years, online surveys generally yielded higher adult use rates than most traditional surveys, but considerable variation was found among traditional surveys. E-cigarette prevalence was greater for less intensive than for more intensive use. Levels of use were higher among current and recent former cigarette smokers than among former smokers of longer quit duration and never smokers, and by those of younger ages. Conclusions: Considerable variation in e-cigarette use estimates was observed even for a specific year. Further study is needed to uncover the source of variation in e-cigarette prevalence measures, with a view towards developing measures that best explain regular use and transitions between the use of e-cigarettes and other tobacco products.

Trends in Tobacco Use Among Adolescents by Grade, Sex, and Race, 1991-2019

“…Joinpoint analysis of e-cigarette use was not conducted; there is a lack of comparable data from the MTF survey because e-cigarette use was limited before 2011, and definitions in the MTF survey have continued to change. 8,35 The MTF survey began asking about vaping in 2015, 36 in 2017, and increased to 20.8% in 2018 and to 27.5% in 2019. 3,40 Frequent (Ն20 days) e-cigarette use among high schoolers increased from 20.0% of e-cigarette users in 2017 to 27.7% in 2018 and then to 34.2% in 2019.…”

The impact of cigarette and e-cigarette use history on transition patterns: a longitudinal analysis of the population assessment of tobacco and health (PATH) study, 2013–2015

“…There could be many other ways to define the tobacco user groups and the transition probabilities may vary by different definitions. Studies have shown considerable variations in prevalence estimations with different definitions of current tobacco product use [30,31]. When studying transitions between two tobacco categories, the complexity increases since we not only need to define the use states for the two categories but also need to consider the usage of tobacco products in other categories.…”

Prevalence of Electronic Cigarette Use and Its Determinants among 13-to-15-Year-Old Students in Greece: Results from the 2013 Global Youth Tobacco Survey (GYTS)

“…This can affect how they are answered. For example, some studies distinguish between daily use and non-daily use of e-cigarettes, while others, such as this one, distinguish between ever use and current use [44]. Current use has been defined by different studies as past-30-day prevalence, as past-5-day prevalence, as more than one cigarette per week or as "fairly regular" use.…”