Mohammadhassan Mirbolouk, MD; Paniz Charkhchi, MD; Sina Kianoush, MD, MPH; S.M. Iftekhar Uddin, MBBS, MSPH; Olusola A. Orimoloye, MBBS, MPH; Rana Jaber, PhD; Aruni Bhatnagar, PhD; Emelia J. Benjamin, MD, ScM; Michael E. Hall, MD, MSc; Andrew P. DeFilippis, MD, MSc; Wasim Maziak, MD, PhD; Khurram Nasir, MD MPH; Michael J. Blaha, MD, MPH
Grant Support: By A-TRAC grant 1P50HL120163.
Disclosures: Drs. Mirbolouk, Uddin, and Orimoloye report grants from A-TRAC during the conduct of the study. Dr. Benjamin reports grants from the National Institutes of Health (NIH) and American Heart Association, served as associate editor for the journal Circulation, and was a member of the NIH/National Center for Biotechnology Information Observational Study Monitoring Board for the CARDIA (Coronary Artery Risk Development in Young Adults) trial outside the submitted work. Dr. DeFilippis reports grants from the National Institute of General Medical Sciences and NIH during the conduct of the study. Dr. Blaha reports grants from the FDA during the conduct of the study and grants from the NIH, FDA, Amgen Foundation, and Aetna Foundation and personal fees from the FDA, American College of Cardiology, Amgen Foundation, Aetna Foundation, MedImmune, Novartis, Sanofi/Regeneron, and Akcea outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3440.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Proctor & Gamble, Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol: Available from Dr. Mirbolouk (e-mail, firstname.lastname@example.org). Statistical code: Not available. Data set: Available at www.cdc.gov/brfss/annual_data/2016/files/LLCP2016XPT.zip.
Corresponding Author: Michael J. Blaha, MD, MPH, 600 North Wolfe Street, Blalock 524D1, Baltimore, MD 21287; e-mail, email@example.com.
Current Author Addresses: Drs. Mirbolouk, Charkhchi, Kianoush, Uddin, and Orimoloye: 600 North Wolfe Street, Blalock 501, Baltimore, MD 21287.
Drs. Jaber, Maziak, and Nasir: 11200 Southwest 8th Street, AHC5, Miami, FL 33199.
Drs. Bhatnagar and DeFilippis: 550 South Jackson Street, 3rd Floor, Louisville, Kentucky 40202.
Dr. Benjamin: 88 East Newton Street, 8th Floor, Suite C, Boston, MA 02118.
Dr. Hall: 2500 North State Street, Jackson, MS 39216.
Dr. Blaha: 600 North Wolfe Street, Blalock 524D1, Baltimore, MD 21287.
Author Contributions: Conception and design: M. Mirbolouk, P. Charkhchi, S. Kianoush, O.A. Orimoloye, A. Bhatnagar, A.P. DeFilippis, W. Maziak, M.J. Blaha.
Analysis and interpretation of the data: M. Mirbolouk, P. Charkhchi, S. Kianoush, S.M.I. Uddin, O.A. Orimoloye, A. Bhatnagar, A.P. DeFilippis, M.J. Blaha.
Drafting of the article: M. Mirbolouk, P. Charkhchi, S. Kianoush, S.M.I. Uddin, O.A. Orimoloye, A.P. DeFilippis, W. Maziak, K. Nasir, M.J. Blaha.
Critical revision for important intellectual content: M. Mirbolouk, P. Charkhchi, S. Kianoush, S.M.I. Uddin, O.A. Orimoloye, R. Jaber, A. Bhatnagar, E.J. Benjamin, M.E. Hall, A.P. DeFilippis, W. Maziak, K. Nasir, M.J. Blaha.
Final approval of the article: M. Mirbolouk, P. Charkhchi, S. Kianoush, S.M.I. Uddin, O.A. Orimoloye, R. Jaber, A. Bhatnagar, E.J. Benjamin, M.E. Hall, A.P. DeFilippis, W. Maziak, K. Nasir, M.J. Blaha.
Provision of study materials or patients: M. Mirbolouk, P. Charkhchi, M.J. Blaha.
Statistical expertise: M. Mirbolouk, P. Charkhchi, S.M.I. Uddin, M.J. Blaha.
Obtaining of funding: A. Bhatnagar, M.J. Blaha.
Administrative, technical, or logistic support: M. Mirbolouk, P. Charkhchi, M.J. Blaha.
Collection and assembly of data: M. Mirbolouk, P. Charkhchi, M.J. Blaha.
Contemporary data on the prevalence of e-cigarette use in the United States are limited.
To report the prevalence and distribution of current e-cigarette use among U.S. adults in 2016.
Behavioral Risk Factor Surveillance System, 2016.
Adults aged 18 years and older.
Prevalence of current e-cigarette use by sociodemographic groups, comorbid medical conditions, and states of residence.
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.
Data were self-reported, and no biochemical confirmation of tobacco use was available.
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.
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.
Mirbolouk M, Charkhchi P, Kianoush S, et al. Prevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016. Ann Intern Med. 2018;169:429–438. [Epub ahead of print 28 August 2018]. doi: https://doi.org/10.7326/M17-3440
Download citation file:
Published: Ann Intern Med. 2018;169(7):429-438.
Published at www.annals.org on 28 August 2018
Cardiology, Coronary Risk Factors, Smoking.
Results provided by:
Copyright © 2020 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use