E-Cigarette Use Among Young Adults Has Doubled Since 2016

• E-cigarette use among 18 to 24-year-olds increased 105% in the U.S. from 2016 to 2021.
  
  
• The rate of e-cigarette usage among young adults increased in every state reporting data since 2016.
  
  
• In 25 states, e-cigarette use among young adults more than doubled between 2016 and 2021.
  
  
• E-cigarette use among 18 to 24-year-olds in Alaska increased 229% from 2016 to 2021. Other states with the highest increases of use during this time include Arizona (193%), North Carolina (190%) and Tennessee (185%). 

E-cigarettes were introduced to the U.S. market in 2007 and have steadily gained popularity among teens and young adults. By 2020, high schoolers were 2.5 times more likely to use e-cigarettes than regular cigarettes.  

The HelpAdvisor research team studied data from the Centers for Disease Control (CDC) to determine where in the U.S. e-cigarette use has been increasing the most among young adults ages 18 to 24.

We studied the trend in self-identified e-cigarette users in this age group and found the usage rate increased in every state for which data was available during the studied period.

The chart below shows how much e-cigarette use increased among 18 to 24-year-olds in each state between 2016 and 2021. 

Click on image to enlarge in a new tab

E-cigarette use for the given age demographic shot up 229% in Alaska from a nationwide low of just 4.8% in 2016 to nearly 16% in 2021. 

All told, e-cigarette use among 18 to 24-year-olds doubled in 25 different states between 2016 and 2021. The rate of use increased 105% nationwide.

The rate of e-cigarette use among 18 to 24-year-olds increased by at least 17% in every state measured. (Florida, South Dakota and the District of Columbia had incomplete data.)

The map below shows where e-cigarette use is most prominent among 18 to 24-year-olds.

The minimum age requirement to purchase e-cigarettes varies between 18 and 21 years old, depending on the state. In 23 states, the minimum age for purchase is 21. 

In six of the nine states with the highest rates of e-cigarette use among 18 to 24-year-olds in 2021, the minimum age at which to legally purchase e-cigarettes is 18. 

Of the eight states with the largest increase of use between 2016 and 2021, only Tennessee requires residents to be at least 21 years old to purchase e-cigarettes. 

E-cigarettes are still relatively new to the marketplace and the health effects of e-cigarette use is still being studied. Some early findings suggest e-cigarettes may pose a number of health risks.

As reported by the American Lung Association:

• The National Academies of Science, Engineering and Medicine finds evidence that youths who use e-cigarettes are at an increased risk for asthma exacerbations.
  
  
• A study from the University of North Carolina found the two primary ingredients in e-cigarettes are toxic to cell tissue. 
  
  
• E-cigarettes contain acrolein, which is an herbicide used in weed killers that can cause acute lung injuries and COPD and may also cause lung cancer and asthma.
  
  
• The Surgeon General declared even secondhand emissions from e-cigarettes to contain nicotine, lead, chemicals found in car exhaust and chemicals linked to serious lung disease. 

Then-Surgeon General Jerome Adams issued an advisory about e-cigarette use among youths in 2018, saying in part, “The recent surge in e-cigarette use among youth, which has been fueled by new types of e-cigarettes that have recently entered the market, is a cause for great concern.” 

The data used for this report came from 2021 Behavioral Risk Factor Surveillance System (BRFSS) data provided by the Center for Disease Control and Prevention (CDC)'s National Center for Chronic Disease Prevention and Health Promotion (NCCD) Division of Population Health, the most recent data available.