30 Million U.S. Adults Have Used E-Cigarettes

Analyzing fresh data from the 2014 National Health Interview Survey, which involved nearly 37,000 respondents, it can be estimated that 30 million American adults have used an e-cigarette at least once, and 8.9 million were current users in that year. The data was released by the CDC June 29.

This was the first time that the NHIS, the main source for national smoking prevalence statistics, asked about e-cigarettes.  The survey asked participants if they had ever used e-cigs, even one time; if they had, a second question asked them if they currently used them every day, some days or not at all (hereafter, triers).  From this data I have produced the first-ever national estimates of e-cigarette use.

About 71% of e-cigarette users are also current smokers (every day or some days), and 22% are former smokers. The rest (about 7% or 595,000) were never cigarette smokers, but nearly 70% of them said they smoke products other than cigarettes (cigars, pipes, water pipes or hookahs, very small cigars that look like cigarettes, bidis or cigarillos) every day, some days or rarely.

Of the 6.3 million smokers who used e-cigarettes, only 22% used them every day.  In contrast, among the nearly 2 million former smokers who used e-cigarettes, about 63% – or 1.25 million – were daily users..  Among never cigarette smokers who vaped, only 16% were daily users.

Among daily smokers, there was virtually no difference in cigarette consumption; regardless of whether they vaped or not, daily smokers consumed 14-15 cigarettes per day on average.  Cigarette consumption was more variable among some-day smokers: those who used e-cigarettes every day smoked only 3.5 cigarettes on the days they smoked, while those who used e-cigs on some days smoked 5.2 cigarettes.  Some-day smokers who had tried e-cigarettes consumed 7.8 cigarettes per day, while those who had never used an e-cig smoked 5.6 cigarettes.

While it is encouraging that almost 2 million former smokers were currently using e-cigarettes in 2014, it is not possible to prove that they had used e-cigarettes to quit.  However, 85% of these former smokers had quit 5 years or less prior to the survey, making it plausible that e-cigarettes played some role in their becoming or staying smoke-free.

The table below compares some characteristics of former smokers who currently used e-cigarettes with former smokers who never used them.  (These comparisons are general observations that might change after additional analysis).  Former smokers who used e-cigarettes were younger and more likely to live in the South; they looked more frequently for health information on the internet during the previous 12 months.

Characteristics of Former Smokers Who Currently Use E-Cigarettes and Former Smokers Who Never Used Them
Characteristic Currently Use E-Cigarettes Never Used E-Cigarettes
Under Age 45 years 59% 22%
Live in the South 46% 36%
Live in the Northeast 9% 19%
Looked for health info/ internet 62% 44%
Quit smoking less than 5 years prior 85% 15%

Another statistic stands out: In 2014, the percentage of adults in the U.S. who smoked was 16.7%, down from17.8% in 2013.

Cigarette smoking in the U.S. continues an inexorable decline.  Rather than impeding progress, e-cigarettes may be accelerating a smoke-free revolution.

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