Young adults increasingly use high-nicotine e-cigarettes, study finds

Researchers from College of California San Diego Herbert Wertheim College of Public Well being and Human Longevity Science have discovered that high-nicotine e-cigarette use rose sharply amongst younger adults between 2017 and 2022 and was related to elevated nicotine dependence and extra persistent vaping. The examine, revealed on Oct. 20, 2026 within the Tobacco Management journal, discovered that by 2022, almost half (49.2%) of younger adults who vaped day by day have been utilizing e-cigarettes containing no less than 4% nicotine – thought of a high-nicotine product. Amongst day by day vapers ages 55 and older, simply 4.5% have been utilizing merchandise with that stage of nicotine. General, amongst individuals who vaped in 2022, the chances of utilizing a high-nicotine e-cigarette have been 12 occasions greater for 18- to 24-year-olds than for adults ages 55 and older.

The Meals and Drug Administration’s (FDA) authorization of those merchandise was based mostly partly on the expectation that the advantages to adults who smoke would outweigh the dangers of making new nicotine dependence amongst younger folks. Our findings counsel that this stability must be reassessed. Younger adults are disproportionately selecting high-nicotine merchandise, together with inside the similar manufacturers utilized by older adults, and that use is related to considerably larger nicotine dependence.”

John P. Pierce, PhD, senior creator and professor, Herbert Wertheim College of Public Well being

The researchers analyzed knowledge from the Inhabitants Evaluation of Tobacco and Well being (PATH) Research, a nationally consultant examine that follows tobacco and nicotine use within the U.S. The evaluation included surveys carried out in 2017, 2019, 2021 and 2022, in addition to longitudinal knowledge from 2,356 adults who vaped in 2019 and whose behaviors have been tracked by way of 2022.

In 2017, fewer than 4% of people that vaped reported utilizing an e-cigarette with no less than 4% nicotine. Amongst 18- to 24-year-olds who vaped day by day, that determine rose from 3.1% in 2017 to 40.1% in 2019 and 49.2% in 2022. By comparability, 32.8% of day by day vapers ages 25 to 34, 17.6% of these ages 35 to 54 and 4.5% of these 55 and older used high-nicotine merchandise in 2022.

The rise in high-nicotine vaping coincided with a considerable improve in nicotine dependence amongst younger adults who completely vaped. In 2017, 18- to 24-year-olds who completely vaped had considerably decrease nicotine dependence scores than those that completely smoked cigarettes. By 2022, their dependence scores had risen to a stage equal to that of 18- to 24-year-olds who completely smoked in 2017.

The examine additionally discovered that nicotine power was related to dependence throughout age teams. Individuals who used high-nicotine e-cigarettes confirmed greater ranges of nicotine dependence than those that used lower-nicotine merchandise. Amongst individuals who vaped in 2019, these utilizing high-nicotine e-cigarettes had 31% decrease odds of being abstinent from vaping 4 years later. General, 40.9% of those that vaped in 2019 – together with those that didn’t vape day by day – have been abstinent by 2022.

The researchers say the sturdy age distinction in nicotine power used raises questions concerning the function of promoting. Amongst individuals who used the identical manufacturers, 18- to 24-year-olds have been extra possible than adults ages 25 and older to decide on high-nicotine variations. Two manufacturers with notably giant variations have been marketed by way of paid social media influencers, though the examine was not designed to determine that advertising and marketing brought on younger adults to decide on higher-nicotine merchandise.

The authors word that the examine can not set up that high-nicotine e-cigarettes straight brought on the rise in nicotine dependence as a result of it was observational relatively than a randomized medical trial. The researchers additionally word that many members, notably within the first two years, didn’t know the nicotine power of their e-cigarette, which might are inclined to make the examine’s estimates extra conservative.

The findings additionally elevate questions on whether or not high-nicotine e-cigarettes proceed to satisfy the general public well being commonplace required for FDA advertising and marketing authorization. The researchers argue that the proof warrants an pressing reassessment of whether or not the advantages of those merchandise for adults who smoke proceed to outweigh the danger of making nicotine dependence amongst individuals who don’t smoke.

“We have to perceive not solely who’s utilizing these merchandise, however how the nicotine content material, product design and advertising and marketing atmosphere are influencing long-term patterns of use,” mentioned Pierce. “Earlier analysis has questioned the effectiveness of e-cigarettes in serving to people who smoke give up. On this examine, we’ve got documented that high-nicotine merchandise have created a brand new technology of people who find themselves depending on nicotine.”