E-Cigarette Use - Women

E-Cigarette Use - Women in United States

United States

Electronic cigarettes, also called e-cigarettes, vapes or vape pens, are electronic devices that use heat to make an aerosol that is inhaled by the user. E-cigarettes are typically used to deliver nicotine, an addictive compound, or tetrahydrocannabinol (THC), the active component of cannabis. Nicotine is harmful to pregnant women and their developing babies and negatively affects brain development in children and adolescents. E-cigarettes may contain other additives such as small particles that can go deep into lungs, cancer-causing chemicals and flavoring chemicals that are linked to lung disease and injury. A 2019 study discovered that e-cigarette use is associated with respiratory diseases, including chronic obstructive pulmonary disease and asthma.

From 2020 to 2021, the prevalence of e-cigarette use among adults increased as the prevalence of cigarette smoking decreased among adults in the United States. E-cigarettes have become increasingly popular over the past decade, especially among youth. A recent study has identified e-cigarette use in adolescence as a strong predictor of regular cigarette use in adulthood.

According to America’s Health Rankings data, the prevalence of e-cigarette use is higher among:

• Women ages 18-24 compared with those ages 25-44; the prevalence is lower with each increase in age group. 
• Non-Hispanic white women compared with non-Hispanic Black women, Hispanic women and Asian women.
• Women with less than a college degree compared with those with a college degree; college graduates have the lowest prevalence.
• Women with an annual household income less than $25,000 compared with those with incomes of $75,000 or more. 

States have implemented policies to prevent e-cigarette-related harms, including: 

• Imposing legal product limits on flavoring and nicotine concentration levels.
• Promoting and enforcing laws against indoor use of tobacco products, with updates for e-cigarettes.
• Restricting e-cigarette advertisements online and on social media such as YouTube, Twitter and Instagram, particularly ads that target youth.

The Community Preventive Services Task Force recommends internet-based interventions to help adults quit smoking. Internet-based tobacco cessation interventions provide information, coaching and social support to individuals interested in quitting. Internet content can be tailored to meet the specific needs of communities. Interventions may also include text messaging, phone calls and medications. 

Studies show mixed results on whether e-cigarettes are an effective smoking cessation method. For this reason, the Food and Drug Administration does not recommend e-cigarettes as a method to quit smoking. 

Healthy People 2030 has several tobacco-related objectives, including reducing e-cigarette use among adolescents. 

Bhatta, Dharma N., and Stanton A. Glantz. “Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis.” American Journal of Preventive Medicine 58, no. 2 (February 1, 2020): 182–90. https://doi.org/10.1016/j.amepre.2019.07.028.

Cornelius, Monica E., Caitlin G. Loretan, Ahmed Jamal, Brittny C. Davis Lynn, Margaret Mayer, Iris C. Alcantara, and Linda Neff. “Tobacco Product Use Among Adults – United States, 2021.” MMWR. Morbidity and Mortality Weekly Report 72, no. 18 (May 5, 2023): 475–83. https://doi.org/10.15585/mmwr.mm7218a1.

England, Lucinda J., Rebecca E. Bunnell, Terry F. Pechacek, Van T. Tong, and Tim A. McAfee. “Nicotine and the Developing Human.” American Journal of Preventive Medicine 49, no. 2 (August 16, 2015): 286–93. https://doi.org/10.1016/j.amepre.2015.01.015.

Soneji, Samir, Jessica L. Barrington-Trimis, Thomas A. Wills, Adam M. Leventhal, Jennifer B. Unger, Laura A. Gibson, JaeWon Yang, et al. “Association Between Initial Use of E-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-Analysis.” JAMA Pediatrics 171, no. 8 (August 1, 2017): 788–97. https://doi.org/10.1001/jamapediatrics.2017.1488.