Use of Electronic Cigarettes increased dramatically over the past decade, making them the most common tobacco product used among youth. Because of the shifting landscape in e-cigarette product design and terminology, combined with different survey definitions, various sources are used to capture data on e-cigarette use. Similar trends have been observed across 3 cross-sectional surveys with data on youth use: the National Youth Tobacco Survey, Monitoring the Future, and the Youth Risk Behavior Surveillance System.7–9 For the latest data as of 2018, the National Youth Tobacco Survey reported 20.8% of high school students and 4.9% of middle school students currently used e-cigarettes (defined as use of an e-cigarette at least 1 day in the past 30 days)10; for 2017, Monitoring the Future reported 17% of 12th graders, 13% of 10th graders, and 7% of eighth graders currently used e-cigarettes8; while the Youth Risk Behavior Surveillance System reported 13.2% of high school students currently used e-cigarettes.9 Current e-cigarette use increased considerably among middle and high school students during 2017-2018 (increasing by 78% from 11.7% to 20.8% among high school students),10 increasing overall tobacco use and reversing a decline observed in recent years.7–9 More than 3 million high school students and 570 000 middle school students currently use e-cigarettes.10 E-cigarette use has been documented as highest among boys, non-Hispanic white youth, and Hispanic youth.7,11 E-cigarette use is generally greatest among adolescents and young adults and decreases with age in adults. Adult e-cigarette users tend to be previous users of combustible tobacco products, such as traditional cigarettes.2
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