CDC Survey Shows Large Majority of Adult E-Cigarette Users in U.S. also Smoke Cigarettes

WASHINGTON, D.C. – New survey data released today by the Centers for Disease Control and Prevention (CDC) show that in 2015, 59 percent of adult electronic cigarette users in the United States were also current cigarette smokers, while 30 percent were former smokers and 11 percent have never been smokers. However, among young adults ages 18-24, 40 percent of e-cigarette users were never smokers, while 43 percent were current smokers and 17 percent were former smokers. Altogether, 3.5 percent of all U.S. adults were current e-cigarette users in 2015, about the same as the 3.7 percent who reported using e-cigarettes in 2014.

The CDC data raise fresh concerns that a large majority of adult e-cigarette users in the U.S. are using e-cigarettes in addition to regular cigarettes, rather than in place of them. The finding that 40 percent of young adults who use e-cigarettes have never been smokers also raises concerns that e-cigarettes may be introducing young non-smokers to tobacco use and nicotine addiction. Other surveys have found that youth use of e-cigarettes has skyrocketed, with the CDC’s 2015 National Youth Risk Behavior Survey showing that 24.1 percent of high school students were current users of e-cigarettes, compared to 10.8 percent who smoked cigarettes.

If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals. They will not benefit public health if smokers use them in addition to cigarettes instead of quitting or if they re-glamorize tobacco use among young people and attract non-smokers.

The evidence to date is limited and inconclusive as to whether e-cigarettes are effective at helping smokers quit. The U.S. Preventive Services Task Force thoroughly evaluated the science and concluded that “the current evidence is insufficient to recommend electronic nicotine delivery systems for tobacco cessation…” An August 2016 report by the World Health Organization concluded that “given the scarcity and low quality of scientific evidence, it cannot be determined whether ENDS [electronic nicotine delivery systems] may help most smokers to quit or prevent them from doing so.”

Food and Drug Administration oversight is critical to realizing the potential benefits and minimizing the risks of e-cigarettes. The FDA must effectively enforce its new e-cigarette rules, including the prohibition on sales to kids, and strengthen these rules by prohibiting the use of flavors and marketing tactics that appeal to young people. The FDA must also evaluate the evidence whether e-cigarettes are effective at helping cigarette smokers quit and ensure smokers have accurate information.