Tuesday, July 14, 2015

30 Million U.S. Adults Have Used E-Cigarettes, Unpublicized CDC Data Reveals

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
CharacteristicCurrently Use E-CigarettesNever Used E-Cigarettes
Under Age 45 years59%22%
Live in the South46%36%
Live in the Northeast9%19%
Looked for health info/ internet62%44%
Quit smoking less than 5 years prior85%15%

Another statistic stands out: In 2014, the percentage of adults in the U.S. who smoked was 16.8%, down from 17.8% 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.


Anonymous said...

Thanks for exposing Brad.

Where is this 2014 NYTS data available?

While your chart lists "never" and "current" e-cig users, it doesn't differentiate between "every day" or "some days" users (which are vastly different types of vapers who were all combined and mislabeled (presumably by CDC) as "current users" (even if they only used an e-cig on two days during 2014).

If CDC provided data for the different categories of "every day" and "some days" e-cig users, that data would be extremely useful
for exposing that virtually all (or all) daily nicotine vapers are either current or daily cigarette smokers or are ex-smokers who quit smoking by switching to vaping.

That data would also debunk CDC's false claims that e-cigs have addicted many nonsmokers, and don't help smokers quit smoking.

A recent survey of MN adults found huge differences between "daily" vapers and infrequent vapers (who reported use in past 30 days) at

Bill Godshall

Brad Rodu said...

The 2014 NHIS data is available at http://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm.

For current smoking, the CDC includes every-day or some-day, and I tried to use the same terminology for e-cig use. Among current smokers who use e-cigs, the majority use them some days. However, among former smokers who use e-cigs, the majority use them every day. This data reveals that 1.25 million former smokers are using e-cigs daily. It doesn’t prove that they used e-cigs to quit, but it is strongly suggestive that e-cigs played a role.

Anonymous said...

Wonder why CDC didn´t ask: "Have you quitted or decreased smoking by switchin´ cigarettes to ecig"?

CarolAST said...

The National Health Interview Survey always shows a lower proportion of smokers than everyone else, for example, Gallup.
The NHIS claims 20.9% in 2005 to 17.8% in 2013, while Gallup shows 25% in 2005 to 19% in 2013, rising to 21% in 2014. It's probably because the NHIS uses in-person interviews, where timid people tell the interviewer they don't smoke for fear of disapproval.

Brad Rodu said...

The NHIS is not focused on tobacco use; it collects information annually on a large number of health conditions and behaviors across a representative sample of the US population. With respect to smoking prevalence, it tends to be on the low side when compared with other annual American instruments such as the National Survey on Drug Use and Health and the Behavioral Risk Factor Surveillance System. See my blog for more details: http://rodutobaccotruth.blogspot.com/2009/11/how-many-americans-smoke.html).