Nicotine-Containing Electronic Nicotine Delivery Systems (ENDS) Use in the United States, Stratified by Age, National Survey on Drug Use and Health, 2021.

Electronic nicotine delivery system (ENDS) use is prevalent in the United States, especially among youth and young adults. It is important to monitor current ENDS use and identify at-risk groups, particularly among tobacco naïve individuals. Using data from the 2021 National Survey on Drug Use and Health, we examined the prevalence of past 30-day nicotine/tobacco ENDS use and correlates, stratified by age. The prevalence of past 30-day ENDS use was as follows: ages 12-17 (5.0%), ages 18-20 (13.5%), ages 21-25 (14.6%), ages 26-34 (7.2%), and ages ≥35 (2.5%). Among youth ages 12-17, female respondents were more likely to report past 30-day ENDS use compared to male respondents (aOR = 1.41, 95% CI = 1.01-1.97). Among all adult age groups, current cigarette smoking status was associated with an increased likelihood of current ENDS use, versus never smoking. Among all age groups, those reporting non-Hispanic Black, non-Hispanic Other, and Hispanic race/ethnicity had a decreased likelihood of past 30-day ENDS use versus non-Hispanic White respondents, while past-year drug/alcohol use disorder, versus no use disorder, was associated with an increased likelihood of past 30-day ENDS use. ENDS use was most prevalent among young adults and least prevalent among persons ages ≥35. Most youth who reported ENDS use also reported never smoking cigarettes-compared to adults who reported ENDS use, who primarily reported current or former cigarette smoking. Our findings-which have identified characteristics of those most likely to use ENDS products-have the potential to inform screening and targeted intervention efforts aimed at reducing ENDS use.