Between 2014 and 2021, the age at which adolescents first began using e-cigarettes dropped by nearly 2 months per calendar year while the age of initiation for other tobacco products remained the same.


At the same time, intensity of e-cigarette use and addiction increased so that by 2019, more e-cigarette users were using a tobacco product within five minutes of waking up compared with cigarette smokers and all other tobacco product users combined.


Tenfold: Between 2014 and 2017, less than 1 percent of e-cigarette users reported using the devices within five minutes of waking up, while by 2021 the total grew to 10.3 percent.

  • Overall, between 2014 and 2021, adolescent e-cigarette addiction surpassed that for all other forms of tobacco products combined.
  • The results are based on a survey of 151,000 students in grades six to 12 with an average age of 15. Findings were published in the Journal of the American Medical Association.
  • However, despite the current findings, trends show fewer teens overall are using e-cigarettes. In 2019, it was estimated around 5.3 million middle and high-schoolers used the products; that total fell to 2.1 million in 2021 during the COVID-19 pandemic.