A Comparative Analysis of E-cigarette Users and State-Specific Prevalence Change in the United States Between 2017 and 2018

Introduction Despite states’ regulatory efforts, e-cigarettes are gaining popularity, which poses a public health concern. The study objective is to compare demographic and state prevalence changes in e-cigarette use from 2017 to 2018. Methods A retrospective analysis was conducted using publicly available data from the Behavioral Risk Factor Surveillance System survey (2017-2018). The prevalence of current e-cigarette use was analyzed with direct age-adjustment based on the 2010 United States Census population. Results The overall use of e-cigarettes increased from 4.3% in 2017 to 5.4% in 2018. Although most demographics reported increased prevalence from 2017 to 2018, the most significant change was observed in younger adults (18-24), males, Hispanics, college graduates, non-smokers, marijuana non-users, and heavy alcoholics. Oklahoma (9.8%), Hawaii (7.8%), Arkansas (7.7%), and Colorado (7.3%) greater prevalence in 2018. Significant inclining prevalence was observed in Alaska, Connecticut, and Massachusetts, while Illinois reported a sharp decline. California, the District of Columbia, and Puerto Rico consistently reported the lowest prevalence. Idaho, Maine, Michigan, North Dakota, and Oregon are transitioning to a higher prevalence of e-cigarette use from 2017 to 2018. Conclusion The rising prevalence of e-cigarettes across demographics warrants a holistic approach to behavioural change interventions, health awareness and education, and regulatory efforts.