Prevalence of ENDS and JUUL Use, by Smoking Status, in National Samples of Young Adults and Older Adults in the U.S

Objectives: In this paper, we estimate the prevalence of electronic nicotine delivery systems (ENDS) and JUUL brand ENDS use among adults in the US, overall and by smoking history. Methods: We obtained 2019 cross-sectional online surveys assessing smoking, use of any ENDS, and JUUL specifically, in a national probability sample of 11,833 US adults. Data were analyzed for young adults (YA; aged 18-24) and older adults (OA; aged 25+). Results: Past 30-day ENDS prevalence was 8.0% in YA and 4.7% in OA; equivalent JUUL figures were 3.1% and 1.2%. ENDS/JUUL use was more prevalent among current and former smokers than never smokers, where prevalence was ≤ 2% (YA: 2.0%/0.9%; OA: 0.9%/0.1%). JUUL use was higher among recent (< 1 year) quitters than among long-term (≥ 1 year) quitters. Among those who had ever used both ENDS and other tobacco, strong majorities reported using other tobacco first. Among JUUL users who also had used other tobacco ≥ 95% had used other tobacco first. Conclusions: Past-30-day ENDS use (including JUUL) was ≤ 8% among young adults and ≤ 5% in older adults. Most (> 98%) ENDS and JUUL users were current or former smokers, which is relevant to assessment of the population impact of these products.