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Notes from the Field: Electronic Cigarette Use Among Middle and High School Students—United States, 2011–2012

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September 6, 2013 / Vol. 62 / No. 35

MMWR Introduction


Electronic cigarette (e-cigarette) experimentation and recent use doubled among US middle and high school students during 2011–2012, resulting in an estimated 1.78 million students having ever used e-cigarettes as of 2012. Moreover, in 2012, an estimated 160,000 students who reported ever using e-cigarettes had never used conventional cigarettes. This is a serious concern because the overall effect of e-cigarette use on public health remains uncertain. Among young people, concerns include the potential negative effect of nicotine on adolescent brain development, as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products.

Electronic cigarettes, or e-cigarettes, are battery powered devices that provide doses of nicotine and other additives to the user in an aerosol. Depending on the brand, e-cigarette cartridges typically contain nicotine, a component to produce the aerosol (e.g., propylene glycol or glycerol), and flavorings (e.g., fruit, mint, chocolate, tobacco). Data from the 2011and 2012 National Youth Tobacco Surveys (NYTS)—a school-based, pencil-and-paper questionnaire given to US middle (grades 6–8) and high (grades 9–12) school students—were used to estimate the prevalence of ever and current (≥1 day in past 30 days) e-cigarette use.

During 2011–2012, among all students, ever e-cigarette use increased from 3.3% to 6.8%; current e-cigarette use increased from 1.1% to 2.1%, and current use of both e-cigarettes and conventional cigarettes increased from 0.8% to 1.6%. In 2012, among all ever e-cigarette users, 9.3% reported never smoking conventional cigarettes; among current e-cigarette users, 76.3% reported current conventional cigarette smoking.