E-cigarettes are advertised as the holy grail for smokers who want to change their habits for good. But what about people who have never smoked a cigarette in their lifetime? Amid concerns about the health benefits and risks of smoking vs. vaping, legislators fail to recognize this invisible problem.
Many Young Vapers Have Never Smoked a Cigarette
Research from the CDC found that in 2021, 4.5% of U.S. adults were current e-cigarette users1“NHIS – 2021 NHIS,” www.cdc.gov, May 07, 2021. https://www.cdc.gov/nchs/nhis/2021nhis.htm. Of those people,
- 29.4% were also current cigarette smokers
- 40.3% were former cigarette smokers
- 30.3% had never been cigarette smokers
Here are the results for e-cigarette users aged 25 to 44.
- 30.6% were current smokers
- 45.8% were former smokers
- 23.6% have never been cigarette smokers
The statistics are even more stark among e-cigarette users aged 18 to 24.
- 16.3% were also current smokers
- 22.3% were former smokers
- 61.4% have never been cigarette smokers
Research suggests that the majority of young people (under 25) who currently use e-cigarettes have never touched a traditional cigarette in their lives. The disparity between never-smokers in different age groups is massive, suggesting something is influencing young people to choose e-cigarettes over cigarettes.
Are Young People Less Likely to Smoke Than Their Predecessors?
Cigarette smoking remains the leading cause of preventable disease, disability, and death in the U.S., but the tide is turning. In 2005, 21 in every 100 adults (20.9%) smoked2Centers for Disease Control and Prevention, “CDC – fact sheet – current cigarette smoking among adults in the united states – smoking & tobacco use,” Smoking and Tobacco Use, May 04, 2023. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm. In 2021, the amount almost halved to 12 in every 100 adults (11.5%).
According to data from Gallup, young people are responsible for this dip. From 2001 to 2003, an estimated 35% of adults aged 18-29 said they smoked cigarettes3G. Inc, “Cigarette Smoking Rates Down Sharply Among U.S. Young Adults,” Gallup.com, Nov. 28, 2022. https://news.gallup.com/poll/405884/cigarette-smoking-rates-down-sharply-among-young-adults.aspx. In 2022, the estimate decreased to 12%. Over this time frame, young adults have transitioned from being the age group that is most likely to smoke cigarettes to the second-least likely.
Why Do Nonsmokers Start Vaping?
Very few studies focus on nonsmokers. From anecdotal research, we know that nonsmokers start vaping as an alternative to stop themselves from snacking4G. Davies, “I’m a non-smoker who got hooked on vaping – before I knew it I was getting through almost two a day,” The Telegraph, Jan. 10, 2024. Accessed: Apr. 03, 2024. [Online]. Available: https://www.telegraph.co.uk/health-fitness/diet/weight-loss/hooked-on-vaping-e-cigarettes/, among other reasons.
Studies also show that infants and young people have elevated sweet and salty preferences relative to adults5A. C. Hoffman, R. V. Salgado, C. Dresler, R. W. Faller, and C. Bartlett, “Flavour preferences in youth versus adults: a review,” Tobacco control, vol. 25, no. Suppl 2, pp. ii32–ii39, 2016, doi: https://doi.org/10.1136/tobaccocontrol-2016-053192. This could in part explain why the youth of today are drawn to fruit-flavored e-liquids, rather than tobacco.
Although there is not a great deal of research into what motivates never-smokers to become vapers, we can track the problem through big brands such as JUUL.
The Rise of JUUL: Nonsmokers to Vapers
The rise of sleek, user-friendly vape brands such as JUUL has had a devastating impact on youth uptake across the U.S.
In 2011, only 1.5% of high school students used e-cigarettes6K. A. Cullen, B. K. Ambrose, A. S. Gentzke, B. J. Apelberg, A. Jamal, and B. A. King, “Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018,” MMWR. Morbidity and Mortality Weekly Report, vol. 67, no. 45, pp. 1276–1277, Nov. 2018, doi: https://doi.org/10.15585/mmwr.mm6745a5. In 2018, the percentage was 20.8%. In just one year, from 2017 to 2018, current e-cigarette use among high school students increased by 78%.
Many factors influenced this extreme spike, but it is widely accepted that JUUL is one of the principal players. By the end of 2018, JUUL held approximately 76% of the e-cigarette market share, making it one of the fastest-growing and most popular brands of all time.
According to research from Truth Initiative7“Behind the explosive growth of JUUL,” Truth Initiative, 2019. https://truthinitiative.org/research-resources/emerging-tobacco-products/behind-explosive-growth-juul, the younger teenagers are, the more likely they are to use JUUL.
The same study also found that:
- 15 to 17-year-olds are 16x more likely to use JUUL compared with those ages 25-34
- 56% of youth and young adults who ever used JUUL or an e-cigarette reported that they were younger than 18 when they first tried the device
The study also concluded that JUUL’s meteoric rise to fame mirrors a rise in young people using e-cigarettes.
- From August 2017 to October 2018, JUUL’s market share rose from 24% to 75%
- From July 2017 to October 2018, the number of young adults between 18 and 21 who tried JUUL increased by more than 400%
JUUL markets e-cigarettes (and particularly disposables) as much more sleek, socially acceptable alternatives to cigarettes, but does this stop young people from trying traditional cigarettes?
Is Vaping a Gateway to Cigarettes?
There are growing concerns over whether vaping leads to smoking. A recent study from 2023 claims that “there is weak evidence that vaping is a gateway to smoking.”8C. P. Mendelsohn and W. Hall, “What are the harms of vaping in young people who have never smoked?,” International Journal of Drug Policy, vol. 117, p. 104064, Jul. 2023, doi: https://doi.org/10.1016/j.drugpo.2023.104064 The researchers go on to say the evidence suggests that vaping diverts young people away from smoking overall and displaces smoking at a population level.
However, other research suggests that nonsmokers who start vaping are at an increased risk of becoming smokers later in life.
One review of 17 studies found strong evidence to suggest there is an association between e-cigarette use among young nonsmokers and later smokers9J. N. Khouja, S. F. Suddell, S. E. Peters, A. E. Taylor, and M. R. Munafò, “Is e-cigarette use in non-smoking young adults associated with later smoking? A systematic review and meta-analysis,” Tobacco Control, vol. 30, no. 1, p. tobaccocontrol-2019-055433, Mar. 2020, doi: https://doi.org/10.1136/tobaccocontrol-2019-055433. However, researchers note that the studies were very diverse, and failed to consider the nicotine content of e-liquids used by nonsmokers, making it difficult to draw strong conclusions about the role of nicotine in this context.
Still, many researchers agree that e-cigarettes are a gateway to cigarettes.
Truth Initiative analyzed data from 2017-2019 on young adults aged 15 to 27. The study compared people who reported never using an e-cigarette and those who reported ever using an e-cigarette. Those who reported ever using an e-cigarette had significantly higher odds of ever using a cigarette, current cigarette use, and current e-cigarette use10E. C. Hair et al., “Association between e-cigarette use and future combustible cigarette use: Evidence from a prospective cohort of youth and young adults, 2017–2019,” Addictive Behaviors, vol. 112, p. 106593, Jan. 2021, doi: https://doi.org/10.1016/j.addbeh.2020.106593.
Denial in the Vape Industry
Ask the CEO of any vape brand, and they will tell you that their products are exclusively for ex-smokers who want to embark on a healthier, happier future. Push them a little further, and they’ll tell you to avoid nicotine completely.
Kevin Burns, the CEO of JUUL, made headlines when he said, “Don’t vape, don’t use JUUL.”11CBS News, “Juul CEO Kevin Burns tells non-smokers not to vape or use his company’s product – ‘Don’t vape. Don’t use Juul.,’” Cbsnews.com, Aug. 29, 2019. https://www.cbsnews.com/news/juul-ceo-kevin-burns-tells-non-smokers-not-to-vape-or-use-his-companys-product/
“Don’t start using nicotine if you don’t have a preexisting relationship with nicotine. Don’t use the product. You’re not our target customer.” – Kevin Burns
Despite adamantly denying that its products are designed to convert nonsmokers, JUUL and other e-cigarette brands continue to market their intuitive, user-friendly devices as cool accessories that appeal to all sorts of age groups, but especially young people.
E-Cigarettes As Accessories
When JUUL first hit the market, it placed ads on social media sites such as Twitter, Facebook, and Instagram. The ads featured 20-somethings at parties, having fun while they use JUUL products.
Researchers traced JUUL’s marketing history back to the very beginning, and found that “JUUL’s advertising imagery in its first 6 months on the market was patently youth-oriented.”12K. Drum, “Juul has been targeted at teens from the start,” Mother Jones. https://www.motherjones.com/kevin-drum/2019/09/juul-has-been-targeted-at-teens-from-the-start/
JUUL use ads, hashtags, and paid influencers to leverage the power of youth-centric social media. However, “Sampling events” are by far the most damning piece of evidence against JUUL. These events, which took place in cities around the U.S., included slumber parties, rooftop bars, and socials. Brands such as Mary Kwok and CHAPMAN were at the events, endorsing JUUL.
According to Dr. Robert Jackler, a professor and the principal investigator at Stanford Research into the impact of tobacco advertising, “There’s overwhelming evidence that the behavior of JUUL contributed to the product being sold to youth.”13T. M. L. Firm, “Is Juul targeting teenagers through its marketing tactics?,” Maher Law Firm. https://www.maherlawfirm.com/is-juul-targeting-teenagers-through-its-marketing-tactics/
JUUL is not the only brand responsible for making e-cigarettes synonymous with social status. In 2022, a UK-based publication called The Observer revealed that ElfBar paid TikTok influencers to promote their products14S. Das and J. Ungoed-Thomas, “Chinese vaping giant flouting UK advertising rules on selling to children,” The Guardian, Jul. 17, 2022. https://www.theguardian.com/society/2022/jul/17/chinese-vaping-giant-flouting-uk-advertising-rules-on-selling-to-children. In the U.S., 60% of TikTok users are between 16 to 24-years-old15B. Doyle, “TikTok Statistics – Everything You Need to Know [August 2020 Update],” Wallaroo Media, Aug. 12, 2020. https://wallaroomedia.com/blog/social-media/tiktok-statistics/, meaning that any TikTok marketing tactics are by default aimed at young people.
Final Thoughts
Vape brands use aspirational marketing to position e-cigarettes as a trendy, social crutches among young people. Whereas their predecessors began smoking to fit the social trend, modern young people are increasingly using e-cigarettes to fit the social standard.
E-cigarettes might be a healthier alternative to traditional cigarettes, but the health benefits vanish when users never smoked in the first place. If legislators, vape industry officials, and campaigners continue to ignore this invisible problem, they could undermine decades of progress in tobacco control.
