Abstract
BACKGROUND: This study considers recent trends in combustible and e-cigarette use among US young adults who smoked cigarettes in adolescence, who are the originating source of most adults who smoke. METHODS: Data come from the Monitoring the Future study, which includes young adults aged 19-30 who were first surveyed in 12th grade as part of a nationally-representative sample. The analysis centres on 3623 observations from 2377 young adults surveyed from 2017 to 2022 who reported they had ever smoked a combustible cigarette in the initial, 12th grade survey. RESULTS: Among young adults who had smoked in adolescence, the percentage who used a combustible cigarette currently (in the past 30 days) significantly declined from 45% in 2017-2018 to 35% in 2021-2022. The percentage who currently used nicotine hovered around 50%, as measured by current use of an e-cigarette or combustible cigarette and this percentage did not significantly trend over the study period. The percentage who currently used e-cigarettes exclusively and not combustible cigarettes tripled from 6% in 2017-2018 to 21% in 2021-2022. About half of this exclusive e-cigarette group deliberately used e-cigarettes to quit combustible cigarettes, in all years. Dual use of both e-cigarettes and combustible cigarettes significantly increased from 11% in 2017-2018 to 17% in 2021-2022. Trends were robust in multivariable regression analyses that controlled demographics. CONCLUSION: Among young adults who had smoked in adolescence, a 10-point decline in cigarette prevalence from 2017 to 2022 coincided with a 7-point increase in the percentage who deliberately used e-cigarettes to quit combustible cigarettes.