Electronic Nicotine Delivery Systems (ENDS)

Introduction

Smoking is one of the modifiable behavioral risk factors of noncommunicable diseases, according to the World Health Organization, that is still widespread among people in the United States. However, focusing on traditional cigarettes only captures part of the problem, since there have been great shifts in the market of tobacco products with the emergence of electronic cigarettes. According to the 2016 report of the Surgeon General, non-combustible cigarettes or electronic nicotine delivery systems (ENDS) have been commercially available in the US since the mid-2000s. Related research has been mounting, concerning the debates on the products’ promises on smoking cessation and claims of lesser harm as a substitute for traditional cigarettes.

ICPSR holds both public- and restricted-use data that highlight the prevalence and implications of e-cigarette use. The ubiquity of ENDS usage and the following attention from researchers is highlighted by the wide range of studies that examine e-cigarette use. Topics include perceptions of lower harm risk compared to traditional cigarettes, the prevalence of certain respiratory conditions among users, and the impact of flavored products, among others. In the following sections, we highlight three emerging topics with research articles that are linked in the ICPSR Bibliography of Data-related Literature.

Flavor preferences among users

Flavored tobacco products used in e-cigarettes are one of the factors that make vaping more appealing to users. Drawing on Population Assessment for Tobacco and Health (PATH) data, several publications are raising concerns about “ease-of-use” and the wide range of flavor options available that make vaping more attractive for users. However, Friedman et al. (2020) highlighted the multifaceted nature of the issue, as their results indicate that youth and young adults are more susceptible to smoking initiation with e-cigarette uptake, however, in the case of adult users non tobacco-flavored products were associated with higher rates of smoking cessation.

Youth and young adults

PATH data on youth and young adults were put to use by researchers to investigate how young people start vaping, how marketing campaigns encourage these groups to experiment with e-cigarettes, and what might be the health implications for them. Based on the most recent estimates of Wave 4 PATH data in Rostron et al. (2020), the proportion of users who initiated ENDS use with flavored products was the highest among youth aged 12-17, closely followed by young adults, with over 93 and 83 percent, respectively. Marketing campaigns targeting youth and young adults may be one contributing factor, as pointed out by Chen-Sankey et al. (2019).

Another series of data, the Monitoring the Future (MTF) longitudinal study of high school students also gathered information on youth’s perceptions of vaping. Evans-Polce et al. (2019) examined initiation patterns and the relationship between e-cigarette and cigarette use in this demographic.

The two series also provide an opportunity to take into account the differing impact of school- and home-based surveys on producing estimates of e-cigarette use among youth, as it was pointed out by Boyd et al. (2020).

Smoking cessation and e-cigarettes

Recent publications using longitudinal PATH data highlighted the ambiguity behind e-cigarettes’ benefit for smoking cessation. Benmarhnia et al. (2018) reported that ENDS were the most common cessation aids in the first two waves of PATH adult sample, as a quarter of quit attempters relied on them. Daily use of ENDS was associated with cutting back on smoking cigarettes in Berry et al. (2019). However, Pierce et al (2020) found that those users who attempted to quit smoking with the aid of e-cigarettes had similar abstinence rates as those using FDA-approved aids or nothing at all, and one year later were still using ENDS products. These and other articles linked to the studies in NAHDAP highlight that while their use might be helpful for putting down traditional cigarettes, e-cigarettes could stick with the user afterwards.

Conclusion

This Research Spotlight does not reflect all of the existing research regarding ENDS. To see how each of the ICPSR studies mentioned in this Spotlight has been examined in other scholarly literature, to gain ideas for extending prior research, or to conduct a larger literature review, you can search the ICPSR Bibliography of Data-related Literature. Your search results will contain publications linked to the study data analyzed in them. Discovering data via the literature in this way can begin your investigation of the existing and potential uses of the data distributed by ICPSR.

When authoring publications that include your secondary analysis of study data downloaded from ICPSR, be sure to cite the study in the publication’s references section, using the provided data citation and unique identifier (in the form of a URL containing a DOI). Once your paper is published, submit its citation to the ICPSR Bibliography via this form, so it can be added to ICPSR’s collection of linked data-related literature, enabling others to find, learn from, and cite your work.