Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Jun 20:365:l2219.
doi: 10.1136/bmj.l2219.

Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys

David Hammond  1 , Jessica L Reid  2 , Vicki L Rynard  2 , Geoffrey T Fong  3   4 , K Michael Cummings  5 , Ann McNeill  6 , Sara Hitchman  6 , James F Thrasher  7 , Maciej L Goniewicz  8 , Maansi Bansal-Travers  8 , Richard O'Connor  8 , David Levy  9 , Ron Borland  10 , Christine M White  2
Affiliations
Comparative Study

Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys

David Hammond et al. BMJ. .

Erratum in

Abstract

Objective: To examine differences in vaping and smoking prevalence among adolescents in Canada, England, and the United States.

Design: Repeat cross sectional surveys.

Setting: Online surveys in Canada, England, and the US.

Participants: National samples of 16 to 19 year olds in 2017 and 2018, recruited from commercial panels in Canada (n=7891), England (n=7897), and the US (n=8140).

Main outcome measures: Prevalence of vaping and smoking was assessed for use ever, in the past 30 days, in the past week, and on 15 days or more in the past month. Use of JUUL (a nicotine salt based electronic cigarette with high nicotine concentration) and usual vaping brands were also assessed. Logistic regression models examined differences in vaping and smoking between countries and over time.

Results: The prevalence of vaping in the past 30 days, in the past week, and on 15 days or more in the past month increased in Canada and the US between 2017 and 2018 (P<0.001 for all), including among non-smokers and experimental smokers, with no changes in England. Smoking prevalence increased in Canada (P<0.001 for all measures), with modest increases in England, and no changes in the US. The percentage of ever vapers who reported more frequent vaping increased in Canada and the US (P<0.01 for all), but not in England. The use of JUUL increased in all countries, particularly the US and Canada-for example, the proportion of current vapers in the US citing JUUL as their usual brand increased threefold between 2017 and 2018.

Conclusions: Between 2017 and 2018, among 16 to 19 year olds the prevalence of vaping increased in Canada and the US, as did smoking in Canada, with little change in England. The rapidly evolving vaping market and emergence of nicotine salt based products warrant close monitoring.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: funding for the project through a grant (1P01CA200512-01) from the US National Institutes of Health; DH, KMC, JFT, and GTF have served as paid expert witnesses in legal challenges against tobacco companies; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

References

    1. National Academies of Sciences, Engineering, and Medicine. Public health consequences of e-cigarettes. The National Academies Press, 2018, accessed 3 Dec 2018, 10.17226/24952. - DOI - PubMed
    1. Hajek P, Phillips-Waller A, Przulj D, et al. A randomized trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med 2019;380:629-37. 10.1056/NEJMoa1808779 - DOI - PubMed
    1. Hammond D, Reid JL, Cole AG, Leatherdale ST. Electronic cigarette use and smoking initiation among youth: a longitudinal cohort study. CMAJ 2017;189:E1328-36. 10.1503/cmaj.161002 - DOI - PMC - PubMed
    1. Leventhal AM, Stone MD, Andrabi N, et al. Association of e-cigarette vaping and progression to heavier patterns of cigarette smoking. JAMA 2016;316:1918-20. 10.1001/jama.2016.14649 - DOI - PMC - PubMed
    1. East K, Hitchman SC, Bakolis I, et al. The association between smoking and electronic cigarette use in a cohort of young people. J Adolesc Health 2018;62:539-47. 10.1016/j.jadohealth.2017.11.301 - DOI - PMC - PubMed

Publication types