Prevalence of Electronic Cigarette Use Among Adult Workers — United States, 2017–2018

Abstract

Electronic cigarettes (e-cigarettes) heat a liquid to produce an aerosol that usually contains nicotine, flavors, and other chemicals and that is inhaled by the user (1). E-cigarette aerosols generally have a lower number and level of harmful toxicants than conventional cigarettes; however, e-cigarette aerosols can contain harmful ingredients, including ultrafine particles, volatile organic compounds, and heavy metals (1,2). The U.S. Surgeon General has determined that evidence is inadequate to conclude that use of e-cigarettes, in general, increases smoking cessation (3). During 2014-2016, an estimated 5.2 million U.S. workers were current e-cigarette users, and prevalence of e-cigarette use was higher among workers in certain industries and occupations (4). To estimate recent national prevalence of e-cigarette use among U.S. workers, CDC analyzed 2017-2018 National Health Interview Survey (NHIS) data for adults aged ≥18 years who were employed during the week before the interview. Among an estimated 156 million U.S. workers, 5.3 million (3.4%) were current e-cigarette users (i.e., "every day" or "some days" use), approximately one half of whom also currently used combustible tobacco products. Current e-cigarette use was highest among males, non-Hispanic Whites, those aged 18-24 years, those with no health insurance, those reporting poor or fair physical health, and those who currently used other tobacco products. Prevalence of e-cigarette use was highest among workers in the accommodation and food services industry and in food preparation and serving-related occupations. Continued surveillance of e-cigarette use in the United States, including among workers, is important to inform the development and implementation of evidence-based strategies to minimize population risks of use of e-cigarettes while continuing to explore their potential usefulness for cessation among adult cigarette smokers (2,3). To maximize the health of workers, employers can integrate comprehensive and effective tobacco cessation programs into workplace health promotion programs (4,5). NHIS is an annual, nationally representative, in-person survey of the noninstitutionalized U.S. civilian population.* The NHIS adult questionnaire is administered to one adult aged ≥18 years randomly selected from each family within the sampled household. † Sample sizes (response rates) for NHIS were 26,742 (53.