Between 2017 and 2022, high-nicotine e-cigarette use surged nearly 80 percent among young adults aged 18 to 24 in the United States, driving up daily vaping rates and matching the nicotine dependence levels of traditional cigarette smokers.
A national data analysis published in the journal Tobacco Control reveals that young adults are gravitating toward vaping products containing high concentrations of nicotine, fundamentally shifting addiction patterns in the United States. Researchers examining data from the Population Assessment of Tobacco and Health Study found that the proportion of 18- to 24-year-olds who vaped climbed from just over 10 percent to nearly 19 percent between 2017 and 2022.
The Surging Adoption of High-Nicotine Vapes Among Young Vapers
The marketplace transformation traces back to technological shifts and flavor introductions that arrived around 2017, when sales hovered steady at six to seven million units per month before tripling to over 20 million units per month by 2021. As manufacturers introduced palatable high-nicotine options containing at least 4 percent nicotine concentrations, youth and young adult adoption rates accelerated rapidly.
In 2017, fewer than 4 percent of individuals who vaped reported using products with a 4 percent or higher nicotine strength. By 2022, however, nearly half of daily vapers aged 18 to 24—specifically 49.2 percent—relied on these high-nicotine formulations. By comparison, high-nicotine use remained heavily stratified across age brackets, reported by 32.8 percent of individuals aged 25 to 34, 17.6 percent of those aged 35 to 54, and just 4.5 percent of daily vapers aged 55 and older.
Closing the Dependence Gap Between Vaping and Cigarettes
The rapid uptake of high-nicotine devices has closed a generational gap in chemical addiction. In 2017, young adults aged 18 to 24 who exclusively vaped exhibited markedly lower nicotine dependence scores than their peers who smoked traditional combustible cigarettes. By 2022, however, exclusive vapers in that young adult cohort had climbed to match the dependence levels recorded among exclusive cigarette smokers five years prior.
Previous research has questioned the effectiveness of e-cigarettes in helping smokers quit. In this study, we have documented that high-nicotine products have created a new generation of people who are dependent on nicotine.
John P Pierce, PhD, senior author and professor at the Herbert Wertheim School of Public Health
The consequences extend directly to cessation barriers. Longitudinal data tracking adult vapers demonstrated that individuals using high-nicotine formulations in 2019 experienced 31 percent lower odds of achieving abstinence from vaping four years later by 2022, challenging assumptions that these high-strength delivery systems serve as effective cessation tools.
Marketing Tactics and Regulatory Scrutiny Under the Food and Drug Administration
When examining identical commercial brands—particularly Vuse and JUUL—researchers found that 18- to 24-year-olds selected high-nicotine options more than twice as often as adults aged 25 and older. Investigators pointed out that specific brands exhibiting large age disparities in nicotine strength had utilized paid social media influencer marketing, though they noted the observational study could not definitively establish direct causation between marketing tactics and consumer choice.
The findings have triggered alarms among public health experts regarding federal regulatory standards. The Food and Drug Administration originally authorized the marketing of certain e-cigarette products under the expectation that benefits to adult cigarette smokers would outweigh the risks of hooking a new generation on nicotine.
Although the health consequences of vaping are expected to be less than cigarette smoking, they will likely still be substantial. These results suggest that there is an urgent need to reassess whether high-nicotine e-cigarettes meet the public health standard required by US Congress for the US FDA to authorize their marketing.
Researchers, writing in Tobacco Control
Study authors emphasized that while the observational design prevents definitive causal claims—and noted that many survey participants in early years were unaware of their exact nicotine percentages, making estimates conservative—the evidence warrants an immediate reassessment.
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