Send to

Choose Destination
Tob Control. 2019 Jan;28(1):50-59. doi: 10.1136/tobaccocontrol-2017-054174. Epub 2018 Apr 25.

Transitions in electronic cigarette use among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013-2015).

Author information

Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA.
School of Community Health Sciences, University of Nevada, Reno, Nevada, USA.
Westat Inc, Rockville, Maryland, USA.
Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA.
Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Medical University of South Carolina, South Carolina, USA.
Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland, USA.
Kelly Government Solutions, Rockville, Maryland, USA.
Center for Tobacco Studies, School of Public Health, Rutgers University, New Brunswick, New Jersey, USA.
Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York, USA.



This study assessed patterns of e-cigarette and cigarette use from Wave 1 to Wave 2 among adult e-cigarette users at Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study.


We examined changes in e-cigarette use frequency at Wave 2 among adult e-cigarette users at Wave 1 (unweighted n=2835). Adjusted prevalence ratios (aPR) were calculated using a predicted marginal probability approach to assess correlates of e-cigarette discontinuance and smoking abstinence at Wave 2.


Half (48.8%) of adult e-cigarette users at Wave 1 discontinued their use of e-cigarettes at Wave 2. Among dual users of e-cigarettes and cigarettes at Wave 1, 44.3% maintained dual use, 43.5% discontinued e-cigarette use and maintained cigarette smoking and 12.1% discontinued cigarette use at Wave 2, either by abstaining from cigarette smoking only (5.1%) or discontinuing both products (7.0%). Among dual users at Wave 1, daily e-cigarette users were more likely than non-daily users to report smoking abstinence at Wave 2 (aPR=1.40, 95% CI 1.02 to 1.91). Using a customisable device (rather than a non-customisable one) was not significantly related to smoking abstinence at Wave 2 (aPR=1.14, 95% CI 0.81 to 1.60).


This study suggests that e-cigarette use patterns are highly variable over a 1-year period. This analysis provides the first nationally representative estimates of transitions among US adult e-cigarette users. Future research, including additional waves of the PATH Study, can provide further insight into long-term patterns of e-cigarette use critical to understanding the net population health impact of e-cigarettes in USA.


electronic nicotine delivery devices; non-cigarette tobacco products; surveillance and monitoring

Conflict of interest statement

Competing interests: MLG receives fees for serving on an advisory board to J&J and grant support from Pfizer. RN served as an expert witness for plaintiff versus tobacco companies. JLP serves as a consultant for plaintiff versus tobacco companies. WMC reports holding stock in General Electric, and 3M Companies and Pfizer. KMC has received grant funding from the Pfizer, Inc., to study the impact of a hospital based tobacco cessation intervention. KMC also receives funding as an expert witness in litigation filed against the tobacco industry. No financial disclosures were reported by the other authors of this paper.

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center