Prevalence, correlates, comorbidity and treatment of electronic nicotine delivery system use in the United States

- Electronic Nicotine Device (END) use is prevalent in the United States.
- END use is substantially comorbid especially with nicotine use disorder.
- END use largely goes untreated in the United States.
- The relationship between END use and traditional tobacco use cessation needs more research.

IntroductionThis study presents nationally representative data on the prevalence, correlates, psychiatric comorbidity and treatment (including pharmacological and nonpharmacological) among electronic nicotine delivery system (ENDS) users.MethodsFace-to-face interviews in the National Epidemiologic Survey on Alcohol and Related Conditions-III.ResultsPrevalences of 12-month and lifetime ENDS use were 3.8% (SE = 0.14) and 5.4% (SE = 0.17). Odds of ENDS use were greater among men than women, regardless of timeframe. Rates were lower among Blacks, Hispanics and Asians/Pacific Islanders relative to Whites. Odds of 12-month and lifetime ENDS use was also higher among younger (<65 years) than older (≥65 years) individuals and higher among individuals with high school education relative to these with some college education. Odds of 12-month and lifetime ENDS use was also higher among individuals with incomes <$70,000.00 compared with those with incomes ≥ $70,000.00 and higher among the previously married relative to those who were currently married. Associations between 12-month ENDS use and severe nicotine use disorder were strong, whereas associations with other substance use disorders and borderline and antisocial personality disorders were modest (AORs = 1.3-2.6). Rates of treatment seeking to cut down or quit tobacco or nicotine use (12-month, 25.0% (SE = 1.6); lifetime, 24.4% (SE = 1.4)) were low.ConclusionsENDS use is substantially comorbid, especially with nicotine use disorder. Virtually all ENDS users smoked cigarettes. Research is needed to understand their role in smoking cessation, adverse effects on bodily systems and their potential for addiction and comorbidity.