High-nicotine e-cigarettes surged among young adults between 2017 and 2022, driving sharp increases in nicotine dependence that now match past cigarette-smoking levels. Researchers tracking the U.S. Population Assessment of Tobacco and Health Study link the rise to widespread adoption of products containing at least 4 percent nicotine.
Young Adults Drive Surge in High-Nicotine Vaping
By 2022, nearly half of young adults who vaped daily relied on high-nicotine e-cigarettes containing at least 4 percent nicotine.
Data published in the journal Tobacco Control shows that among daily vapers aged 18 to 24, the proportion using these potent products climbed from 3.1 percent in 2017 to 40.1 percent in 2019, ultimately reaching 49.2 percent by 2022, according to findings from researchers at the University of California San Diego Herbert Wertheim School of Public Health and Human Longevity Science.
That generational concentration stands in sharp contrast to older demographics. Among daily vapers aged 55 and older, just 4.5 percent used products with equivalent nicotine concentrations in 2022. Overall, the odds of choosing a high-nicotine device were 12 times higher for 18- to 24-year-olds than for adults in the oldest cohort.
| Age Group | 2017 High-Nicotine Use | 2022 High-Nicotine Use |
|---|---|---|
| 18–24 years | 3.1% | 49.2% |
| 25–34 years | Not reported | 32.8% |
| 35–54 years | Not reported | 17.6% |
| 55 and older | Not reported | 4.5% |
Dependence Scores Rise to Match Cigarettes
In 2017, young adults who exclusively vaped recorded substantially lower nicotine dependence scores than their peers who exclusively smoked traditional cigarettes. This shift toward concentrated nicotine formats coincided with a dramatic escalation in dependence among young users.
Longitudinal tracking of 2,356 adults who vaped in 2019 revealed that baseline product strength directly influenced long-term cessation success.
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, senior author and professor at the Herbert Wertheim School of Public Health, via UC San Diego
FDA Standards Face Questions Over Marketing
The sharp age-based divergence in product potency has intensified scrutiny over industry marketing practices. Within identical brands, younger consumers consistently opted for higher-nicotine versions compared to adults aged 25 and older.
Investigators noted that two brands exhibiting particularly wide generational gaps utilized paid social media influencers, though the observational study could not definitively establish direct causation between marketing and product selection.
The Food and Drug Administration originally authorized certain vaping products under the statutory expectation that their utility in helping adult smokers quit would outweigh the risk of hooking non-smoking youths. These dynamics have prompted public health experts to question whether current market offerings align with regulatory requirements.
Our findings suggest that this balance needs to be reassessed. Young adults are disproportionately choosing high-nicotine products, including within the same brands used by older adults, and that use is associated with substantially greater nicotine dependence.
John P. Pierce, senior author and professor at the Herbert Wertheim School of Public Health, via Mirage News
Study authors emphasized that while the observational design cannot prove high-nicotine e-cigarettes directly caused the rise in dependence, the accumulated evidence warrants an urgent reassessment of federal authorization standards and the commercial environment influencing long-term usage patterns.