Trends in Electronic Nicotine Delivery Systems and Cigarette Use Among Texas College Students, 2015-2024.

Abstract

Introduction: We examined trends in past 30-day electronic nicotine delivery systems (ENDS) and past 30-day cigarette use among Texas college students from 2015-2024. We hypothesized that ENDS use would a) decline from 2015-2017 similar to national surveillance research, b) increase from 2017-2019 after the surging popularity of JUUL and similar pod-vapes, and then c) decline again from 2019-2024 after the enactment of federal tobacco policies and the onset of the COVID-19 pandemic. We also hypothesized that cigarette smoking would decline steadily over the ten-year period.

Methods: Participants were 45,129 18-25-year-old Texas college students who participated in at least one of ten repeated cross-sectional surveys from 2015-2024. Discontinuous growth curve models were used to analyze trends in past 30-day ENDS use and cigarette smoking across the 10-year period.

Results: Results indicated that ENDS use decreased from 2015-2017 (AOR=0.88, 95%CI: 0.81, 0.96), increased from 2017-2019 (AOR=2.08, 95%CI: 1.96, 2.20), and then decreased from 2019-2024 (AOR=0.95, 95%CI: 0.93, 0.97). Past 30-day cigarette smoking decreased steadily across the ten-year study period (AOR = 0.82, 95%CI: 0.80, 0.83).

Conclusions: Findings suggest that while cigarette use has declined over the past decade among Texas college students, there have been inconsistent changes in ENDS use. Although the present study cannot infer causaility, these changes align with the timing of tobacco legislation and FDA regulations. The sharp increase in ENDS between 2017-2019 highlights the need to remain vigilant about new products and marketing strategies from tobacco companies, as they may undermine the effectiveness of tobacco control efforts.

Implications: The present study provides new information on trends in cigarette and ENDS use among college students in Texas, a state with minimal tobacco control efforts. While cigarette use has steadily decreased over the past decade, ENDS use has fluctuated, and remains high. Policy efforts made at the national level may aid in tobacco prevention and cessation efforts in states with minimal tobacco control efforts.