Trends in Electronic Cigarette Use Among Emergency Department Patients at a University Health System Between 2018 and 2023

Abstract

Background

E-cigarette use and its health impacts remain understudied in medicine and public health.

Objectives

This study aimed to investigate the prevalence, demographics, and self-reported health effects of e-cigarette use among emergency department (ED) patients.

Methods

This is a cross-sectional survey study of patients age ≥18 years from 2 urban academic EDs between February 2018 and November 2023. The primary outcome was frequent e-cigarette use (defined as ≥3 times/wk); secondary outcomes included self-reported symptoms, perceptions of health risks, and persistence of use despite adverse symptoms. Predictors of frequent use were examined with multivariable logistic regression, including variables with univariate p < 0.20 or clinical relevance. Results are reported as odds ratios (95% CI) with α = 0.05. Analyses were performed in SPSS.

Results

Among 3,656 respondents, 147 (4.0%) met our definition of frequent vaping. Of these frequent users, 84 (57%) were male and the greatest proportion fell in the 18–24-year age group. In multivariable analysis, male sex, and younger age independently predicted frequent use: females had roughly half the odds of frequent vaping (OR: 0.50, 95% CI: 0.35–0.72), while odds declined with increasing age (25–34 years OR: 0.46; 35–44 years OR: 0.40; ≥45 years OR: 0.10; p < 0.001). Among frequent users, 48% worried about additive safety and 54% reported coughing.

Conclusions

Frequent vaping was most common among younger males in this study. Many of these users report continued vaping despite concerns about potential health risks. EDs are strategically positioned to screen adult patients for frequent e-cigarette use and deliver brief, targeted cessation counseling.