Electronic Cigarette Use Among Working Adults—United States, 2014

June 10, 2016 / Vol. 64 / 22

MMWR Introduction

Electronic cigarettes (e-cigarettes) are battery powered devices that deliver a heated aerosol, which typically contains nicotine, flavorings, and other additives, to the user. The e-cigarette marketplace is rapidly evolving, but the long-term health impact of these products is not known. Carcinogens and toxins such as diacetyl, acetaldehyde, and heavy metals have been documented in the aerosol from some e-cigarettes. The prevalence of e-cigarette use among US adults has increased in recent years, particularly among current and former conventional cigarette smokers; in 2014, 3.7% of all US adults, including 15.9% of current cigarette smokers, and 22.0% of former cigarette smokers, used e-cigarettes every day or some days. The extent of current e-cigarette use among US working adults has not been assessed.

CDC analyzed 2014 National Health Interview Survey (NHIS) data for adults aged ≥18 years who were working during the week before the interview, to provide national estimates of current e-cigarette use among US working adults by industry and occupation. Among the estimated 146 million working adults, 3.8% (5.5 million) were current (every day or some days) e-cigarette users. Prevalence was highest among males, non-Hispanic whites, people aged 18-24 years, people with annual household income <$35,000, people with no health insurance, cigarette smokers, other combustible tobacco users, and smokeless tobacco users. By industry and occupation, workers in the accommodation and food services industry and in food preparation and serving-related occupations had the highest prevalence of current e-cigarette use.

Recent increases in e-cigarette use among US adults and youths, coupled with uncertainties regarding their safety and the impact of e-cigarette use on patterns of conventional tobacco use, underscore the importance of continued public health surveillance of e-cigarette use. Efforts to implement proven strategies to reduce tobacco use and promote tobacco-free norms in the workplace are also warranted, particularly among those populations with the greatest prevalence of use. For example, employers can implement policies prohibiting the use of all forms of tobacco use in the workplace. Additionally, it is important for employers to offer comprehensive tobacco cessation services within their employee health care plans and wellness programs, including coverage of FDA-approved cessation medications. Furthermore, employers, businesses, trade associations, and worker representatives can work in partnership with their state and local health departments to educate workers about the health risks of tobacco use and the benefits of quitting tobacco use completely.