- Exclusive vape use among US adults increased by an average of 18.8 per cent a year between 2015 and 2023.
- Exclusive cigarette smoking fell by 6.6 per cent a year between 2019 and 2023.
- By 2023, exclusive vaping was more common than combustible tobacco use among adults aged 18 to 24.
- Dual use of cigarettes and non-combustible products remained low and broadly stable.
Exclusive vaping among US adults increased by an average of 18.8 per cent a year over an eight-year period as cigarette smoking continued to fall, a new study has found.
Researchers said the results point to a population-wide movement away from combustible tobacco and towards products that do not burn tobacco, particularly vapes.
The authors wrote: “The findings from this descriptive study indicate that US adult tobacco use is increasingly shifting away from combustible tobacco products, mostly cigarettes, toward exclusive use of non-combustible tobacco products, primarily ECs (e-cigarettes).”
The study analysed National Health Interview Survey data collected between 2015 and 2023. Exclusive vape use rose significantly across every age group and among both men and women.
Over the same period, exclusive use of combustible tobacco fell by an average of 3.6 per cent a year. The decline in cigarette smoking accelerated later in the study, dropping by 6.6 per cent annually between 2019 and 2023.
Young adults lead the shift
The change was clearest among younger adults. Exclusive combustible tobacco use among people aged 18 to 24 fell from 14.2 per cent in 2015 to 2.9 per cent in 2023.
Exclusive use of non-combustible products, including vapes and oral tobacco, moved in the opposite direction. It rose from 3.9 per cent to 10.9 per cent in the same age group.
The researchers said: “By 2023, exclusive EC use was more common than combustible tobacco among adults aged 18-24.”
Adults aged 25 to 34 also recorded a substantial change. Exclusive combustible use fell from 19.1 per cent to 9.8 per cent, while exclusive non-combustible use rose from 3.1 per cent to 9.4 per cent.
The shift was slower among older adults. Combustible products remained the most common form of tobacco use among those aged 35 and over, particularly people aged 55 and above.
The authors said this showed a continuing need to help older smokers move away from burned tobacco.
Exclusive use doubles
Across the adult population, exclusive use of non-combustible products increased from 2.7 per cent in 2015 to 5.6 per cent in 2023.
Vaping accounted for the most prominent increase, with exclusive vape use rising at an average annual rate of 18.8 per cent. The researchers found statistically significant growth among all age groups and both sexes.
Exclusive combustible use, which included cigarettes, cigars, pipes and hookah, declined from 15.7 per cent to 11.2 per cent.
The researchers described the overall pattern as a shift towards lower-risk product use, based on evidence that avoiding combustion reduces exposure to many of the harmful chemicals found in cigarette smoke.
They wrote: “While non-combustible tobacco product use can cause nicotine dependence and is not without health risks, the absence of burned tobacco reduces exposure to harmful and potentially harmful chemicals.”
They cautioned that non-combustible products can still cause nicotine dependence and are not risk-free.
Dual use remains stable
One concern surrounding the growth of vaping is whether people simply add vapes to continued smoking rather than switching completely.
The study found little evidence of a broad rise in this pattern. Dual use of combustible and non-combustible products remained low and broadly stable between 2015 and 2023.
Its prevalence stood at 2.8 per cent at both the beginning and end of the study period, although it varied between individual years.
The most common combination was cigarettes and vapes. That pattern did not increase significantly over time.
Biomarker research has found that smokers who switch completely to non-combustible products achieve much larger reductions in exposure to harmful chemicals than those who continue smoking alongside them.
National survey tracks changing habits
The research was published in the August 2026 edition of JNCI Cancer Spectrum and used nine years of data from the National Health Interview Survey.
The annual survey covers approximately 27,000 adults and is designed to represent the civilian, non-institutionalised US population.
Researchers divided participants into three main groups: exclusive users of combustible products, exclusive users of non-combustible products and people who used both.
The analysis was observational and measured population trends rather than following individual smokers as they switched products. It therefore cannot show how many people moved directly from cigarettes to vaping or whether vaping caused the decline in smoking.
The researchers also warned that tobacco use was self-reported and that the survey used different definitions for current cigarette smoking and current use of other products.
Despite those limits, they said the figures showed a positive change in US tobacco use, driven by declining smoking and increased exclusive use of non-combustible alternatives.
The study concluded: “The findings from this study indicate a positive trend in tobacco use in the United States between 2015 and 2023, characterized by reduced use of smoked tobacco products, a pattern most evident among younger adults.”
The research was supported by grants from the US National Cancer Institute and the Food and Drug Administration’s Center for Tobacco Products. The funders had no role in the study’s design, analysis or publication decision. One author disclosed work as a paid expert witness in litigation against the cigarette industry.
