High-nicotine vaping rose rapidly among young adults
High-nicotine e-cigarette use increased sharply among young adults in the United States between 2017 and 2022, according to a new study from researchers at the University of California San Diego. The analysis links use of these products with greater nicotine dependence and more persistent vaping over time.
Published in Tobacco Control on October 20, 2026, the study draws on data from the Population Assessment of Tobacco and Health, or PATH, Study, a nationally representative U.S. survey that follows tobacco and nicotine use. The findings add evidence to a policy debate over whether higher-nicotine vaping products can help adult smokers while creating new risks for younger people.
By 2022, nearly half of daily vapers aged 18 to 24 reported using e-cigarettes containing at least 4% nicotine. The researchers classify products at that level as high nicotine. The equivalent share among daily vapers aged 55 and older was 4.5%.
A widening age divide
The age differences documented in the study were substantial. Among all people who vaped in 2022, the odds of using a high-nicotine product were 12 times higher for people aged 18 to 24 than for adults 55 and older.
The shift was especially pronounced among young adults who vaped daily. In 2017, 3.1% of daily vapers aged 18 to 24 said they used an e-cigarette containing at least 4% nicotine. That figure rose to 40.1% in 2019 and reached 49.2% in 2022.
Older age groups reported lower use in 2022. The study found high-nicotine product use among 32.8% of daily vapers aged 25 to 34, 17.6% of those aged 35 to 54, and 4.5% of those aged 55 and older. Those differences indicate that the growth of high-nicotine vaping has not been evenly distributed across adult users.
Dependence and continued use
The researchers examined repeated PATH surveys conducted in 2017, 2019, 2021 and 2022. They also used longitudinal data from 2,356 adults who were vaping in 2019 and whose behavior was tracked through 2022.
That approach allowed the team to look beyond a single point in time. Their central finding was that high-nicotine e-cigarette use was associated with increased nicotine dependence and with vaping that persisted over the following years.
An association cannot, by itself, prove that nicotine concentration caused every user’s dependence or continued vaping. But the pattern is relevant because nicotine delivery is central to how strongly a product may reinforce repeated use. The study’s results show that the highest reported uptake of high-nicotine products was concentrated among the youngest adult group in the data.
A regulatory question
John P. Pierce, the study’s senior author and a professor at UC San Diego’s Herbert Wertheim School of Public Health and Human Longevity Science, said the results warrant reassessing the expected tradeoff behind authorization of such products. That expectation, he said, was that potential benefits to adults who smoke would outweigh the risk of creating new nicotine dependence among young people.
The study does not argue that all vaping products have the same role or impact. Instead, it highlights a specific pattern: young adults were disproportionately selecting products with at least 4% nicotine, including within brands used by older adults, and that use was associated with substantially greater dependence.
For regulators and public-health officials, the distinction is important. A product designed or authorized with smoking cessation or substitution in mind may be used by populations with different prior nicotine histories and different patterns of daily use. Age-specific uptake can therefore change how the overall public-health balance is evaluated.
What the study can and cannot answer
The PATH Study provides a broad view of self-reported tobacco and nicotine behavior in the U.S., and its longitudinal element gives the research more value than a one-time survey alone. Still, the supplied findings describe relationships in survey data rather than a controlled experiment.
The research does not establish why young adults increasingly chose high-nicotine devices, nor does it specify which policy intervention would best address the trend. It also does not mean every person using a high-nicotine e-cigarette will develop the same level of dependence or continue vaping at the same rate.
What it does provide is a clear signal that the market changed quickly over a five-year period. In 2017, high-nicotine products were reported by fewer than 4% of people who vaped. By 2022, their use was common among daily young-adult vapers, while remaining far less prevalent among the oldest adults in the study.
Why the result matters
Nicotine policy often involves competing objectives: reducing harms for people who smoke while preventing initiation and dependence among people who otherwise might not use nicotine products. The new analysis suggests that concentration, age and frequency of use need to be considered together rather than treating vaping as a single, uniform behavior.
For young adults, the study’s results point to a cohort in which high-nicotine vaping became widespread and was linked with more entrenched use. The authors’ call is not merely about product availability; it is about whether the assumptions used to judge benefits and risks still hold when real-world use is concentrated among younger users.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
