Types of Electronic Nicotine Delivery Systems (ENDS) Used by People of Different Age and Smoking Status Groups: Results from a US Nationally Representative Survey.

Objectives The type of electronic nicotine delivery system (ENDS) used by different age groups may be associated with ENDS and cigarette use behaviours. This study sought to identify differences in the use of ENDS device type based on age and cigarette use status to inform policy about regulating ENDS. Design This was a cross-sectional study. Setting Data was derived from a national survey conducted in 2021 in the USA. Participants Participants include 2369 US youth and adults (13 years or older) who reported past 30-day ENDS use. Outcome measures Past 30-day fairly regular use (i.e., several times a week or more) of ENDS device types, namely cigalikes, disposables, refillable tank/box mods, closed pods, refillable pods and drippers. Cigarette smoking status was also measured. Results We used weighted regression models to determine the association between ENDS device type current regular use and age group and the association between each ENDS type current regular use and smoking status separately for each age group. Youth ENDS users 13–17 years old were more likely to regularly use cigalikes (OR=2.71), disposables (OR=3.44), closed pods (OR=2.57) and drippers (OR=2.86) and 18–29 years old were more likely to regularly use disposables (OR=3.67), closed pods (OR=1.58) and drippers (OR=1.94), compared with 30+ years old ENDS users (all p<0.05). Among 13–17 years old, current (vs never) smokers had greater odds of current regular use for cigalikes (OR=2.79), disposables (OR=2.33), refillable tanks (OR=2.27), closed pods (OR=2.62) and drippers (OR=6.32; all p<0.05). Similarly, 18–29 years old current (vs never) smokers had higher odds of reporting current regular use of refillable tanks (OR=1.80), refillable pods (OR=2.63), closed pods (OR=2.20) and drippers (OR=4.89; p<0.05). Conclusions Both age and smoking status were associated with current regular use of ENDS, especially for youth and young adults. These findings inform regulatory agencies as they monitor and enforce policy on ENDS allowed on the US market.