E-Cigarette Access Sources, Use Frequency, and Quit Attempts among U.S. High School Students
Olayemi Timothy Adekeye, Thomas P. McCoyBackground:
Despite federal tobacco 21 (T21) legislation and retail regulations, e-cigarettes remain the most commonly used tobacco product among U.S. adolescents.
Purpose:
This study examined how U.S. high school students obtain e-cigarettes and how source access pathways are associated with frequency of vaping behavior and cessation efforts.
Methods:
We conducted a cross-sectional analysis of data from the 2023 national Youth Risk Behavior Survey. Analyses focused on adolescents reporting ever and past 30-day e-cigarette use. Survey-weighted negative binomial modeling examined associations between access source and frequency of past 30-day use, while weighted logistic regression assessed associations with quit attempts in the past year. Nominal logistic regression evaluated demographic correlates of access pathways.
Results:
Among U.S. high school students, 13.9% reported past 30-day e-cigarette use, with social sources representing the most common access pathway (51.2%). However, adolescents obtaining e-cigarettes from retail/commercial sources reported the highest frequency of use (
Conclusions:
Although peer-mediated access remains predominant, retail access (e.g., through vape and tobacco shops) is strongly associated with heavier adolescent e-cigarette use. Comprehensive youth vaping prevention efforts should address both retail and social supply chains, with targeted enforcement, school-based prevention, and equity-focused strategies.