E-cigarettes and Older Adults who Smoke: A Missed Opportunity to Further Reduce Harm?

Objectives: Smoking prevalence among older adults (45+ years) is higher and shown less decline in comparison to younger adults (25 to 44 years). Current evidence indicates that e-cigarettes can help people to stop smoking, but there is lower prevalence of e-cigarette use by older adults. In this paper, we examine the prevalence and patterns of e-cigarette use by adults in the United States (US) who currently smoke. Methods: Data from a probability-based sample of 3612 adult (25+ years) members of Ipsos' KnowledgePanel in the US were collected in July 2024. Respondents self-reported their use of combustible cigarettes and e-cigarettes using an online questionnaire. Results: Older adults smoked more cigarettes per day and reported lower intention to quit. E-cigarette prevalence was lower among older adults compared to younger adults (7.2% vs 23.4%). Younger adults primarily used pod systems compared to older adults who primarily used open system devices. Fruit was the most often reported flavor used by both younger and older adults. Adults reported using e-cigarettes primarily to quit smoking. Conclusions: Manufacturers should consider the barriers to e-cigarette use by older adults who are smoking and design products that are appealing to older smokers. Reducing smoking prevalence in this group is a public health priority.