Vaping rebounds among older teen girls

Clinical takeaway: Continue to screen all adolescents for e-cigarette use, with attention to rising use among older teen girls. Offer prevention counseling or cessation support as appropriate.

Cigarette smoking among adolescents has fallen sharply, but vaping remains a concern. Understanding how use differs by age and sex may help guide prevention and cessation efforts.

Researchers analyzed data on adolescents ages 12 to 17 from eight waves of the nationally representative Population Assessment of Tobacco and Health (PATH) Study spanning 2014–2024. The 2024 wave included 8,002 participants.

The study defined “current established” vaping as a history of fairly regular e-cigarette use plus use within the past 30 days. Daily use was not required.

Vaping was more common among boys in 2014–2018, but rates rose sharply among both sexes during the 2018–2019 surge, narrowing the gap. That surge coincided with the growing popularity of compact, pod-based e-cigarettes such as JUUL, which used nicotine salts and were easy to conceal.

Rates declined by 2021, when vaping became more common among girls. Among girls ages 15 to 17, established vaping subsequently rose from 4.9% in 2021 to 7.8% in 2024, approaching the 2018–2019 peak of 8.2%.

By comparison, 4.6% of boys ages 15 to 17 reported established vaping in 2024. Younger adolescents had lower, more variable rates, with vaping among girls ages 12 to 14 declining in the latest year.

Meanwhile, established cigarette smoking—defined as more than 100 lifetime cigarettes plus past-30-day use—fell from 1.6% overall in 2014–2015 to 0.2% in 2024.

The observational analysis relied on self-reported use and could not determine why vaping became more common among girls or whether vaping displaced cigarette smoking.

“I want pediatricians to pay attention to possible vaping, especially for their female patients,” said study coauthor Benjamin Toll, PhD, of the Medical University of South Carolina, in a news release.

Source: Sanford BT, et al. (2026 Oct 19) JAMA Pediatr. Rates of Nicotine Use Among Children and Adolescents