Evidence map›Paper›PMID 40253576›Full record

ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2025

Electronic Nicotine Delivery Systems Use and Nicotine Exposure Among Adults Who Use ENDS Alone or With Cigarettes: The Population Assessment of Tobacco and Health Study 2013-2019.

Kathryn C Edwards, Katherine Garcia-Rosales, Maciej L Goniewicz, David Ashley, Dorothy Hatsukami, Lanqing Wang, Jun Feng, Benjamin C Blount, Eva Sharma, Lori S Merrill and 21 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Kathryn C EdwardsWestat, Behavioral Health and Health Policy, Rockville, MD, USA.ORCID 0000-0002-0645-1705
Katherine Garcia-RosalesWestat, Behavioral Health and Health Policy, Rockville, MD, USA.
Maciej L GoniewiczRoswell Park Comprehensive Cancer Center, Buffalo, NY, USA.ORCID 0000-0001-6748-3068
David AshleyTRS Consulting56, Lilburn, GA, USA.ORCID 0000-0002-1060-5893
Dorothy HatsukamiUniversity of Minnesota, Minneapolis, MN, USA.ORCID 0000-0002-1108-2609
Lanqing WangDivision of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.ORCID 0000-0001-6620-7096
Jun FengDivision of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Benjamin C BlountDivision of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Eva SharmaWestat, Behavioral Health and Health Policy, Rockville, MD, USA.ORCID 0000-0002-1328-508X
Lori S MerrillWestat, Behavioral Health and Health Policy, Rockville, MD, USA.ORCID 0000-0001-9792-6376
Kristie TaylorWestat, Behavioral Health and Health Policy, Rockville, MD, USA.
Kara DuffyCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Arit HarvankoCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Arseima Del Valle-PineroCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Carol H ChristensenCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Cindy M ChangCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Dana van BemmelCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Derick L RiversCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Elena V MishinaCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Eric A TolliverCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Esther J RohCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Hoda T HammadCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Prabha KcCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Kerui XuCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.ORCID 0000-0002-4230-4980
Ruben Montes de OcaCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Yu-Ching ChengCenter for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
Colm EverardNational Institute on Drug Abuse, Bethesda, MD, USA.
Heather L KimmelNational Institute on Drug Abuse, Bethesda, MD, USA.ORCID 0000-0001-8278-0095
Carlos BlancoNational Institute on Drug Abuse, Bethesda, MD, USA.
Wilson ComptonNational Institute on Drug Abuse, Bethesda, MD, USA.ORCID 0000-0003-3108-5118
Andrew HylandRoswell Park Comprehensive Cancer Center, Buffalo, NY, USA.

Funding

FDA HHSNIDA NIH HHSNIH HHS
6 · The paper itself

Abstract

introductionEvaluating nicotine exposure (total nicotine equivalents-2; TNE-2) changes over time can provide data on the public health impact of electronic nicotine delivery systems (ENDS). This study describes TNE-2 levels of those who use ENDS with or without cigarettes from 2013-2019, and models how changing ENDS use behavior impacts change in TNE-2. AIMS AND

methodsCreatinine-corrected TNE-2 was assessed for exclusive ENDS use and dual ENDS and cigarette use from Waves (W) 1-5 of the Population Assessment of Tobacco and Health Study. Exploratory analyses using generalized estimated equations modeled how changing ENDS use (ie, frequency of use, flavor use, device type) between wave pairs (W1-W2, W2-W3, etc.) impacted changes in TNE-2.

resultsFor exclusive ENDS use at each wave, TNE-2 levels increased from 10.1 µmol/g at W1 to 18.4 µmol/g at W5, a positive linear trend (p = .03). Among those who exclusively used ENDS at all waves, TNE-2 levels peaked at W3 and then decreased at W5, exhibiting a significant quadratic trend (p = .02). Switching from non-daily to daily use (n = 15) was associated with a greater increase in TNE-2 than continued daily use (n = 304). For dual use, TNE-2 levels remained relatively flat, and there were no significant effects of changing ENDS behavior on TNE-2.

conclusionsFor exclusive ENDS use, TNE-2 levels over time differ when looking within-subjects versus repeated longitudinal assessments, and frequency of use was the only significant predictor of change in TNE-2. TNE-2 from dual-use did not significantly change from 2013-2019 and was not impacted by change in ENDS use behavior. IMPLICATIONS: Exclusive ENDS use was associated with a positive linear trend in nicotine exposure between 2013 and 2019, which may reflect how newer generations of ENDS are better at delivering nicotine. When limiting analysis to within-subject use at all waves the trend was quadratic, with nicotine exposure peaking at W3 and returning toward W1 levels by W5. This may be related to people trying to titrate their nicotine exposure in response to changes in ENDS characteristics. Dual ENDS and cigarette use had more consistent levels of exposure over time, which could be due to the greater ease of nicotine titration via cigarettes.

Indexed as

Cigarette SmokingElectronic Nicotine Delivery SystemsNicotineTobacco ProductsVapingAdultFemaleHumansMaleMiddle AgedYoung AdultNicotine

Identifiers

PMID40253576
PMCPMC12453681

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.