LAUSR

Key Points Question How are e-cigarettes associated with nicotine addiction among US adolescents? Findings In this survey study of 151 573 respondents, age at initiation of e-cigarette use decreased and intensity of use and addiction increased between 2014 and 2021. By 2019, more e-cigarette users were using their first tobacco product within 5 minutes of waking than users of cigarettes and all other tobacco products combined. Meaning These findings suggest that clinicians need to be ready to address youth addiction to these new highly addictive nicotine products during many clinical encounters, and stronger regulation is needed, including comprehensive bans on the sale of flavored tobacco products.