{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T12:50:59Z","timestamp":1793969459550,"version":"4.8.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surveillance of nicotine\/tobacco use typically examines binary use (vs. non-use) of each product in isolation, but this fails to capture product substitution and subtypes of multi-product use. The current analysis uses more temporally and behaviorally granular classifications to examine trends of electronic nicotine delivery systems and\/or cigarette use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Quarterly trends in cigarette and electronic nicotine delivery systems use from the National Health Interview Survey (NHIS) 2014-2024 were examined. Smoking\/vaping status was defined using self-reported frequency (every day, some days, not at all) for each product, yielding nine categories including non-use. Trends were analyzed overall and by age groups (18-29, 30-44, 45-59, \u226560).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Use of either product declined modestly (18% in 2014 Q1 to 16% in 2024 Q4). Exclusive smoking decreased substantially (80%-50% of those using either product), which was largely offset by a pronounced increase in exclusive vaping (from 5% to 40%). Dual use exhibited a U-shaped pattern with an initial decline and subsequent increase. While use of either product remained stable for most age groups, age significantly moderated trends: adults aged 18-29 exhibited the steepest decline in exclusive smoking (73%-7%), followed by adults aged 30-44 (78%-47%) and 45-59 (84%-72%). Conversely, exclusive smoking among adults aged \u226560 remained predominant and largely unchanged (86%-85%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A marked shift from exclusive smoking to exclusive vaping occurred from 2014 to 2024. This transition may represent population-level harm reduction by migration to noncombustible products, especially among younger adults, with limited change among older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Population-level shifts from exclusive smoking to exclusive vaping\u2014within an overall stable level of tobacco\/nicotine product use\u2014may indicate that noncombustible nicotine products have complemented traditional tobacco control efforts over this time period in reducing and\/or preventing cigarette smoking. The balance between allowing access to lower-risk alternatives for adults who smoke and preventing uptake among non-users remains critical. The persistence of exclusive smoking among older adults highlights the need for targeted interventions for this priority population. Finally, the recent increase in dual use underscores the importance of continued surveillance, for which quarterly National Health Interview Survey data can provide valuable insights.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag135","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:36:07Z","timestamp":1781627767000},"source":"Crossref","is-referenced-by-count":1,"title":["Shifts away from exclusive cigarette smoking toward exclusive vaping in the United States: Quarterly analysis of the National Health Interview Survey data, 2014-2024"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5131-5892","authenticated-orcid":false,"given":"Sooyong","family":"Kim","sequence":"first","affiliation":[{"name":"Pinney Associates, Inc , Bethesda, MD 20814 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7026-6988","authenticated-orcid":false,"given":"Arielle","family":"Selya","sequence":"additional","affiliation":[{"name":"Pinney Associates, Inc , Bethesda, MD 20814 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Niaura","sequence":"additional","affiliation":[{"name":"School of Global Public Health, New York University , New York, NY 10003, \u00a0","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"2026071210264077800_ref1","volume-title":"TOBACCO PRODUCT USE AMONG ADULTS\u2014United States. 2022 National Health Interview Survey (NHIS) Highlights","author":"U.S. Centers for Disease Control and Prevention"},{"key":"2026071210264077800_ref2","doi-asserted-by":"publisher","first-page":"EVIDpha2500339","DOI":"10.1056\/EVIDpha2500339","article-title":"Tobacco product use among U.S. adults, 2023-2024","volume":"5","author":"Agaku","year":"2026","journal-title":"NEJM Evid"},{"key":"2026071210264077800_ref3","doi-asserted-by":"publisher","first-page":"118","DOI":"10.15585\/mmwr.mm7407a3","article-title":"Notes from the field: tobacco product use among adults\u2014United States, 2017-2023","volume":"74","author":"Arrazola","year":"2025","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026071210264077800_ref4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1056\/NEJMsa1607538","article-title":"Tobacco-product use by adults and youths in the United States in 2013 and 2014","volume":"376","author":"Kasza","year":"2017","journal-title":"N Engl J Med"},{"key":"2026071210264077800_ref5","article-title":"Transitions in cigarette and ENDS use in the PATH study: a multistate transition model analysis of adults in 2021\u20132022 compared to previous years","author":"Brouwer","year":"2025","journal-title":"medRxiv."},{"key":"2026071210264077800_ref6","volume-title":"National Survey on Drug Use and Health (NSDUH) Detailed Tables","author":"Substance Abuse and Mental Health Services Administration"},{"key":"2026071210264077800_ref7","doi-asserted-by":"publisher","first-page":"e088162","DOI":"10.1136\/bmjopen-2024-088162","article-title":"Thirty-six-year trends (1986\u20132022) in cigarette smoking and snus use in northern Sweden: a cross-sectional study","volume":"14","author":"Sj\u00f6din","year":"2024","journal-title":"BMJ Open"},{"key":"2026071210264077800_ref8","volume-title":"Adult Smoking Habits in the UK","author":"Office for National Statistics","year":"; 2024"},{"key":"2026071210264077800_ref9","doi-asserted-by":"publisher","first-page":"e2454962","DOI":"10.1001\/jamanetworkopen.2024.54962","article-title":"Prevalence of popular smoking cessation aids in England and associations with quit success","volume":"8","author":"Jackson","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026071210264077800_ref10","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1186\/s12954-024-01125-4","article-title":"Joint smoking-vaping prevalence rates among American youth and young adults 2011-2022","volume":"21","author":"Rodu","year":"2024","journal-title":"Harm Reduct J"},{"key":"2026071210264077800_ref11","volume-title":"National Center for Health Statistics. 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