{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:08:18Z","timestamp":1789402098687,"version":"build-2803163510"},"reference-count":9,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"US Navy Bureau of Medicine and Surgery"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n This study compared annual prevalences of traditional cigarette smoking vs e-cigarette vaping among active-duty US Navy or Marine Corps personnel from 2017 to 2021.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Trends were estimated using the annual Periodic Health Assessment (PHA), a standardized evaluation of medical readiness for military duties. We estimated crude and age-adjusted prevalences of tobacco-use type for each annual PHA and plotted linear trends.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The study included 496\u2009079 active-duty service members who completed \u22651 PHA between 2017 and 2021. Trends of cigarette smoking were inversely related to e-cigarette vaping; as smoking decreased, vaping increased. The age-adjusted annual prevalence of cigarette smoking (single-product use) declined from 7.7% to 4.2%. In contrast, the age-adjusted annual prevalence of e-cigarette vaping increased from 2.8% to 8.3%.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n By the end of the study period, single-product use of e-cigarettes (vaping) was nearly twice as prevalent as cigarette smoking\u2014a striking reversal in the dominant form of tobacco use within 5\u00a0years. This finding illustrates how rapidly vaping has supplanted traditional smoking among Navy and Marine Corps personnel, marking a fundamental shift in nicotine consumption with implications for military health monitoring and tobacco cessation programs.<\/jats:p>\n <\/jats:sec>\n \n Implications<\/jats:title>\n The study shows e-cigarette vaping rapidly supplanting traditional cigarette smoking among Navy and Marine Corps personnel. It marks a fundamental shift in nicotine consumption with implications for military health monitoring and tobacco cessation programs. Historically, military personnel have been at high-risk for cigarette addiction, yet the uptake of e-cigarettes (vaping) is relatively new. Estimating trends of nicotine use is important for allocating resources and prioritizing cessation interventions or other programs.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ntr\/ntag188","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:39:07Z","timestamp":1787744347000},"source":"Crossref","is-referenced-by-count":0,"title":["Smoking and vaping trends among active-duty US Navy and Marine Corps personnel: results from the Annual Periodic Health Assessment, 2017-2021"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8195-9392","authenticated-orcid":false,"given":"James K","family":"Romine","sequence":"first","affiliation":[{"name":"Naval Health Research Center , 140 Sylvester Road, San Diego, CA, 92106 ,","place":["USA"]},{"name":"Leidos, Inc ., San Diego, CA, 92106 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber L","family":"Dougherty","sequence":"additional","affiliation":[{"name":"Naval Health Research Center , 140 Sylvester Road, San Diego, CA, 92106 ,","place":["USA"]},{"name":"Leidos, Inc ., San Diego, CA, 92106 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7817-3516","authenticated-orcid":false,"given":"Eyal","family":"Oren","sequence":"additional","affiliation":[{"name":"San Diego State University, School of Public Health , San Diego, CA, 92182 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9766-341X","authenticated-orcid":false,"given":"Giovanni","family":"Appolon","sequence":"additional","affiliation":[{"name":"San Diego State University, School of Public Health , San Diego, CA, 92182 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"MacGregor","sequence":"additional","affiliation":[{"name":"Naval Health Research Center , 140 Sylvester Road, San Diego, CA, 92106 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"2026091411593866800_ref1","doi-asserted-by":"publisher","first-page":"e2632","DOI":"10.1093\/milmed\/usae208","article-title":"Tobacco use prevalence in the military health system: a retrospective study","volume":"189","author":"Patrick","year":"2024","journal-title":"Mil Med"},{"key":"2026091411593866800_ref2","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1080\/08897077.2022.2095075","article-title":"Use of electronic cigarettes among U.S. Military service members\u2014prevalence and associated risk factors","volume":"43","author":"Gill","year":"2022","journal-title":"Subst Abus"},{"key":"2026091411593866800_ref3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.7205\/MILMED-D-01-2008","article-title":"Tobacco use in the Army: illuminating patterns practices and options for treatment","volume":"174","author":"Nelson","year":"2009","journal-title":"Mil Med"},{"key":"2026091411593866800_ref4","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1001\/jamapediatrics.2016.4662","article-title":"E-cigarette use among youth and young adults: a major public health concern","volume":"171","author":"Murthy","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2026091411593866800_ref5","doi-asserted-by":"publisher","first-page":"43","DOI":"10.18332\/tpc\/135516","article-title":"E-cigarette and dual product use as an emerging health threat to the US military","volume":"7","author":"Keltner","year":"2021","journal-title":"Tob Prev Cessat"},{"key":"2026091411593866800_ref6","author":"Rigotti"},{"key":"2026091411593866800_ref7","doi-asserted-by":"publisher","first-page":"848","DOI":"10.7205\/MILMED-D-14-00501","article-title":"Tobacco research in the military: reflections on 20 years of research in the United States Air Force","volume":"180","author":"Talcott","year":"2015","journal-title":"Mil Med"},{"key":"2026091411593866800_ref8","first-page":"2","article-title":"Tobacco and nicotine use among active component U.S. military service members: a comparison of 2018 estimates from the Health Related Behaviors Survey and the Periodic Health Assessment","volume":"31","author":"Mancuso","year":"2024","journal-title":"MSMR."},{"key":"2026091411593866800_ref9","author":"Annual Periodic Health Assessment","year":"2016"}],"container-title":["Nicotine & Tobacco 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