By Timothy S. Donahue
Top Takeaways:
- Gender Reversal: Girls have reported higher vaping rates than boys since 2021.
- Older Teens: Established vaping reached 7.8% among girls ages 15–17, compared with 4.6% of boys.
- Smoking Declines: Established combustible cigarette use fell below 0.5% for both sexes.
Boys no longer lead in teenage vaping.
A new study published Oct. 19 in JAMA Pediatrics found that girls have reported higher rates of established e-cigarette use than boys since 2021, reversing a longstanding pattern in youth nicotine use.
Researchers at the Medical University of South Carolina analyzed nationally representative data from the Population Assessment of Tobacco and Health (PATH) Study on adolescents ages 12 to 17 from 2014 to 2024.
The shift was most pronounced among older teenagers. Vaping prevalence among girls ages 15 to 17 increased from 4.9% in 2021 to 7.8% in 2024, compared with 4.6% among boys of the same age.
The researchers defined established users as adolescents who reported regular product use and use within the past 30 days, distinguishing them from those who had only experimented with vaping.
Historically, boys reported higher vaping rates, but that gap narrowed during the 2018–2019 surge in youth e-cigarette use. After overall rates declined by 2021, vaping among older teenage girls began to climb again.
“We have to sound the alarm bells for girls,” said Benjamin Toll, director of the MUSC Health Tobacco Treatment Program. “But we also need to make sure that we’re addressing the boys, too.”
The study also documented a substantial decline in combustible cigarette use. By 2024, fewer than 0.5% of adolescent boys and girls were established cigarette smokers.
Toll described the decline as a “massive public health win,” while lead author Brandon Sanford suggested that vaping may be displacing some cigarette smoking among adolescents. However, the observational study did not establish whether vaping caused the decline in smoking or explain why girls’ vaping rates have increased.
Researchers said further investigation is needed into potential influences, including marketing, social factors, motivations for use, and perceptions of nicotine products.
“There may be some complacency with people thinking we’ve gotten through the Juul crisis,” Toll said. “I want pediatricians to pay attention to possible vaping, especially for their female patients.”
