Cigarette smoking among US youth has become increasingly denormalised since 2015, while e-cigarette norms have shown greater variability.
Trends in social norms toward cigarette smoking and e-cigarette use among U.S. youth between 2015 and 2021
September 2025
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Vu, G. T., Sun, T., Hall, W., Connor, J. P., Thai, P., Gartner, C., Leung, J., & Chan, G. (2025). Trends in Social Norms Toward Cigarette Smoking and E-cigarette Use Among U.S. Youth Between 2015 and 2021. Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/ntaf120
In this paper, PhD candidate Giang Vu and colleagues focused on understanding trends in social norms towards cigarette smoking and e-cigarette use among youth to support effective public health interventions and tobacco control policies. Social norms data from the US national longitudinal cohort PATH study indicate denormalisation of cigarette smoking among US youth has occurred since 2015; however, in 2021, young people with friends who vaped were 15 times more likely to use e-cigarettes.
Ms Vu led the study published in leading international journal Nicotine & Tobacco Research which found peer influences were a major factor in vaping trends, while disapproval of e-cigarettes from people important to teens such as parents reduced the likelihood of a teen vaping by 70%.
The team analysed data from 20,800 American youths between 2015 and 2021 and found while the proportion with friends who smoked declined during the study period, having friends who vaped remained common. In 2015, about 32% of young people had friends who vaped, which decreased to 22% by 2021. Media reporting of lung disease associated with vaping and COVID-19 related disruptions to social networks and access most likely contributed to the decline.
Vu et al concluded that educational campaigns should focus on providing accurate information about e-cigarette use and its risks, leveraging the protective influence of important people in young people's lives, and equipping youth with tools to resist peer pressure.
Ms Vu presented her results at the APSAD 2024 Opening Plenary and the SRNT-E annual conference of the European chapter of the Society for Research on Nicotine and Tobacco in Romania in September 2025.
Read the full paper in Nicotine & Tobacco Research.
