Nicotine use has historically been more common among males, but a new study suggests that the pattern has reversed for adolescent e-cigarette use.

Published in JAMA Pediatrics, the study found that girls' vaping rates surpassed boys' in 2021 and remained higher through 2024.

Study Tracks Decade of Regular E-Cigarette Use in US Teens

Researchers from the Medical University of South Carolina analysed a decade of national survey data, covering 2014 to 2024, on nicotine use among adolescents aged 12 to 17.

Lead author Dr Brandon Sanford stressed that the investigation filtered out casual experimenters to isolate frequent, established users. Participants had to report regular use within the previous 30 days to qualify.

'These aren't youth who simply tried vaping once or twice,' Dr Sanford stated. 'We're talking about adolescents who are regularly using e-cigarettes now.'

Teen Girls Outpace Boys in Regular Vaping, Study Finds

The demographic split proved most pronounced among high schoolers aged 15 to 17. Regular vaping among older girls climbed steadily from 4.9 percent in 2021 to 7.8 percent in 2024.

By contrast, regular e-cigarette use among boys in that exact age group registered at 4.6 percent. The latest figures approach the historic peak recorded during the national vaping surge of 2018 and 2019.

Among younger adolescents aged 12 to 14, girls generally had higher vaping rates than boys after 2021, although rates fluctuated from year to year. While rates among middle school girls dipped slightly in 2024, researchers warned against premature celebration.

'Even though the rate dropped from 2023 to 2024, it's still high,' co-author Dr Naomi Brownstein said. 'There are still a lot of middle school girls vaping.'

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Discreet Pods and High Nicotine Fuel Youth Vaping Surge

The initial market disruption arrived between 2018 and 2019, driven by pod-based e-cigarettes that introduced concentrated nicotine salts. These compact, pod-based devices used nicotine salts and made e-cigarettes more discreet and easier to conceal.

Unlike traditional cigarettes, vape cartridges deliver hundreds or even thousands of continuous puffs. Dr Sanford noted that without a natural stopping point, young people struggle to track how much nicotine they inhale each day.

According to the CDC, 1.63 million US middle and high school students reported current e-cigarette use in 2024. Among these users, 87.6% used flavoured products and 55.6% used disposable e-cigarettes.

Teen Cigarette Smoking Hits Record Low as Vapes Take Over

As vaping surged in popularity, traditional cigarette smoking among American teens plunged to historic lows. By the final wave of data in 2024, fewer than 0.5% of both boys and girls were established cigarette smokers.

Dr Benjamin Toll of the MUSC Hollings Cancer Center hailed the vanishing smoking figures as a massive public health win. However, he cautioned that the underlying addiction battle has merely shifted platforms.

'We have to understand why, and we need to mobilize our public health efforts,' Dr Toll remarked. 'We need both prevention and intervention for these young people who are vaping at alarmingly high rates.'

He warned that healthcare providers cannot afford complacency simply because early brand controversies faded from the news. 'I want pediatricians to pay attention to possible vaping, especially for their female patients,' Dr Toll emphasized.

Nicotine Risks of E-Cigarettes in Developing Brains

CDC findings confirm that adolescent nicotine exposure harms critical neural pathways governing mood, learning, and impulse control. Surveys show nearly two-thirds of young vapers want to quit, yet struggle against intense chemical dependency.

'I think it says a lot about where we ought to be putting our resources,' Dr Sanford concluded. 'In terms of prevention efforts, treatment development and public health policy.'

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