E-cigarette access and age verification among adolescents, young adults, and adults

Background: Adolescents and young adults continue to access e-cigarettes despite regulatory efforts to prevent sales to those under 21. Prior research on sources of acquiring e-cigarettes excludes key online sources. This study aims to update evidence on where and how different age groups (adolescents, young adults, and adults) access e-cigarettes. Methods: A cross-sectional, online survey of 13-40 year-olds who used e-cigarettes in the past 30 days was conducted from November-December 2021. Study outcomes: where past 30-day users obtained and bought ecigarettes (retail stores; online, including e-cigarette company and multi-brand websites; social media; home delivery applications; and someone they know); and whether and how age was verified. Results: In our sample, 55.0% reported obtaining e-cigarettes from retail stores, 44.9% online, and 24.0% from someone they know (n = 2,256), although most 13-17-year-olds obtained their e-cigarettes from someone they know. Double the proportion of 21-40-year-olds (7.0%) and higher than 18-20-year-olds (9.8%), 13.4% of 13-17-year-olds obtained e-cigarettes through social media. Social media, Snapchat, Instagram, and TikTok were common platforms to buy e-cigarettes among those under 21; common sources on social media included friends their age, store/company accounts, and influencers. Approximately 20.0% of those under 21 bought e-cigarettes from internet vendors (including multi-brand websites) and 10.4-15.5% used home delivery applications. Across participants, 14.2% reported that their age was not verified, and 17.8% reported that their age was rarely verified. Conclusions: A sizeable proportion of adolescents and young adults under 21 years and adults above 21 acquired e-cigarettes from retail and online sources. Less than a quarter of those underage reported having their age verified all the time, warranting enforcement of existing age verification regulation and development of strategies to prevent underage access online.