A2.2-1

Appendix 2.2

Key Measures of Use

Overview A2.2-2

Ever Use A2.2-2

Past-30-Day Use A2.2-2

Frequent Use A2.2-3

Susceptibility to Use A2.2-3

Dual Use and Poly Use A2.2-3

Other Measures A2.2-3

NYTS Measures—Special Issues A2.2-4

Data Analysis A2.2-4

References A2.2-16

List of Tables

Table A2.2-1 E-cigarette items from sources of national data on e-cigarette use among youth and 

young adults A2.2-5

Table A2.2-2 E-cigarette items from PATH on e-cigarette use among youth and young adults A2.2-10
A Report of the Surgeon General

A2.2-2 Appendix 2.2

Overview

Standardizing measures of e-cigarette use is currently a challenge because of rapid and ongoing changes 

in the marketplace and in the products themselves. Also 

challenging is the task of performing robust analyses of 

the data on use of these products, given the variety of 

approaches employed to assess ever use and past-30-day 

use of e-cigarettes in the peer-reviewed literature articles included in this review. E-cigarettes are known by a 

variety of names, and names may vary by country, region, 

age group, cigarette smoking status, or reason for using 

the device. Common names for these products include 

“e-cigarette,” “e-cig,” “vape pen,” “mods,” “hookah pen,” 

“e-hookah,” “e-cigar,” and “e-pipe.” Because specific 

e-cigarette brands are often also distributed regionally, it 

is unclear whether the inclusion of brand callouts in measurement items in the national surveys influence individual respondents. The surveys employed in this report 

(NYTS, MTF, NATS) do not ask about type of e-cigarette 

device used (e.g., whether it was an “open system” or 

“closed system” device, or whether nicotine was present or 

absent in the fluid). Therefore, this information is absent 

in this report. Key terms and measures employed in the 

chapter are reviewed here and illustrated in Tables A2.2-1 

and A2.2-2. 

Ever Use

The definition of ever (lifetime) use of e-cigarettes 

varies slightly among the surveys used in this report. In the 

NYTS, NATS, and Styles surveys, an ever user is defined as 

“one who has ever used e-cigarettes, even just one time.” 

In the MTF, ever use is defined by someone “smoking an 

electronic vaporizer at least once or twice.” There are also 

notable differences in measures of ever e-cigarette use 

on the NYTS between the survey periods 2011–2013 and 

2014. These differences are explained in more detail in a 

later section (see NYTS Measures—Special Issues).

Past-30-Day Use

Use of a tobacco product on at least 1 day in the past 

30 days has traditionally been used to measure “current 

use” for adolescents and young adults. However, surveillance of tobacco-use behaviors among youth is enhanced 

through the assessment of additional measures. Therefore, 

additional data regarding the intensity of use (e.g., the 

number of days the product was used in the past 30 days) 

are also provided (see below). Measures of past-30-day 

use of e-cigarettes are available on the NYTS, MTF, and 

Styles surveys (Table A2.2-1). On these instruments, past30-day use includes use on at least 1 day in the 30 days 

preceding the survey. Similar to the measures of ever use, 

there are notable differences in measures of past-30-day 

use on the NYTS between the survey periods 2011–2013 

and 2014. These differences are explained in more detail in 

a later section (see NYTS Measures—Special Issues). On 

the NATS, “current use” is measured as use of the product 

“now,” which can refer to “every day,” “some days,” or 

“rarely.” See Table A2.2-1 for these details.

Because of the novelty of e-cigarettes, it is possible that solely assessing past-30-day use may capture 

an appreciable number of recent e-cigarette initiates who 

were only experimenting with these products, but may not 

continue using them regularly (Kozlowski and Giovino 

2014; Warner 2015). For example, the 2014 Minnesota 

Adult Tobacco Survey found that among current smokers 

who reported past-30-day e-cigarette use, 59% had used 

e-cigarettes on 5 or fewer of the past 30 days (infrequent 

users); 28.7% had used e-cigarettes between 6 and 29 of 

the past 30 days (intermediate users); and 12.3%  had 

used e-cigarettes on all 30 of the past 30 days (daily users) 

(Amato et al. 2016). These findings suggest that defining 

prevalence among young adults as any e-cigarette use in 

the past 30 days may include experimenters who may not 

progress to regular use. Future research is warranted to 

further explore how many past-30-day users go on to more 

persistent use patterns and the most appropriate measures 

to use in assessing youth tobacco behaviors, particularly 

for novel products.
Key Measures of Use A2.2-3

E-Cigarette Use Among Youth and Young Adults

Frequent Use

Measures of frequency of use are increasingly recommended for tobacco use surveillance studies of youth and 

young adults (Kozlowski and Giovino 2014; Amato et al. 

2016; Warner 2015). In the NYTS, the frequency of use 

for youth is measured as the number of days a respondent 

used an e-cigarette in the last 30 days. For the purposes 

of the present report, frequent use for youth was defined 

as use on 20 or more of the last 30 days preceding the 

survey (Kozlowski and Giovino 2014). In the NATS, frequent use for young adults is defined as using e-cigarettes 

“every day.” No past-30-day timeframe defines the young 

adult measure; rather, respondents in that study report 

whether they “now use” e-cigarettes “every day,” “some 

days,” rarely,” or “not at all.”

Susceptibility to Use

Susceptibility to use is defined as the absence of 

a firm resolve to not start smoking (Evans et al. 1995; 

Pierce et al. 1996, 1998). Originally developed to understand conventional cigarette smoking among youth, susceptibility predicts the onset of cigarette smoking among 

youth (Pierce et al. 1996) and has been widely applied in 

related studies (e.g., Unger et al. 1997; Filice et al. 2003; 

Gritz et  al. 2003; Sun et al. 2005; Bunnell et al. 2015). 

This construct is applied in the present report to be consistent with past reports (e.g., USDHHS 2012; Mowery 

et al. 2004; CDC 2010). Using the 2014 NYTS, susceptibility to e-cigarette use for the present report was defined 

as failure to respond “definitely not” to the following questions: (a) “Do you think that you will try an electronic cigarette or e-cigarette soon?” (b) “If one of your best friends 

were to offer you an electronic cigarette or e-cigarette, 

would you use it?” (c) “Have you ever been curious about 

using an electronic cigarette or e-cigarette such as blu, 

21st  Century Smoke, or NJOY?” Alternative response 

options for these questions were, “definitely yes,” “probably yes,” and “probably no.” These items are consistent 

with the measurement of susceptibility to conventional 

cigarette smoking by youth (Evans et al. 1995; Pierce et al. 

1996, 1998, 2005; Portnoy et al. 2014).

Dual Use and Poly Use

For the purposes of this chapter, “dual use” is defined 

as use of e-cigarettes and one other tobacco product, usually 

conventional cigarettes. Use of both products must have 

occurred in the same reporting period (e.g., either lifetime 

or in the past 30 days; see, for example, Tables 2.7a and 

2.7b). “Poly use” is defined as use of e-cigarettes and two or 

more other tobacco products, which include conventional 

cigarettes, traditional cigars, cigarillos, filtered little 

cigars, hookahs, pipe tobacco, smokeless tobacco, snus, 

dissolvable tobacco, and bidis/kreteks. Sometimes these 

products are divided into combustibles (which, in analyses, are typically limited to cigarettes, all cigar products, 

and hookahs) and noncombustibles (typically limited to 

smokeless tobacco, snus, and dissolvable tobacco).

Other Measures

Measures specific to other constructs, such as reasons to use e-cigarettes and the use of flavored e-cigarettes, 

are provided in Tables A2.2-1 and A2.2-2.
A Report of the Surgeon General

A2.2-4 Appendix 2.2

NYTS Measures—Special Issues

Measures of ever use and past-30-day use of 

e-cigarettes on the NYTS varied between 2011–2013 and 

2014. From 2011 to 2013, the NYTS asked, “Which of 

the following tobacco products have you tried, even just 

one time?” The response option “electronic cigarettes or 

e-cigarettes, such as Ruyan or NJOY” was the 9th choice 

of 11 choices in a check-all-that-apply list. The literature 

on “check-all-that-apply” approaches to survey items suggests, however, that these approaches elicit fewer answers 

for two reasons: satisficing and primacy. “Satisficing” is 

when respondents minimally answer a question to quickly 

move through the survey; “primacy” is the likelihood that 

the respondent will pay the most attention to the first item 

in a list with many response options (Smyth et al. 2005). 

As the e-cigarette response options for both ever and 

past-30-day use questions were only the 9th choice out 

of 11 choices, and outdated brand callouts were included, 

the pre-2014 NYTS e-cigarette items could have suffered 

from satisficing and primacy and, as a result, potentially 

underestimated e-cigarette use in 2011–2013.

In 2014, the ever and past-30-day use survey questions for e-cigarettes on the NYTS were changed so that 

each of these products was asked about individually in 

a forced-choice setup. Ever e-cigarette use was assessed 

with the question “Have you ever used e-cigarettes such 

as blu, 21st Century Smoke, or NJOY, even one time?” 

Response options were only “No” or “Yes.” Past-30-day use 

of e-cigarettes was assessed by the question “During the 

past 30 days, on how many days did you use e-cigarettes 

such as blu, 21st Century Smoke, or NJOY?” At the time 

of the survey, these brands were among the most popular 

nationwide; however, as noted previously, brands do vary 

regionally. It is likely that this change in item wording and 

approach captured more positive responses in 2014 than 

the approach used in 2011–2013. This is substantiated by 

a study of New Jersey adolescents using the New Jersey 

Youth Tobacco Survey (NJYTS) to compare the pre-2014 

(i.e., 2011–2013) check-all-that-apply method with the 

2014 forced-choice method. The study showed that the 

prevalence of e-cigarette use increased by 9.3 percentage 

points, from 14.9% to 24.2%, when using the forcedchoice method employed in 2014 (Delnevo et al. 2016). 

Thus, the change in prevalence estimates between 2011–

2013 and 2014 is likely attributable in part to the change 

in the survey question. However, the extent to which 

the NJYTS findings may be generalizable to the NYTS is 

unclear for several reasons: the questions assessed on the 

surveys are not absolutely identical; the NJYTS sample is 

markedly smaller; that study did not employ a random 

sampling design; and the demographic makeup of students varies between the two populations.

In 2013, the NYTS assessed perceived harm from 

e-cigarettes relative to harm from conventional cigarettes asking, “Do you believe any of the following are less 

harmful than cigarettes?” The e-cigarette response option 

was written as “Using electronic cigarettes, such as Ruyan 

or NJOY.” The brand references in this item changed in 

2014 to be parallel with the ever use and past-30-day items 

for e-cigarette use. In 2012 and 2013, the NYTS assessed 

awareness of e-cigarette use, but this item was dropped in 

2014 because of the extremely high prevalence of awareness observed in 2013.

Data Analysis

Data were analyzed for the present report using SAScallable SUDAAN version 9.2 and weighted to account for 

the complex survey design, as well as adjusted for nonresponse. Each survey was analyzed separately. Chapter 2 

focuses on data from the NYTS and NATS surveys, as these 

are the surveys that focus exclusively upon nationwide 

e-cigarette and other tobacco product use. National prevalence estimates and 95% confidence intervals (CIs) were 

calculated. Differences were considered statistically significant if CIs did not overlap. Estimates with a relative standard error of greater than 40% were not reported because 

of the inherent instability of such estimates.
E-Cigarette Use Among Youth and Young Adults

Key Measures of Use A2.2-5

Table A2.2-1 E-cigarette items from sources of national data on e-cigarette use among youth and young adults

Construct/topic NYTS (2015) NATS (2014) Styles (2014) MTF (2015)

Preamble The next 12 questions are 

about electronic cigarettes or 

e-cigarettes. E-cigarettes are 

electronic devices that usually 

contain a nicotine-based liquid 

that is vaporized and

inhaled. You may also know 

them as vape-pens, hookahpens, electronic hookahs 

(e-hookahs), electronic cigars 

(e-cigars), electronic pipes 

(e-pipes), or e-vaporizers. Some 

look like cigarettes, and others 

look like pens or small pipes. 

These are battery-powered 

devices that produce vapor 

instead of smoke. Some brand 

examples are NJOY, blu, VUSE, 

MarkTen, Finiti, Starbuzz, and 

Fantasi.

Electronic cigarettes, or 

e-cigarettes as they are often 

called, are battery-operated 

devices that simulate smoking 

a cigarette but do not involve 

the burning of tobacco. The 

heated vapor produced by 

an e-cigarette often contains 

nicotine.

—  Electronic vaporizers make a 

mist that is inhaled and have 

the feel of cigarette smoking. 

Examples include e-cigarettes 

and epens.

Lifetime use: Ever use Have you ever used an 

electronic cigarette or 

e-cigarette, even once or twice?

A. Yes

B. No

Have you ever used an 

electronic cigarette, even just 

one time in your entire life?

1. Yes

2. No

Have you ever tried any of the 

following products, even just 

one time?

5. Electronic cigarettes or 

e-cigarettes, such as Ruyan or 

NJOY

Have you ever used an 

electronic vaporizer such as an 

e-cigarette?

1. Never

2. Once or twice

3. Occasionally but not 

regularly

4. Regularly in the past

5. Regularly now

Regular use: Current regular 

use

 — Do you now use electronic 

cigarettes every day, some days, 

rarely, or not at all?

1. Every day

2. Some days

3. Rarely

4. Not at all

 — — 
A Report of the Surgeon General

A2.2-6 Appendix 2.2

Construct/topic NYTS (2015) NATS (2014) Styles (2014) MTF (2015)

Past-30-day use: Ever Use —  — In the past 30 days, which of 

the following products have you 

used at least once?

5. Electronic cigarettes or 

e-cigarettes, such as blu, NJOY, 

or LOGIC

—

Past-30-day use: Number of 

days used

During the past 30 days, 

on how many days did you 

use electronic cigarettes or 

e-cigarettes?

A. 0 days

B. 1–2 days

C. 3–5 days

D. 6–9 days

E. 10–19 days

F. 20–29 days

G. All 30 days

— — During the last 30 days, on how 

many days (if any) have you 

used an electronic vaporizer 

such as an e-cigarette?

1. 0 days

2. 1 or 2 days

3. 3–5 days

4. 6–9 days

5. 10–19 days

6. 20–30 days

Cessation: Use to quit What are the reasons why you 

have used electronic cigarettes 

or e-cigarettes?

C. To try to quit using tobacco 

products, such as cigarettes

At any time during the past 

12 months, did you completely 

switch from smoking 

conventional cigarettes to using 

electronic or e-cigarettes?

1. Yes

2. No

 —  —

Perceptions: E-cigarette 

awareness 

— Before today, had you ever 

heard of electronic cigarettes or 

e-cigarettes?

1. Yes

2. No

Which, if any, of the following 

products have you heard of?

3. Electronic cigarettes or 

e-cigarettes, such as Ruyan or 

NJOY

— 

Table A2.2-1 Continued
E-Cigarette Use Among Youth and Young Adults

Key Measures of Use A2.2-7

Construct/topic NYTS (2015) NATS (2014) Styles (2014) MTF (2015)

Perceptions (absolute): 

E-cigarette harm 

How much do you think people 

harm themselves when they use 

e-cigarettes some days but not 

every day?

A. No harm

B. A little harm

C. Some harm

D. A lot of harm

How harmful do you think 

using electronic cigarettes is to 

a person’s health?

1. Not harmful at all 

2. Moderately harmful

3. Very harmful

 — The next questions ask for 

your opinions on the effects 

of using certain drugs and 

other substances. How much 

do you think people risk 

harming themselves (physically 

or in other ways) if they ... 

use electronic cigarettes 

(e-cigarettes) regularly?

1. No risk

2. Slight risk

3. Moderate risk

4. Great risk

Perceptions (relative to 

cigarettes): E-cigarette harm 

What are the reasons why you 

have used electronic cigarettes 

or e-cigarettes?

F. They are less harmful than 

other forms of tobacco, such as 

cigarettes.

 — —  —

Table A2.2-1 Continued
A Report of the Surgeon General

A2.2-8 Appendix 2.2

Construct/topic NYTS (2015) NATS (2014) Styles (2014) MTF (2015)

Perceptions: Reasons for 

e-cigarette use

What are the reasons why you 

have used electronic cigarettes 

or e-cigarettes?

A. I have never tried an 

electronic cigarette.

B. Friend or family member 

used them.

C. To try to quit using tobacco 

products, such as cigarettes.

D. They cost less than other 

tobacco products, such as 

cigarettes.

E. Famous people on TV or in 

movies use them.

F. They are less harmful than 

other forms of tobacco, such 

as cigarettes.

G. They are available in flavors, 

such as mint, candy, fruit, or 

chocolate.

H. They can be used in areas 

where other tobacco 

products, such as cigarettes, 

are not allowed.

I. I used them for some other 

reason.

—  What are the reasons you 

have used an electronic vapor 

product, such as an electronic 

cigarette (e-cigarette), 

electronic hookah (e-hookah), 

or vape pen? 

1. A friend or family member 

used them.

2. To try to quit using other 

forms of tobacco, such as 

cigarettes.

3. They cost less than other 

forms of tobacco, such as 

cigarettes.

4. Famous people on TV or in 

movies use them.

5. They are less harmful than 

other forms of tobacco, such 

as cigarettes.

6. They are available in flavors 

such as mint, candy, fruit, or 

chocolate.

7. They can be used in areas 

where other tobacco 

products, such as cigarettes, 

are not allowed.

8. I used them for some other 

reason.

What have been the most 

important reasons for your 

using an electronic vaporizer 

such as an e-cigarette? (Mark 

all that apply.)

• To help me quit regular 

cigarettes.

• Because regular cigarette use 

is not permitted.

• To experiment—to see what 

it’s like.

• To relax or relieve tension.

• To feel good or get high.

• Because it looks cool.

• To have a good time with my 

friends.

• Because of boredom, nothing 

else to do.

• Because it tastes good.

• Because I am “hooked”—I 

have to have it.

Susceptibility: Curiosity Have you ever been curious 

about using an electronic 

cigarette or e-cigarette, even 

once or twice?

A. Definitely yes

B. Probably yes

C. Probably not

D. Definitely not

— — — 

Table A2.2-1 Continued
E-Cigarette Use Among Youth and Young Adults

Key Measures of Use A2.2-9

Construct/topic NYTS (2015) NATS (2014) Styles (2014) MTF (2015)

Susceptibility: Intention to use Do you think you will try 

an electronic cigarette or 

e-cigarette soon?

A. Definitely yes

B. Probably yes

C. Probably not

D. Definitely not

Do you think you will use 

an electronic cigarette or 

e-cigarette in the next year? 

Would you say:

1. Definitely yes

2. Probably yes

3. Probably no 

4. Definitely not

 — —

Susceptibility: Peer influence If one of your best friends 

were to offer you an electronic 

cigarette or e-cigarette, would 

you use it?

A. Definitely yes

B. Probably yes

C. Probably not

D. Definitely not

— — (12th grade) How many of your 

friends would you estimate ... 

use an e-cigarette, e-pen, etc.?

1. None

2. A few

3. Some

4. Most

5. All

Flavored product use: 

Past-30-day flavored 

product use

Which of the following tobacco 

products that you used in the 

past 30 days were flavored 

to taste like menthol (mint), 

alcohol (wine, cognac), candy, 

fruit, chocolate, or other 

sweets?

E. Electronic cigarettes or 

e-cigarettes

Were any of the electronic 

cigarettes that you used in the 

past 30 days flavored to taste 

like menthol, mint, clove, spice, 

candy, fruit, chocolate, or other 

sweets?

1. Yes

2. No

—  — 

Photos of products included in 

survey

No No No No

Notes: MTF = Monitoring the Future; NATS = National Adult Tobacco Survey; NYTS = National Youth Tobacco Survey; PATH = Population Assessment of Tobacco and 

Health Study.

Table A2.2-1 Continued
A Report of the Surgeon General

A2.2-10 Appendix 2.2

Table A2.2-2 E-cigarette items from PATH on e-cigarette use among youth and young adults

Construct/topic PATH (2014)—adult study PATH (2014)—youth study

Preamble The next questions are about electronic or e-cigarettes. 

E-cigarettes look like regular cigarettes but are battery-powered 

and produce vapor instead of smoke.

E-cigarettes can be bought as one-time, disposable products or 

can be bought as reusable kits with a cartridge. Some people 

refill their own cartridges with nicotine fluid, sometimes called 

“e-juice” or “e-liquid.”

Disposable e-cigarettes, e-cigarette cartridges, and e-liquid come 

in many different flavors and nicotine concentrations.

The next questions are about electronic cigarettes, often called 

e-cigarettes. E-cigarettes look like regular cigarettes but are 

battery-powered and produce vapor instead of smoke. There are 

many types of e-cigarettes. Some common brands include NJOY, 

blu, and Smoking Everywhere.

E-cigarettes can be bought as one-time, disposable products or 

can be bought as reusable kits with a cartridge. Some people 

refill their own cartridges with nicotine fluid, sometimes called 

“e-juice” or “e-liquid.” Disposable e-cigarettes, e-cigarette 

cartridges, and e-liquid come in many different flavors and 

nicotine concentrations.

Regular use: Current regular use Do you now use e-cigarettes:

1. Every day

2. Some days

3. Not at all

—

Regular use: Daily quantity On average, on those [FILL NUMBER OF DAYS FROM AE1022 

days/days you used], how many [ECIGFILL] did you usually use 

each day? Please enter a number.

1. Less than 1 each day

2. |__|__|__|

In the past 30 days, on the days you used an e-cigarette, how 

many [ECIGFILL] did you use per day?

1. Less than 1 [ECIGFILL] per day

2. 1 [ECIGFILL] per day

3. 2 to 5 [ECIGFILL] per day

4. 6 to 10 [ECIGFILL] per day

5. 11 to 20 [ECIGFILL] per day

6. More than 20 [ECIGFILL] per day

Regular use: Type of e-cigarettes 

used

Please think about the e-cigarette you use most of the time.

Is your e-cigarette rechargeable?

1. Yes

2. No

Does your e-cigarette use cartridges?

1. Yes

2. No

Can you refill your [e-cigarette/e-cigarette cartridges] with 

“e-liquid”?

1. Yes

2. No

Please think about the e-cigarette you use most of the time.

Is your e-cigarette rechargeable?

1. Yes

2. No

Does your e-cigarette use cartridges?

1. Yes

2. No

Can you refill your [e-cigarette/e-cigarette cartridges] with 

“e-liquid”?

1. Yes

2. No
E-Cigarette Use Among Youth and Young Adults

Key Measures of Use A2.2-11

Construct/topic PATH (2014)—adult study PATH (2014)—youth study

Regular use: Brand [Do/Did] you have a regular brand of e-cigarettes that you 

usually [use/used]?

1. Yes

2. No

What brand of e-cigarette [do/did] you [usually/last] use? Please 

select it from the choices below by touching the screen. [If you 

do not see it below, touch the button marked “NEXT.” If you do 

not see it below, touch the box marked “Something else.”]

About how long (did you use/have you been using) your regular 

brand of e-cigarette?

1. I___I___I

DAYS

2. I___I___I

MONTHS

3. I___I___I

YEARS

You said earlier that you last used an e-cigarette [TIME OF LAST 

USE]. Think about the very last puff you took. Was the brand 

[NEQBRAND]?

1. Yes

2. No

[Do/Did] you have a regular brand of e-cigarettes that you 

usually [use/used]?

1. Yes

2. No

What brand of e-cigarette [do/did] you [usually/last] use? Please 

select it from the choices below by touching the screen. [If you 

do not see it below, touch the button marked “NEXT.” If you do 

not see it below, touch the box marked “Something else.”]

Lifetime use: Ever use — Have you ever used an e-cigarette, such as NJOY, blu, or 

Smoking Everywhere, even one or two times?

1. Yes

2. No

Lifetime use: Age of first use How old were you when you first used an e-cigarette, even one 

or two times?

|__|__|

When you first used an e-cigarette, even one or two times, were 

you...

1. Less than 18 years old,

2. 18 to 24 years old,

3. 25 to 34 years old,

4. 35 to 44 years old,

5. 45 to 54 years old, or

6. 55 years old or older?

How old were you when you first tried an e-cigarette, even one 

or two times?

|__|__|

When you first tried an e-cigarette, even one or two times, were 

you ...

1. Less than 12 years old,

2. 12 to 14 years old, or

3. 15 to 17 years old?

Table A2.2-2 Continued
A Report of the Surgeon General

A2.2-12 Appendix 2.2

Construct/topic PATH (2014)—adult study PATH (2014)—youth study

Lifetime use: Number used entire 

life

How many disposable e-cigarettes or e-cigarette cartridges have 

you used in your entire life?

1. 1 or more puffs but never a whole one

2. 1 to 10

3. 11 to 20

4. 21 to 50

5. 51 to 99

6. 100 or more

How many disposable e-cigarettes or e-cigarette cartridges have 

you used in your entire life?

1. 1 or more puffs but never a whole one

2. 1 to 10

3. 11 to 20

4. 21 to 50

5. 51 to 99

6. 100 or more

Past-30-day use (A) In the past 30 days, have you used an e-cigarette, even one or 

two times?

1. Yes

2. No

(B) (Y) When was the last time you used an e-cigarette, even one 

or two times? 

1. Earlier today

2. Not today but sometime in the past 7 days

3. Not in the past 7 days but sometime in the past 30 days

4. Not in the past 30 days, but sometime in the past 6 months

5. Not in the past 6 months but sometime in the past year

6. 1–4 years ago

7. 5 or more years ago

—

Past-30-day use: Number of days 

used

On how many of the past 30 days did you use an e-cigarette?

1. |__|__|

In the past 30 days, on how many days did you use an 

e-cigarette?

|__|__|

Cessation: Use to quit (A) [Do/Did] you use e-cigarettes as a way of cutting down on 

your cigarette smoking?

1. Yes

2. No

—

Susceptibility: Curiosity — Have you ever been curious about using e-cigarettes?

1. Very curious

2. Somewhat curious

3. A little curious

4. Not at all curious

Table A2.2-2 Continued
E-Cigarette Use Among Youth and Young Adults

Key Measures of Use A2.2-13

Construct/topic PATH (2014)—adult study PATH (2014)—youth study

Susceptibility: Intention to use — Do you think that you will try an e-cigarette soon?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

Susceptibility: Peer influence — If one of your best friends were to offer you an e-cigarette, would 

you use it?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

Perceptions: E-cigarette awareness — Have you ever seen or heard of an electronic cigarette or 

e-cigarette before this study?

1. Yes

2. No

Perceptions: Reasons for 

e-cigarette use

The next questions are about the reasons people use e-cigarettes. 

Please select which reasons apply to you.

I use e-cigarettes because:

• They [are/were] affordable.

• People in the media or other public figures [use/used] 

e-cigarettes.

• I [can/could] use e-cigarettes at times when or in places where 

smoking cigarettes [isn’t/wasn’t] allowed.

• They might [be/have been] less harmful to me than cigarettes.

• They might [be/have been] less harmful to people around me 

than cigarettes.

• [ECIGFILL] [come/came] in flavors I [like/liked].

• Using e-cigarettes helps people to quit smoking cigarettes.

• E-cigarettes don’t smell.

• Using an e-cigarette [feels/felt] like smoking a regular 

cigarette.

• E-cigarettes [are/were] more acceptable to nontobacco users.

• People who are important to me [use/used] e-cigarettes.

• I [like/liked] socializing while using an e-cigarette.

• The advertising for e-cigarettes [appeals/appealed] to me.

The next questions are about the reasons people use e-cigarettes. 

Please select which reasons apply to you.

I use e-cigarettes because:

• They [are/were] affordable.

• People in the media or other public figures [use/used] 

e-cigarettes.

• I [can/could] use e-cigarettes at times when or in places where 

smoking cigarettes [isn’t/wasn’t] allowed.

• They might [be/have been] less harmful to me than cigarettes.

• They might [be/have been] less harmful to people around me 

than cigarettes.

• [ECIGFILL] [come/came] in flavors I [like/liked].

• Using e-cigarettes helps people to quit smoking cigarettes.

• E-cigarettes don’t smell.

• Using an e-cigarette [feels/felt] like smoking a regular 

cigarette.

• E-cigarettes [are/were] more acceptable to nontobacco users.

• People who are important to me [use/used] e-cigarettes.

• I [like/liked] socializing while using an e-cigarette.

• The advertising for e-cigarettes [appeals/appealed] to me.

Table A2.2-2 Continued
A Report of the Surgeon General

A2.2-14 Appendix 2.2

Construct/topic PATH (2014)—adult study PATH (2014)—youth study

Perceptions (absolute): E-cigarette 

harm 

— How much do you think people harm themselves when they use 

e-cigarettes?

1. No harm

2. Little harm

3. Some harm

4. A lot of harm

Perceptions (severity): E-cigarette 

harm 

(Y) How long do you think someone has to use e-cigarettes 

before it harms their health?

1. It will never harm their health

2. Less than 1 year

3. 1 year

4. 5 years

5. 10 years

6. 20 years or more

—

Perceptions (relative to cigarettes): 

E-cigarette harm 

— Is using e-cigarettes less harmful, about the same, or more 

harmful than smoking cigarettes?

1. Less harmful

2. About the same

3. More harmful

Perceptions: Addictive potential — How likely is someone to become addicted to e-cigarettes?

1. Very unlikely

2. Somewhat unlikely

3. Neither likely nor unlikely

4. Somewhat likely

5. Very likely

Flavored product use: First use of 

flavored product

When you first started using e-cigarettes, did you use cartridges 

or disposable e-cigarettes flavored to taste like menthol, mint, 

clove, spice, candy, fruit, chocolate, alcohol (such as wine or 

cognac), or other sweets?

1. Yes

2. No

Was the first e-cigarette you used flavored to taste like menthol, 

mint, clove, spice, candy, fruit, chocolate, alcohol (such as wine 

or cognac), or other sweets?

1. Yes

2. No

Flavored product use: Past-30-day 

flavored product use

(Y/A) In the past 30 days, were/was any of the [products] you 

used flavored to taste like menthol, mint, clove, spice, fruit, 

chocolate, alcoholic drinks, candy, or other sweets?

In the past 30 days, were any of the [ECIGFILL] you used 

flavored to taste like menthol, mint, clove, spice, candy, fruit, 

chocolate, alcohol (such as wine or cognac), or other sweets?

1. Yes

2. No

Table A2.2-2 Continued
E-Cigarette Use Among Youth and Young Adults

Key Measures of Use A2.2-15

Construct/topic PATH (2014)—adult study PATH (2014)—youth study

Photos of products included in 

survey

Yes Yes

Notes: PATH = Population Assessment of Tobacco and Health Study. Y = youth interview; A = adult interview.

Table A2.2-2 Continued
A Report of the Surgeon General

A2.2-16 Appendix 2.2

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