Methodology Differences Impacting Prevalence Estimates of Youth Use of Electronic Nicotine Delivery Systems (ENDS) across Waves 5–7 of the Population Assessment of Tobacco and Health

Arielle Selya; Michael J. Hannon; Sooyong Kim; Saul Shiffman

doi:10.2478/cttr-2026-0010

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Methodology Differences Impacting Prevalence Estimates of Youth Use of Electronic Nicotine Delivery Systems (ENDS) across Waves 5–7 of the Population Assessment of Tobacco and Health

Contributions to Tobacco & Nicotine Research

Volume 35 (2026): Issue 3 (August 2026)

By: Arielle Selya, Michael J. Hannon, Sooyong Kim and Saul Shiffman

Open Access

|Sep 2026

Abstract

Background

The Population Assessment of Tobacco and Health (PATH) is a commonly-used longitudinal survey on nicotine/tobacco product use meant to represent the US population. Accurate surveillance to prevent youth electronic nicotine delivery systems (ENDS) use requires understanding the impact of methodological differences in Wave 6 (∼2021), specifically older ages (14–17 vs. usual 12–17) and survey mode (some telephone interviews vs. usual self-completed).

Methods

Changes in past-30-day (P30D) youth ENDS prevalence and patterns of use (i.e., frequency, device type, flavors, and brand) were examined year-over-year and for the 3-year period (2019–2022). Analyses compared combined age groups and survey modes (i.e., among all youth in each wave regardless of methodological differences) with methodologically-comparable sub-groups (i.e., same age range and survey mode). The impact of age on point estimates and trends (i.e., interaction with wave) was examined.

Results

Youth P30D ENDS prevalence significantly declined over the prior 3 years, but not year-over-year in either the naïve or methodologically-comparable analyses. However, 14–17-year-olds reported higher prevalence and steeper declines (age-wave interaction p < 0.0001) over the past 3 years (12.2% to 7.5%) than 12–13-year-olds (1.7% to 1.2%). Age differences had more modest impacts on patterns of ENDS use.

Discussion

Methodological differences in PATH Wave 6 introduced artifacts in estimates of prevalence, and to a lesser extent, patterns of youth ENDS use. Waves 5 and 7 are approximately comparable (∼95% equivalent) with respect to these differences. Future research examining prevalence trends over these waves should account for differences in survey mode and age range.

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Articles in this issue

DOI: https://doi.org/10.2478/cttr-2026-0010 | Journal eISSN: 2719-9509 (formerly 1612-9237)

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Language: English, French, German

Page range: 148 - 156

Submitted on: Dec 12, 2025

Accepted on: Jun 18, 2026

Published on: Sep 8, 2026

Published by: Beiträge zur Tabakforschung GmbH

In partnership with: Paradigm Publishing Services

Keywords:

Adolescents,

electronic cigarettes,

trends,

Related subjects:

© 2026 Arielle Selya, Michael J. Hannon, Sooyong Kim, Saul Shiffman, published by Beiträge zur Tabakforschung GmbH
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License.

Volume 35 (2026): Issue 3 (August 2026)