The surge in disposable vaping devices among adolescents has outpaced researchers' understanding of who is using them and how. A nationally representative cross-sectional analysis of over 22,000 U.S. middle and high school students now provides a clearer behavioral and psychosocial profile — one that distinguishes disposable from nondisposable e-cigarette users in ways that have meaningful implications for nicotine dependence trajectories in young people.
Drawing from the 2023 National Youth Tobacco Survey, researchers classified students into six mutually exclusive tobacco-use groups and applied multinomial logistic regression with weighted sampling to identify distinguishing correlates. Youth who predominantly used disposable e-cigarettes reported nicotine-containing product use at a rate of 81.9%, compared to 49.6% among those primarily using nondisposable devices — a striking 32-percentage-point gap. Disposable users also showed stronger preference for fruit-flavored products and were more likely to report getting high from nicotine, suggesting higher acute nicotine exposure consistent with the higher nicotine concentrations typical of disposable pod-style devices. Social media exposure to e-cigarette content and peer vaping norms emerged as significant correlates, while psychological distress patterns were also observed across user groups.
This study arrives at a critical juncture. Disposable e-cigarettes — particularly high-nicotine salt formulations — have largely supplanted earlier cartridge-based systems among adolescents, yet regulatory frameworks have struggled to keep pace. The finding that disposable users exhibit markedly higher nicotine dependence indicators compared to nondisposable users challenges any assumption that all youth vaping carries equivalent risk profiles. Fruit flavoring as a dominant preference reinforces a long-standing concern that flavor variety functions as a gateway feature for adolescent initiation rather than a harm-reduction tool for adult smokers. Critically, this is a cross-sectional design, meaning causality cannot be established — it is unknown whether disposable devices drive dependence or whether more dependence-prone youth self-select them. The behavioral clustering of social media exposure with heavy use warrants longitudinal follow-up. Still, as a nationally representative sample of over 22,000 students, the findings carry substantial epidemiological weight and should inform targeted prevention messaging.