Introduction:
Large-scale, ongoing cohort studies may offer a complementary approach for monitoring population patterns of e-cigarette use alongside established national surveillance systems. This study assessed the prevalence and patterns of current and daily e-cigarette use among adults in the All of Us Research Program from 2017 to 2023 and compared observed patterns with those from established national surveys.

Material and methods:
This repeated cross-sectional analysis included adults aged 18 years or older who completed the All of Us Lifestyle Survey between 2017 and 2023. Current and daily e-cigarette use were ascertained through self-reported survey items. The analytic cohort was sex-balanced through random subsampling of female participants (1:1 ratio), and overall prevalence estimates were age-standardized to the 2020 U.S. Census adult age distribution. All analyses were descriptive.

Results:
The analytic sample included 418,772 participants. Age-standardized prevalence of current e-cigarette use was 6.1% (95% CI: 6.0–6.2), and daily use was 2.4% (95% CI: 2.3–2.4). Prevalence was highest among adults aged 18–24 years (13.3%), male participants (7.0%), and those with depression (7.5%). Annual current use prevalence rose from 3.8% in 2017 to 8.5% in 2023, with a dip to 4.5% in 2020. Among young adults reporting current e-cigarette use, the proportion reporting never combustible cigarette use grew from 51.5% in 2017 to 65.2% in 2023.

Conclusions:
E-cigarette use was most common among young adults, with patterns consistent with nationally representative datasets. These findings support the potential of the All of Us Research Program as a complementary resource for monitoring e-cigarette use.