Rethinking Nicotine: CVS Health Survey Uncovers Widespread Misconceptions About E-Cigarette Safety Among Young Adults
Over the past few decades, the public conversation around tobacco and nicotine use has transformed dramatically. Once glamorized in movies, magazines, and advertisements, cigarette smoking has fallen out of favor, replaced by a more informed—and cautious—attitude toward its risks. Thanks to widespread awareness campaigns, stricter regulations, and corporate initiatives, cigarette smoking is no longer the cultural norm it once was. In fact, annual cigarette sales in the United States have plummeted by more than 70% since the 1980s.
Despite this progress, smoking remains the leading cause of preventable death in the U.S., responsible for nearly one in five deaths annually. And while traditional cigarette use may be declining, a new trend has emerged to take its place: e-cigarette usage, commonly known as vaping. Once touted as a “safer” alternative to combustible tobacco, vaping has gained substantial popularity among young people—fueled in part by appealing flavors, sleek designs, and aggressive marketing tactics.
Between January 2020 and December 2022, unit sales of e-cigarettes in the U.S. surged by nearly 47%, according to industry data. Much of this growth is attributed to increased usage among youth and young adults, many of whom believe vaping to be a harmless habit. To better understand this emerging trend, CVS Health conducted a national survey of over 500 individuals between the ages of 18 and 28. The findings offer a revealing and, at times, troubling snapshot of young adults’ perceptions and behaviors related to nicotine use.
The Misconception of “Safer” Alternatives
One of the most striking takeaways from the CVS Health survey is the widespread belief among young adults that nicotine-only products, such as e-cigarettes, are entirely safe. An overwhelming 90% of survey respondents stated that they considered e-cigarettes to be risk-free. This perception stands in stark contrast to a growing body of scientific evidence that suggests otherwise.
While e-cigarettes do not contain tobacco in the traditional sense, most are loaded with nicotine—a highly addictive substance that can interfere with brain development in adolescents and young adults. Studies have shown that nicotine exposure during these critical years can impair attention, learning, and impulse control. Moreover, e-cigarettes contain a cocktail of other harmful substances, including heavy metals, volatile organic compounds, and cancer-causing agents. The aerosol produced by vaping devices is not “just water vapor,” as some marketing campaigns suggest, but a complex mixture that can damage the lungs and cardiovascular system over time.
Beyond nicotine’s well-documented risks, repeated exposure to certain chemicals used in flavored e-cigarettes has been linked to chronic respiratory conditions. Researchers have also raised concerns about the accumulation of toxic metals—such as lead and nickel—in the brain due to prolonged vaping.
Despite these dangers, e-cigarettes remain largely unregulated in terms of their long-term safety. To date, the U.S. Food and Drug Administration (FDA) has not approved any e-cigarette product as a safe or effective tool for smoking cessation. This absence of regulation, coupled with savvy marketing efforts, continues to fuel misconceptions among younger users.
Stress, Anxiety, and the Challenge of Quitting
The CVS Health survey also delves into the motivations and challenges young adults face when attempting to quit nicotine. Among respondents who use nicotine products, two out of three said that the most significant barrier to quitting is emotional distress—specifically stress, anxiety, or other mental health struggles.
This finding aligns with broader public health research indicating a strong correlation between nicotine use and mental health. For many young adults, vaping serves as a coping mechanism during times of emotional difficulty. However, this reliance can quickly spiral into dependency, reinforcing a cycle that becomes harder to break over time.
Fortunately, evidence-based solutions exist. According to the Centers for Disease Control and Prevention (CDC), combining behavioral counseling with FDA-approved medications can more than double an individual’s chances of successfully quitting. Yet these resources are often underutilized, particularly among younger populations. The CVS Health survey found that nearly 50% of young adults were unaware of smoking cessation programs altogether—a significant gap in public health education.
A Call for Greater Awareness and Action
The implications of these survey findings are clear: there is a pressing need to increase awareness about the health risks associated with both traditional cigarettes and e-cigarettes. Just as public health campaigns in the 1990s and early 2000s helped to stigmatize cigarette smoking and reduce its prevalence, a similar movement is now needed to combat misinformation surrounding vaping and nicotine-only products.
CVS Health has been at the forefront of this effort. In 2014, the company took a bold step by removing all tobacco products from its stores—a move that many experts credit with catalyzing broader change across the retail pharmacy sector. According to subsequent reports, the decision contributed to a nationwide decline in cigarette purchases, with 100 million fewer packs sold within a year of the removal.
Building on this commitment, CVS Health continues to expand its cessation support services. MinuteClinic®, a member of the CVS Health family of companies, offers both in-person and virtual smoking cessation programs tailored to individual needs. These programs provide participants with access to trained healthcare providers, personalized quit plans, and ongoing counseling.
Additionally, CVS Pharmacy® locations nationwide offer a range of over-the-counter nicotine replacement products, including patches, gums, and lozenges. Pharmacists are available to educate customers on how to use these products effectively, serving as a first line of support for those looking to break free from nicotine dependence.
For those enrolled in Aetna® health plans, tobacco use screenings are among the no-cost preventive services offered. These screenings help identify at-risk individuals early and connect them to resources that can support their journey toward quitting.
Empowering a Smoke-Free Generation
The findings from CVS Health’s survey underscore a critical truth: while progress has been made in reducing cigarette use, the battle against nicotine addiction is far from over. The rise of vaping has introduced new challenges, particularly among younger Americans who are often unaware of the risks or unsure of how to seek help.
As public health officials, educators, employers, and healthcare providers navigate this evolving landscape, collaboration will be key. Efforts to reduce youth nicotine use must be multifaceted, involving stronger regulatory oversight, targeted education campaigns, increased access to cessation services, and continued innovation in tobacco control.
CVS Health’s continued investment in these areas reflects its broader mission to improve community health and well-being. By identifying gaps in knowledge, raising awareness about available resources, and providing tangible support, the company hopes to empower a new generation to make informed, healthy choices—free from the grip of nicotine addiction.
