The number of American adults who use electronic nicotine delivery systems (ENDS) increased by 3 million people in 2018, up 38.3% from 8.1 to 11.2 million. Search data for ENDS were analyzed against relevant traits including state longitude, tobacco tax rate and national tobacco program funding. Searches increased 88% (95% CI, 70–100) over the last 5 years and peaked on 8 September 2019, after the CDC issued a warning about the link between ENDS and high-profile lung damage cases. Searches aimed at buying ENDS subsequently dropped 25% (95% CI, 20.1–29.6), while health-related ENDS searches spiked to their all-time high, increasing 22% (95% CI, −6 to 55) compared with the first half of 2019. ENDS searches are now more concentrated than 5 years ago, reversing the trend of the early 2010s, likely because certain states have passed laws to curb the use of ENDS. The public prefers searching for ‘vaping’ over ‘e-cigarette’ in a phenomenon similar to ‘high fructose corn syrup’ versus ‘sugar’. Consequently, public policy discussions and public education campaigns need to use ‘vaping’ terms, and more states should enact policies that are strongly associated with lower ENDS usage, many of which we identify.

中文翻译：

---

电子烟与公共卫生意识：谷歌搜索查询的横断面分析

使用电子尼古丁输送系统 (ENDS) 的美国成年人数量在 2018 年增加了 300 万人，从 8.1 增加到 1120 万，增加了 38.3%。ENDS 的搜索数据针对相关特征进行了分析，包括州经度、烟草税率和国家烟草计划资金。过去 5 年，搜索量增加了 88%（95% CI，70–100），并在 2019 年 9 月 8 日达到顶峰，此前 CDC 发布了关于 ENDS 与高调肺损伤病例之间联系的警告。旨在购买 ENDS 的搜索随后下降了 25%（95% CI，20.1-29.6），而与健康相关的 ENDS 搜索飙升至历史最高点，与第一次相比增加了 22%（95% CI，-6 至 55） 2019 年的一半。ENDS 搜索现在比 5 年前更加集中，扭转了 2010 年代初期的趋势，可能是因为某些州已通过法律限制 ENDS 的使用。在类似于“高果糖玉米糖浆”而不是“糖”的现象中，公众更喜欢搜索“电子烟”而不是“电子烟”。因此，公共政策讨论和公共教育活动需要使用“电子烟”术语，并且更多的州应该制定与降低 ENDS 使用密切相关的政策，其中许多是我们确定的。