By Tom Latek
Kentucky Today
A new report from the Kentucky Injury Prevention and Research Center (KIPRC) reveals a sharp increase in emergency department (ED) visits related to e-cigarette dependence and nicotine toxicity among Kentucky residents between 2018 and 2024, with some of the steepest rises occurring among youth and young adults.
The analysis, conducted by KIPRC epidemiologists Mira Mirzaian, MPH, and Lara Daniels, MPH, used data from the Kentucky Outpatient Services Database, maintained by the Office of Data Analytics within the Cabinet for Health and Family Services.
“This database captures emergency department encounters across the state and serves as a key source for monitoring substance use-related morbidity,” Mirzaian said. “In addition to outpatient records, we include a subset of inpatient hospitalization, specifically cases where patients were admitted directly from the ED to a non-ambulatory inpatient facility.”
E-cigarette dependence-related visits among Kentuckians under age 18 rose from fewer than 300 in 2018 to over 2,700 in 2024, which she called particularly concerning, while visits among adults aged 25 and older more than quadrupled during the same period.
The analysis used an “any mention” approach, meaning cases were included if a nicotine-related code appeared anywhere in the medical record, as part of a medical classification system used to classify and code diseases, symptoms and procedures.
“This is a common surveillance strategy that helps ensure we don’t miss relevant cases, especially when nicotine use is a contributing factor rather than the main reason for the visit,” Mirzaian said.
That said, ED visits only represent a small portion of total e-cigarette use. This data reflects acute cases that required medical attention, not the full extent of use in the state.
Increasing ED visits may reflect a combination of factors.
“The steady rise in ED visits involving youth over time may indicate increased use and, in some cases, more acute/severe health effects requiring emergency care,” Mirzaian said. “At the same time, there’s been growing clinical awareness of vaping-related harms, along with broader adoption of nicotine-specific diagnosis codes.”
The data show a sharp rise in Kentucky resident emergency department visits coded with “vaping-related disorder,” a diagnosis code introduced in October 2022. While the initial jump may be tied to the adoption of this new code, the continued rise suggests there may be a real increase in vaping-related health harms, something researchers say warrants further exploration.
KIPRC is located at the University of Kentucky.