Report: Hospital Codes Paint Picture of Vaping Use in NJ

Data Shows Use Detected Beginning at Age 11-12, Peaking at 18-24

A new analysis of New Jersey hospital discharge data shows the beginning of an uptick in hospitalizations where e-cigarette usage is documented between the ages of 11 and 12, and peak e-cigarette use happens between the ages of 18-24. Discharge data also shows the greatest concentration of hospital patients with e-cigarette use or vaping documented during their visit is in Middlesex County.

The Center for Health Analytics, Research and Transformation (CHART) at the New Jersey Hospital Association analyzed hospital inpatient and emergency department claims from January 2017 to August 2019 to dig deeper into an initial report that found New Jersey hospitals are on pace to see nearly 16,000 patients who use e-cigarettes in 2019 alone. CHART searched the data for documentation pointing to e-cigarette use and recommended diagnosis codes to capture vaping trends at a more detailed level for the new bulletin, The Vaping Crisis: Who’s at Risk & How Widespread is It?  

Vaping and e-cigarettes have been targeted toward young audiences as evidenced by testimony to the United States Congress earlier this year. In New Jersey, the age when e-cigarette use is documented in hospital records is getting younger. Data shows that in 2018, detection of e-cigarette use begins around age 13. The 2019 data shows incidence beginning around age 11.

“The only way we are going to understand the increased prevalence of vaping-related illness that is showing up in our hospitals is to understand who is using e-cigarettes and when they are introduced to these products,” said Cathleen Bennett, president and CEO of NJHA. “The level of detail this CHART bulletin provides is integral to New Jersey’s leadership in defeating this growing public health threat.”

CHART’s analysis differs from the national numbers reported on e-cigarette or vaping product use associated-lung injury, as the New Jersey data includes all hospital visits where vaping or e-cigarette use was documented through diagnosis codes. As of mid-October, the Centers for Disease Control and Prevention has reported 1,604 lung injury cases associated with the use of e-cigarettes or vaping, including 34 deaths – one in New Jersey.

Other findings in the report include:

  • E-cigarette use in New Jersey is overwhelmingly male, concentrated in Black and White populations. Vaping is least common among the Asian population in the state.
  • While peak e-cigarette use occurs among the 18-24 age group, peak nicotine dependence occurs in the 45-54 age range.
  • The growth in e-cigarette usage based on hospital claims data has accelerated in recent years from 6,088 in 2017 to 15,853 projected for 2019. This could be the result of a combination of increased activity and better awareness of the need to document e-cigarette usage.

The NJHA report argues that additional research and more consistent reporting of e-cigarette usage will help the healthcare community in assessing the extent of use of vaping products and educating users about the risks involved.

NJHA is currently in the process of creating tools for healthcare providers to prompt conversations about vaping with their patients, as well as best practices for documenting e-cigarette use in a patient’s medical history.

Visit the CHART website at to download a copy of the full report.

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