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Oklahoma, Kentucky and Indiana topped a new study ranking e-cigarette use in all 50 states.
The analysis by the insurance-services website QuoteWizard found that vaping rates in the top three states were between 6 percent and 7.1 percent. The state with the lowest share of vapers is California (3 percent).
In addition, the number of high schoolers and middle school students nationwide who used e-cigarettes in 2018 numbered 3.6 million, according to the Centers for Disease Control and Prevention.
The QuoteWizard research indicates that health insurers may have to create a separate question for premium purchasers about vaping due to the increased popularity of this tobacco product. Currently, they ask only a generic question about tobacco use.
The study’s numbers add to the debate over whether e-cigarettes should be viewed as a safer alternative for those seeking to quit smoking or a habit with similar risks as traditional tobacco products, according to QuoteWizard.
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E-cigarette Use by State
| Rank | State | Crude e-cigarette Use Prevalence (%) |
| 1 | Oklahoma | 7.1 |
| 2 | Kentucky | 6.1 |
| 3 | Indiana | 6 |
| 4 | Tennessee | 5.9 |
| 5 | Wyoming | 5.8 |
| 6 (tie) | Arkansas | 5.7 |
| 6 (tie) | West Virginia | 5.7 |
| 8 | Nevada | 5.4 |
| 9 (tie) | Arizona | 5.3 |
| 9 (tie) | Colorado | 5.3 |
| 9 (tie) | Ohio | 5.3 |
| 12 | Missouri | 5.2 |
| 13 | Utah | 5.1 |
| 14 (tie) | Alabama | 4.9 |
| 14 (tie) | Michigan | 4.9 |
| 14 (tie) | Mississippi | 4.9 |
| 14 (tie) | New Mexico | 4.9 |
| 14 (tie) | Rhode Island | 4.9 |
| 14 (tie) | Virginia | 4.9 |
| 20 | Delaware | 4.8 |
| 21 (tie) | Hawaii | 4.7 |
| 21 (tie) | Pennsylvania | 4.7 |
| 21 (tie) | T21. Texas | 4.7 |
| 24 (tie) | Idaho | 4.6 |
| 24 (tie) | Kansas | 4.6 |
| 24 (tie) | New Hampshire | 4.6 |
| 24 (tie) | North Carolina | 4.6 |
| 28 | Louisiana | 4.5 |
| 29 (tie) | Georgia | 4.4 |
| 29 (tie) | Illinois | 4.4 |
| 29 (tie) | New Jersey | 4.4 |
| 29 (tie) | Oregon | 4.4 |
| 33 (tie) | Florida | 4.3 |
| 33 (tie) | North Dakota | 4.3 |
| 33 (tie) | Washington | 4.3 |
| 33 (tie) | Wisconsin | 4.3 |
| 37 (tie) | Maine | 4.1 |
| 37 (tie) | South Carolina | 4.1 |
| 39 | Iowa | 4 |
| 40 (tie) | Montana | 3.9 |
| 40 (tie) | South Dakota | 3.9 |
| 42 (tie) | Nebraska | 3.8 |
| 42 (tie) | New York | 3.8 |
| 44 | Minnesota | 3.7 |
| 45 | Alaska | 3.5 |
| 46 (tie) | Maryland | 3.3 |
| 46 (tie) | Massachusetts | 3.3 |
| 48 | Connecticut | 3.2 |
| 49 | Vermont | 3.1 |
| 50 | California | 3 |
