The data could help to strengthen a growing crackdown on e-cigarettes on the heels of bans on sales of flavored vaping products in New York and Michigan. Last week, the Trump administration said it, too, plans to outlaw sales of the flavored liquids that have come under criticism as enticing to teens.
This year’s rise in vaping rates did not top 2018’s, the largest increase in teen use of any substance the National Institutes of Health-funded survey has tracked in its 44 years of existence. But the latest jumps are still worrying and historically unusual, lead researcher and University of Michigan professor Richard Miech told The Washington Post.
“It ranks among the top in terms of the increases we’ve seen,” Miech said. “It seems as if teen nicotine vaping is not going away by itself. Something needs to be done.”
The researchers behind the study expressed particular alarm at the numbers on daily vaping, a measure that past versions of the survey have not reported and that the researchers defined as e-cigarette usage on 20 days or more within the last 30. Such frequent use of e-cigarettes suggests nicotine addiction, they write in the NEJM.
“New efforts are needed to protect youth from using nicotine during adolescence, when the developing brain is particularly susceptible to permanent changes from nicotine use and when almost all nicotine addiction is established,” they say in a letter to the editor.
About 35 percent of 12th-graders said they vaped nicotine within the preceding year, according to the letter. Sixteen percent of eighth-graders said the same. Both numbers are roughly five percentage points higher than last year’s.
Findings from the Monitoring the Future Survey, which is supported by NIH’s National Institute on Drug Abuse, are typically released in December, and more details will come this year. But Miech said the researchers wanted to get their nicotine vaping statistics out early to inform public policy as more officials signal interest in taking significant steps to get e-cigarettes out of underage hands.
A spate of mysterious vaping-linked lung illnesses largely affecting young people has increased scrutiny of e-cigarettes in recent weeks, as federal and state authorities investigate hundreds of cases and seven deaths. But lawmakers announcing new e-cigarette restrictions have focused on the broader issue of underage vaping as officials indicate the lung illnesses are mostly connected to marijuana products, often ones bought off the street.
Alarm over youth vaping spiked after the Monitoring the Future survey’s revelations last December that about 37 percent of high school seniors reported using e-cigarettes within the preceding year. That figure, a 10 percentage-point rise from 2017, prompted renewed hand-wringing that e-cigarettes — which have yet to gain FDA approval — were exposing a new generation to unknown health effects.
A recent report from the Centers for Disease Control and Prevention found that e-cigarettes were the most popular product among the nearly 5 million high school and middle school students who had used tobacco products within a 30-day period.
Critics of the recent crackdown on vaping have called flavor bans an overreaction, and they warn of scaring smokers away from a product that experts generally agree poses fewer health risks than traditional cigarettes. The debate over how to combat teen vaping has pitted different public health interests against one another, experts say, as vaping advocates point to the known deadly toll of conventional smoking and research that indicates that most of the millions of adult e-cigarette users in the United States are current or former smokers.
Vaping has boosters not only in industry but also among public health officials: The British government, for example, continues to promote vaping as a tool to quit smoking, and vape shops sit on the grounds of two English hospitals at the recommendation of the country’s public health agency. A 2018 report from Public Health England (PHE) echoed earlier findings that vaping is “at least 95% less harmful” than smoking, as the PHE Director for Health Improvement John Newton put it.
“E-cigarettes have really split the public health community into two camps,” Miech told The Post. “The people who focus on older adults, they’re really pro-vaping … because they think it’s a good way to reduce smoking prevalence.”
But then there are experts focused on adolescents, he added, who worry that vaping’s exploding popularity is ruining decades of progress on youth exposure to nicotine.
Miech sees the proposed bans on sales of flavored e-cigarette products as a good “middle ground” that lets adult smokers continue vaping while deterring youths drawn in by tastes such as mango, coffee and chocolate. He thinks the rise in teen vaping calls for national solutions, saying that local and school-level efforts to combat youth smoking largely failed in the 1990s.
Some smokers who love flavors will pay the price of a ban, he said, acknowledging many vaping advocates’ concerns that unflavored and tobacco-flavored liquids are unappealing even to adults.
The Vapor Technology Association has said the Trump administration’s planned policy would force smokers “to choose between smoking again ... or finding what they want and need on the black market.”
Miech, though, says he prefers that “it’s the smokers that are paying the price rather than our youth.”