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Teen vaping of marijuana surges, spurring public health worries

By some accounts, the gritty corridor of enterprise near Skid Row in downtown Los Angeles is a major black-market hub for cannabis vape products in the United States.
By some accounts, the gritty corridor of enterprise near Skid Row in downtown Los Angeles is a major black-market hub for cannabis vape products in the United States. (Rob Kuznia/For The Washington Post)
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Marijuana vaping by teens surged in 2019, signaling that more adolescents are using the drug and consuming highly potent vape oils, according to new government data and drug-use researchers.

The growing popularity of vaping both nicotine and marijuana, shown in data released Wednesday by the National Institute on Drug Abuse, will come as little surprise to anyone who knows teenagers. But researchers and public health officials expressed alarm at the size of the one-year jump in consumption of vape oils, traditional marijuana and nicotine and what it could portend.

“Any marijuana use among kids is a bad idea,” said Neal Benowitz, a clinical pharmacologist and emeritus professor of medicine at the University of California at San Francisco who studies vaping. “From my perspective, marijuana use is much more hazardous” than tobacco or nicotine use. He noted research that has shown marijuana’s impact on memory and learning, traffic accidents and, among some heavy users, the onset of psychosis, as well as the risk of contaminants in black-market products.

Nearly 21 percent of 12th-graders said they had vaped marijuana in the previous year, up 7.7 percent from 2018, according to the data in the 45th Monitoring the Future survey, conducted for NIDA by the University of Michigan. Among 10th-graders, 19.4 percent had vaped the drug in the previous year, and among eighth-graders, 7 percent said they had.

The percentage of 12th-graders who said they had vaped marijuana in the previous month jumped from 7.5 percent in the 2018 survey to 14 percent in the 2019 survey — the second-largest jump for any drug in the history of the survey.

“This is a really big increase,” Jonathan P. Caulkins, a drug-policy researcher at Carnegie Mellon University, wrote in an email. Caulkins said he had expected large increases in states that have legalized marijuana, but not a nationwide rise of such proportions.

David Hammond, a public health professor at the University of Waterloo who studies marijuana consumption in Canada and the United States, said the data show not just a switch to a new delivery system, but an increase in overall consumption. He said he has reached similar conclusions from his own research.

“This drug is here to stay. These new forms of delivery, whether you like them or not . . . they’re here to stay,” Hammond said. “What we need is a market that’s fairly regulated.”

In just a few years, vaping has quickly surged to the second-most-popular method of consuming marijuana behind smoking, he added. The reasons are obvious.

“It’s super convenient. It sits there in your pocket. It’s ready to go as soon as you take a puff. It doesn’t smell. It’s very portable,” he said.

Although some states have legalized recreational use of marijuana for adults, adolescents cannot purchase the drug legally and are much more likely to use vape oils found on the black market, Benowitz said.

An outbreak of lung disease associated with contaminated vaping products has killed 52 people and hospitalized 2,409, many of them teenagers and young adults, according to the Centers for Disease Control and Prevention. Most who have fallen ill vaped THC, the psychoactive ingredient in marijuana obtained on the black market.

Dried marijuana flowers contain about 20 percent to 30 percent THC, Hammond said. Vape oils, however, generally run at 70 to 90 percent THC, he said, exposing users to much higher concentrations in each puff. Users can mitigate that by consuming less.

The survey showed that near-daily use of marijuana (20 or more occasions in the previous 30 days by any method) rose 1.3 percent among 10th-graders, to 4.8 percent, and nearly doubled among eighth-graders, to 1.3 percent.

However, use of prescription opioids, amphetamines and smokeless tobacco declined, the survey showed. A long-term decline in the use of alcohol by adolescents stalled in 2019, the data show.

While cigarette smoking is also on a steady decline, according to the survey, nicotine vaping has jumped along with marijuana consumption. In the survey, 35 percent of 12th-graders reported vaping nicotine in the previous 12 months, up 5.6 percentage points from 2018. Among 10th-graders, 31 percent had done so, and among eighth-graders, 17 percent had.

When researchers asked students why they vaped, nearly 61 percent said to experiment, nearly 42 percent said they enjoyed the flavor, nearly 38 percent said to have a good time with friends and more than 37 percent said to relax or relieve tension.

NIDA Director Nora D. Volkow cited the concentration of nicotine in vaping devices as a particular concern, noting that stronger doses of nicotine are delivered more quickly to the bloodstream via vaping devices than by smoking cigarettes.

“It’s a new technology to administer drugs that when used inappropriately is very nefarious,” she said.

Last month, the Trump administration was poised to ban most forms of flavored e-cigarettes before an 11th-hour decision by the president to hold off.

Hammond said the companies marketing to teens have figured out what sells.

“Whether they have intentionally targeted kids or not, that has been the effect of their marketing of their devices,” he said. “If you make something techy and you put cool flavors in it . . . you don’t have to be a scientist to figure that out.”

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