Vaping crisis: One in four high school students in US used electronic cigarettes this year, says study

Researchers say since 2014, e-cigarettes have been the most commonly used tobacco product among youth.


                            Vaping crisis: One in four high school students in US used electronic cigarettes this year, says study

The vaping crisis has worsened in the US, and the latest estimates now reveal that a large number of American high school and middle school students have tried e-cigarettes.

About one in four high school students and 10% of middle school students in the US used electronic cigarettes in 2019, shows analysis by experts from the US Food and Drug Administration (FDA), and the US Centers for Disease Control and Prevention (CDC).

The findings, says the research team, suggest that an estimated 4.1 million high school students and 1.2 million middle school students are using e-cigarettes in 2019. A total of 19,018 students participated in the 2019 National Youth Tobacco Survey.

“In 2019, the prevalence of self-reported e-cigarette use was high among high school and middle school students, with many current e-cigarette users reporting frequent use and most of the exclusive e-cigarette users reporting the use of flavored e-cigarettes,” say the researchers in their findings published in JAMA.

The team estimated how common e-cigarette use is among students, including current use (past 30 days), frequent use (20 or more days in the past 30 days), usual e-cigarette brand, and the use of flavored products.

“The results of this survey are particularly concerning given relatively high exposure to nicotine through the use of nicotine salt-based e-cigarette products such as JUUL, which was the most commonly reported brand among youth using e-cigarettes in 2019,” says the team.

According to the researchers, nicotine salts allow particularly high levels of nicotine to be inhaled more easily, with less irritation than the free-base nicotine that has traditionally been used in tobacco products, including e-cigarettes. 

“For young people, this is of particular concern because it could promote the development of nicotine dependence, making it easier to initiate and proceed to regular e-cigarette use or transition to cigarette or other combustible tobacco product use. Furthermore, the aerosol that users inhale and exhale from e-cigarettes can potentially expose themselves and bystanders to other harmful substances, including heavy metals, volatile organic compounds, and ultrafine particles that can be inhaled deeply into the lungs,” the researchers cautioned.

The team says that since 2014, e-cigarettes have been the most commonly used tobacco product among youth, and the popularity of e-cigarettes shaped like USB flash drives and other similar devices could have contributed to youth uptake.

“These devices can be used discreetly, may have high nicotine content, and come in flavors that appeal to youth. Most e-cigarettes contain nicotine, and nicotine exposure during adolescence can harm the developing brain, which continues to develop until about age 25 years. Nicotine exposure during adolescence can affect learning, memory, and attention, and can increase the risk for future addiction to other drugs,” says the study.

As of October 29, 2019, 1,888 cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to CDC from 49 states. Further, 37 deaths have been confirmed in 24 states. Even as investigations are on, the CDC has issued a warning asking people to stay away from e-cigarettes or vaping products containing a compound called tetrahydrocannabinol (THC). They suspect that THC is the most likely culprit behind the outbreak. 

“Irrespective of the ongoing investigation, e-cigarette, or vaping, products should never be used by youths, young adults, or women who are pregnant. Adults who do not currently use tobacco products should not start using an e-cigarette, or vaping, products,” says CDC.

As of October 29, 2019, 1,888 cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to CDC from 49 states. Further, 37 deaths have been confirmed in 24 states. (Getty Images)

In the current study, an estimated 27.5% of high school students and 10.5% of middle school students reported current e-cigarette use. The analysis shows that among current e-cigarette users, an estimated 34.2% of high school students and 18% of middle school students reported frequent use. An estimated 63.6% of high school students and 65.4% of middle school students reported exclusive use of e-cigarettes. 

“Among current e-cigarette users, an estimated 59.1% of high school students and 54.1% of middle school students reported JUUL as their usual e-cigarette brand in the past 30 days. Among current e-cigarette users, 13.8% of high school students and 16.8% of middle school students reported not having a usual e-cigarette brand,” says the study.

The researchers also found that among students, who are exclusive e-cigarette users, an estimated 72.2% of high school students and 59.2% of middle school students used flavored e-cigarettes, with fruit, menthol or mint, and candy, desserts, or other sweets being the most commonly reported flavors.

“With the assumption that the prevalence estimates from this survey are nationally representative and could be used to project to national population totals for US high school and middle school students, the data would suggest that in 2019, an estimated 4.1 million high school students and 1.2 million middle school students currently use e-cigarettes. An estimated 1.6 million students reported frequent use of e-cigarettes, an estimated 970,000 students use e-cigarettes daily, and an estimated 2.4 million exclusive e-cigarette users use flavored e-cigarettes,” the findings state.

According to the research team, the numbers would also indicate that among these exclusive e-cigarette users, an estimated 1. 6million high school and middle school students use fruit-flavored e-cigarettes, an estimated 1.2 million use menthol- or mint-flavored e-cigarettes, and an estimated 830,000 use candy, dessert or other sweet-flavored e-cigarettes.

While the FDA and CDC are yet to identify the cause of lung injuries among Americans, they have stated that the common factor among all the patients is their reported use of e-cigarette or vaping products.

“No one compound or ingredient has emerged as the cause of these illnesses to date, and it may be that there is more than one cause of this outbreak. Many different substances and product sources are still under investigation,” says the CDC.

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