New data show teen vaping declined with school closures

New data show teen vaping declined with school closures
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More than 2 million U.S. middle and high school students reported that they are using e-cigarettes, a drop from last year as many students were forced into remote learning as a result of the pandemic, according to the government's annual National Youth Tobacco Survey.

According to the survey, more than 8 in 10 of the youth said they use flavored e-cigarettes.

The survey, conducted by the Centers for Disease Control and Prevention (CDC), shows the continuing challenge facing public health agencies as nontraditional cigarettes continue to be popular among teenagers.

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Electronic cigarettes were first introduced on the market as a "healthier" alternative to smoking traditional tobacco cigarettes, but it began to spread to young people, who were drawn in by sweet and fruit-flavored e-cigarette pods easily accessible in stores. Since 2014, e-cigarettes have been the most commonly used tobacco product among U.S. youth. 

Last year, nearly 20 percent of high school students and 5 percent of middle schoolers said they’d recently vaped. 

This year, according to a CDC report from the survey, 11.3 percent of high school students said they currently vape, along with an estimated 2.8 percent of middle school students.

But the CDC said not to compare the results to previous years because the 2021 survey was conducted online due to COVID-19 protocols. Prior to the pandemic, the survey was conducted in person, inside the school classroom.

Matt Myers, president of the Campaign for Tobacco-Free Kids, said it's not surprising that the survey showed a drop.

"A decline in the number of youth reporting e-cigarette use would not be surprising as half of participating kids completed the survey from home and kids faced less peer pressure and reduced access to e-cigarettes because of additional time at home, remote learning and other pandemic restrictions," Myers said. 

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He said the results raise concerns that rates would be much higher if the survey had been conducted entirely in schools.

"As kids return to school, we face the real risk of a resurgence of the youth e-cigarette epidemic unless the FDA quickly eliminates all flavored e-cigarettes," Myers said.

Still, health officials said the survey offers an important snapshot of youth vaping trends in the country.

“These data highlight the fact that flavored e-cigarettes are still extremely popular with kids. And we are equally disturbed by the quarter of high school students who use e-cigarettes and say they vape every single day,” said Mitch Zeller, director of the Food and Drug Administration's (FDA) Center for Tobacco Products, which is responsible for regulating e-cigarettes.

Among youth who use e-cigarettes, nearly 44 percent of high school students and about 17 percent of middle school students reported using e-cigarettes in at least 20 of the past 30 days. 

The most commonly used device type was disposables, followed by prefilled or refillable pods, cartridges and tanks. Disposable e-cigarettes are generally cheaper than the other products, and rapidly gained popularity among young people as regulators cracked down on other devices. 

While much attention has been given to the role of Juul in promoting youth vaping, the company is no longer among the top brands favored by kids, since it no longer sells fruit-flavored cartridges. 

Among high school users, 26 percent reported that their usual brand was Puff Bar. The survey found 10.8 percent of kids used Vuse, followed by SMOK. Fewer than 6 percent of current high school-age youth said they prefer Juul.

Among middle schoolers, 30.3 percent reported that their usual brand was Puff Bar, and 12.5 percent reported Juul. Notably, more than 15 percent of high school users and 19 percent of middle school users reported not knowing the e-cigarette brand they usually used.

The Trump administration banned popular cartridge-based fruit and mint flavors but not tobacco and menthol.

Disposable e-cigarettes, open tank systems and e-liquids of any flavor, including those mixed in vape shops, also remained available under the policy.

The ​​FDA said it is aware of a number of companies, such as Puff Bar, that exploit a loophole by claiming their products contain only synthetic nicotine not sourced from tobacco, "which may raise separate regulatory and legal issues that the agency is considering how best to address."

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According to the survey, almost 85 percent of youth e-cigarette users said they used flavored products. The most common flavors were fruit flavors, but also included candy, mint and menthol.

Advocacy groups said the results show the FDA has shirked its responsibility. The agency missed a court-ordered deadline earlier this month to decide which e-cigarette products can stay on the market.

The agency made decisions on more than 90 percent of the new tobacco products that were submitted, but not on the largest companies like Juul, Vuse and NJOY. In the lead-up to the Sept. 9 deadline, FDA rejected the applications of more than 300 companies to sell more than 6 million products.

“FDA’s ongoing delays and inadequate action to evaluate products with substantial market share and enforce marketing denial orders to date leave the door open for further addiction to products that contain nicotine, proven to harm brain development in children," Lisa Lacasse, president of the American Cancer Society Cancer Action Network, said in a statement.