A 19-year-old at a Ronkonkoma vape shop in 2014.

A 19-year-old at a Ronkonkoma vape shop in 2014. Credit: Johnny Milano

Tobacco vaping among high school students fell significantly between 2022 and 2023, new nationwide data shows.

Ten percent of high school students used tobacco e-cigarettes within the previous 30 days, compared with 14.1% in 2022, according to results of the National Youth Tobacco Survey, which were published Thursday in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

But experts expressed concern about increased tobacco use by students grades six to eight, and that nearly 30% of high school students using e-cigarettes said they were doing so daily.

“We’re not nearly where we need to be,” said Dr. Rachel Boykan, a pediatrician at Stony Brook Children’s Hospital and clinical professor of pediatrics at the Renaissance School of Medicine at Stony Brook University.

The percent of middle school students vaping tobacco in the previous 30 days rose from 3.3% to 4.6%, an increase not considered statistically significant because of the relatively small sample size, said the CDC’s Lisa Neff, the study’s senior author.

The increase in middle school students’ 30-day use of any tobacco products, including traditional cigarettes, cigars and via hookahs, was considered statistically significant, rising from 4.5% to 6.6%.

“The finding among middle school students is very disappointing, and something we want to look into further,” Neff said.

“That’s one kid in every [middle school] classroom who is using e-cigarettes,” Boykan said of the survey’s findings. “These are really young kids.”

The younger children are when they begin using nicotine, the more difficult it may be to quit, Boykan said.

Nearly 15% of middle school students reported trying a tobacco product at least once, as did about 28% of high school students.

Yolonda Richardson, president and CEO of the Washington, D.C.-based Campaign for Tobacco-Free Kids, said in a statement that the decline in high school e-cigarette use “is terrific news for our nation’s health.”

But she said the middle school increase “underscores the urgent need to eliminate flavored e-cigarettes.”

Among high school and middle school students who reported using e-cigarettes in the previous 30 days, nearly 90% said they used flavored products.

New York banned flavored vaping products in 2020, but illegal flavored nicotine is widely sold nationwide.

Boykan said her patients tell her they buy flavored vaping tobacco at Long Island stores and online.

Richardson called on federal authorities to more strongly crack down on illegal sales.

The Food and Drug Administration referred to a statement released last week by Brian King, director of the FDA’s Center for Tobacco Products, who said the agency “has taken multiple significant actions against those making, distributing, importing, or selling illegal e-cigarette products… especially those that appeal to youth.”

Boykan said the amount of nicotine in the most popular brands of e-cigarettes is much higher than several years ago and much higher than in combustible cigarettes.

Nicotine harms young people’s brains, which continue developing until age 25, and has been associated with worsened anxiety, depression and other behavioral problems, she said.

Youth e-cigarette use soared between 2017 and 2019, from 11.7% of high school students reporting 30-day use in 2017 to 27.5% in 2019. The number dropped to 19.6% in 2020, in a survey taken before pandemic school closures, and to 11.3% in 2021. Neff cautioned, though, that numbers from 2021-2023 were not directly comparable with earlier data, because of a change in how data was collected.

The most recent state data, from 2022, shows a drop in e-cigarette use among high school students from 22.5% using tobacco e-cigarettes in the previous 30 days in 2020 to 18.7% in 2022.

Richard Miech, a research professor at the University of Michigan Institute for Social Research and a principal investigator of its annual federally funded survey of youth drug and alcohol use, said the drop in tobacco consumption, as well as other drug and alcohol use, between 2020 and 2021 was in part because of remote learning, when “you’re no longer exposed to all of those risk factors that might make you more likely to use substances,” such as new groups of friends.

He was buoyed at how the 2023 high school rates are roughly half the 2020 ones, which indicate that most students who avoided nicotine during the pandemic never started once in-person instruction resumed.

Miech said the drop in vaping just before the pandemic was likely because of crackdowns on flavored tobacco, national media campaigns on vaping and the 68 deaths and 2,800 hospitalizations in 2019 and early 2020 tied primarily to vaping THC.

The new CDC survey data was collected online March through June from what researchers said was a nationally representative sample of more than 22,000 students from 179 schools.

The study was of tobacco e-cigarette use and did not measure vaping cannabis. Neff said there was a question on cannabis e-cigarette use but the data has not yet been analyzed.

Tobacco vaping among high school students fell significantly between 2022 and 2023, new nationwide data shows.

Ten percent of high school students used tobacco e-cigarettes within the previous 30 days, compared with 14.1% in 2022, according to results of the National Youth Tobacco Survey, which were published Thursday in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

But experts expressed concern about increased tobacco use by students grades six to eight, and that nearly 30% of high school students using e-cigarettes said they were doing so daily.

“We’re not nearly where we need to be,” said Dr. Rachel Boykan, a pediatrician at Stony Brook Children’s Hospital and clinical professor of pediatrics at the Renaissance School of Medicine at Stony Brook University.

WHAT TO KNOW

  • The percent of high school students nationwide who reported vaping tobacco in the previous 30 days fell between 2022 and 2023, from 14.1% to 10%, according to results of the National Youth Tobacco Survey.
  • But the percent of middle school students who used any tobacco products, including e-cigarettes, traditional cigarettes or cigars, in the previous 30 days rose from 4.5% to 6.6%.
  • Experts say nicotine harms young people’s brains and has been linked to anxiety, depression and other behavioral problems.

The percent of middle school students vaping tobacco in the previous 30 days rose from 3.3% to 4.6%, an increase not considered statistically significant because of the relatively small sample size, said the CDC’s Lisa Neff, the study’s senior author.

The increase in middle school students’ 30-day use of any tobacco products, including traditional cigarettes, cigars and via hookahs, was considered statistically significant, rising from 4.5% to 6.6%.

“The finding among middle school students is very disappointing, and something we want to look into further,” Neff said.

“That’s one kid in every [middle school] classroom who is using e-cigarettes,” Boykan said of the survey’s findings. “These are really young kids.”

The younger children are when they begin using nicotine, the more difficult it may be to quit, Boykan said.

Nearly 15% of middle school students reported trying a tobacco product at least once, as did about 28% of high school students.

Yolonda Richardson, president and CEO of the Washington, D.C.-based Campaign for Tobacco-Free Kids, said in a statement that the decline in high school e-cigarette use “is terrific news for our nation’s health.”

But she said the middle school increase “underscores the urgent need to eliminate flavored e-cigarettes.”

Among high school and middle school students who reported using e-cigarettes in the previous 30 days, nearly 90% said they used flavored products.

New York banned flavored vaping products in 2020, but illegal flavored nicotine is widely sold nationwide.

Boykan said her patients tell her they buy flavored vaping tobacco at Long Island stores and online.

Richardson called on federal authorities to more strongly crack down on illegal sales.

The Food and Drug Administration referred to a statement released last week by Brian King, director of the FDA’s Center for Tobacco Products, who said the agency “has taken multiple significant actions against those making, distributing, importing, or selling illegal e-cigarette products… especially those that appeal to youth.”

Boykan said the amount of nicotine in the most popular brands of e-cigarettes is much higher than several years ago and much higher than in combustible cigarettes.

Nicotine harms young people’s brains, which continue developing until age 25, and has been associated with worsened anxiety, depression and other behavioral problems, she said.

Youth e-cigarette use soared between 2017 and 2019, from 11.7% of high school students reporting 30-day use in 2017 to 27.5% in 2019. The number dropped to 19.6% in 2020, in a survey taken before pandemic school closures, and to 11.3% in 2021. Neff cautioned, though, that numbers from 2021-2023 were not directly comparable with earlier data, because of a change in how data was collected.

The most recent state data, from 2022, shows a drop in e-cigarette use among high school students from 22.5% using tobacco e-cigarettes in the previous 30 days in 2020 to 18.7% in 2022.

Richard Miech, a research professor at the University of Michigan Institute for Social Research and a principal investigator of its annual federally funded survey of youth drug and alcohol use, said the drop in tobacco consumption, as well as other drug and alcohol use, between 2020 and 2021 was in part because of remote learning, when “you’re no longer exposed to all of those risk factors that might make you more likely to use substances,” such as new groups of friends.

He was buoyed at how the 2023 high school rates are roughly half the 2020 ones, which indicate that most students who avoided nicotine during the pandemic never started once in-person instruction resumed.

Miech said the drop in vaping just before the pandemic was likely because of crackdowns on flavored tobacco, national media campaigns on vaping and the 68 deaths and 2,800 hospitalizations in 2019 and early 2020 tied primarily to vaping THC.

The new CDC survey data was collected online March through June from what researchers said was a nationally representative sample of more than 22,000 students from 179 schools.

The study was of tobacco e-cigarette use and did not measure vaping cannabis. Neff said there was a question on cannabis e-cigarette use but the data has not yet been analyzed.

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