After years of sharp growth, the rate of vaping among high school and middle school students dropped significantly nationwide last year, though experts are unsure whether the decrease is part of a long-term trend or mostly a pandemic-related blip.
The percent of high school seniors who vaped in the previous year fell from 40.6% in 2019 to 31.5% in 2021, according to a federally funded University of Michigan study. A separate study by federal researchers also found a big drop in recent use.
But the 2021 surveys were from the first half of the year, when many students were learning remotely. The real test of whether the decline in vaping is long term, experts say, will be when data from 2022, when most classes were in-person, is released later this year or in early 2023.
“When you’re at school is when the peer pressure comes to use drugs,” including vape products, said Richard Miech, a research professor at the University of Michigan Institute for Social Research and a principal investigator of its annual survey of youth drug and alcohol use.
WHAT TO KNOW
- Two major nationwide, federally funded studies found a significant drop in youth vaping in 2021. In one, the percentage of high schoolers who vaped in the previous 30 days fell more than 40%, from 19.6% in 2020 to 11.3% on 2021.
- Experts say it’s unclear how much of the decline was because of the pandemic. School is where many kids first get introduced to vaping, and the 2021 surveys were conducted when many classes were still remote.
- Surveys in 2020 conducted before the pandemic shut down schools showed declines in vaping compared with 2019. Health concerns and bans on flavored vape products in states such as New York may have been factors, experts say.
Miech noted that use of almost all drugs declined in 2021 among eighth-, 10th- and 12th-graders, which was unusual. What’s unclear, he said, is if students who didn’t start vaping in 2021 began doing so once they were back in school — or if many will never vape.
Vaping involves inhaling the addictive tobacco substance nicotine and other chemicals that are heated in e-cigarettes. Vape liquids also can contain THC, the chemical in marijuana that causes a high.
Nicotine and THC can impair brain development in kids and young adults, and some of the chemicals used in vaping can cause cancer and other health problems.
The legal age to vape and smoke was raised to 21 nationwide in 2019.
Some people use vaping to help stop smoking traditional cigarettes, although it hasn't been approved for smoking cessation, and data shows young people who start vaping are more likely to later smoke.
Miech suspects the rate of youth vaping will rise in 2022 but not return to 2019 levels. That’s in part because surveys conducted in early 2020, before COVID-19 school closures, began to show a decline, he said.
In New York State, 22.5% of high schoolers had vaped in the previous 30 days in 2020, compared with 27.4% in 2018, according to the state health department.
The Michigan study, and the federal National Youth Tobacco Survey, also saw declines. The federal survey found that 19.6% of high schoolers had vaped in the previous 30 days in early 2020, compared with 27.5% in 2019. The middle school rate was 4.7%, down from 10.5%.
Rates dropped sharply again in 2021, to 11.3% of high schoolers and 2.8% of middle schoolers. The Centers for Disease Control and Prevention said the 2021 numbers are not directly comparable with previous years because the 2021 survey was online, completed in schools or at home, and previous ones were primarily in-school.
Miech said the 68 deaths and more than 2,800 hospitalizations nationwide in 2019 and early 2020 that were tied to vaping “definitely gave vaping a bad name.” The CDC concluded that an additive to some vape products containing THC was the “primary cause” of the illnesses.
Education campaigns on the dangers of vaping appear to be having an effect, prompting many to quit, Miech said.
Juan Lugo, 20, of Shirley, said he vaped during high school.
'I do sports and noticed my lungs — I ran out of breath a lot.'
-Juan Lugo, 20, of Shirley
Credit: Newsday/David Olson
“I just thought it was water vapor” and not harmful, Lugo said recently during a break from a physics class at Suffolk County Community College in Brentwood.
But, he said, “I do sports and noticed my lungs — I ran out of breath a lot.”
He quit vaping, as did most of his friends. “A majority of us were like, it’s not worth it,” he said.
Meg Riordan, vice president of research for the Washington, D.C.-based Campaign for Tobacco-Free Kids, said greater awareness of health risks may be a factor in the drop in vaping. But she’s concerned by signs that the 2021 decrease was mostly temporary.
She pointed to an online survey by Stanford University researchers published July 18 that was conducted in late 2021, when most instruction was in-person. It found that nearly 30% of respondents ages 13 to 20 had vaped in the previous 30 days, a much higher proportion than the federal and Michigan numbers from early 2021.
The Stanford survey was not nationally representative and “not as rigorous” as other studies, Riordan said. “But it’s an indicator of cause for concern,” she said.
Another worrisome statistic: Kids who continue to vape are doing so more frequently.
The federal survey found that in 2021, 44% of high school vapers used e-cigarettes at least 20 of the previous 30 days, up from 34% in 2019.
That’s probably because nicotine is so highly addictive, said Dr. Rachel Boykan, a pediatrician and professor of clinical pediatrics at the Renaissance School of Medicine at Stony Brook University.
Riya Subbaiah, 19, who while a student at Friends Academy in Locust Valley helped lead a 2021 American Heart Association online forum on teen vaping, said that once pandemic restrictions were implemented, some teenagers “were vaping way, way more often, with all that time isolated.”
Dylan McGovern, 20, of St. James, who quit vaping about three years ago, is concerned about the long-term effects of e-cigarettes.
'My generation is like the guinea pigs. We're the test subjects for it.'
-Dylan McGovern, 20, of St. James
Credit: Newsday/David Olson
“My generation is like the guinea pigs,” he said. “We’re the test subjects for it.”
Boykan said not all health effects of e-cigarettes, including long-term consequences, are known, but “the more data we get, the more dangerous they seem.”
The CDC says that although “e-cigarette aerosol generally contains fewer harmful chemicals than the smoke from burned tobacco products,” it can contain cancer-causing chemicals and “tiny particles that reach deep into the lungs.”
In addition, nicotine can harm brain development up to age 25, the CDC says.
Eric Lamay, 24, of Greenlawn, said vaping helped him quit smoking cigarettes a few years ago, and now he’s planning to stop vaping.
'I understand it’s not really good for you.'
-Eric Lamay, 24, of Greenlawn
Credit: Newsday/David Olson
“I understand it’s not really good for you,” he said.
New York banned all flavored vape products in May 2020, but Lamay said a friend supplies him with flavored products from Connecticut, where they are legal.
Boykan believes flavor bans may be one reason youth vaping rates fell. But, she said of flavored vape products, “I see them in my patients’ hands. They’re getting them and they’re using them.”
Cheryl Richter, executive director of the New York State Vapor Association, which represents vape shops, said that although the flavor ban is strictly enforced at vape shops, flavored vape products are easily available at some gas stations, delis and bodegas.
Ahmet Nayci, a manager at Vapor Smoke Shop in East Meadow, said when customers ask him for flavored e-cigarettes, he tells them he has none. “I ask them where they get it from, and the majority say they get it from the gas stations,” he said.
Taobi Silva, who co-owns a vape store and manages a smoke shop on the Shinnecock reservation — which asserts it is exempt from the flavor ban because of its legal sovereignty — said although sales of flavored products increased following the state ban, “It has not really skyrocketed.” People won’t drive out of their way to the reservation if they can obtain flavored products illegally at nearby gas stations, delis and bodegas, he said.
Spokespeople for Nassau and Suffolk counties said all retailers that sell vape products are inspected and are fined if they violate vaping laws — with 48 fines for gas stations, delis and convenience stores in Suffolk for violating the flavor ban, and 57 vape-related fines for similar businesses in Nassau in the past year.
Meanwhile, the flavor ban has put most vape shops out of business, because adults also prefer flavors, Richter said.