Youth vaping remains a significant public health concern. Despite ongoing efforts to reduce tobacco use among adolescents, vaping remains prevalent among U.S. middle and high school students. According to the 2023 National Youth Tobacco Survey (NYTS), 1 in 10 high school students and nearly 2 in every 25 middle school students reported vaping nicotine in the past 30 days.

Since 2014, e-cigarettes have become the most used tobacco product among youth. Between 2022 and 2023 there was an overall decline in youth vaping, though the numbers remain alarmingly high. The NYTS found that approximately 2.8 million youth currently use tobacco products, with nearly 1 in 4 youths who vape reporting daily use and 1 in 3 reporting use at least 20 of the last 30 days. This is particularly concerning considering adolescents have reported symptoms of nicotine dependence after using tobacco 1-3 times per month. In addition, many young people who experiment with e-cigarettes often continue to use them regularly. This is fueled by the accessibility of flavored e-cigarettes, which contain high levels of nicotine, and are available in youth-appealing flavors.

The 2023 NYTS found that 89.4% of current e-cigarettes users prefer flavored e-cigarettes, with fruit flavor being the top choice, followed by candy, desserts and other sweets. Over half of youth reported the use of flavors labeled with “ice” or “iced”, which likely explains the inclusion of mint and menthol among the preferred flavors.

The prevalence of e-cigarette use is worrisome due to the numerous health risks associated with vaping, particularly for young people. The e-liquids used in vaping devices contain a mix of harmful substances, including nicotine, carcinogens, heavy metals and other chemicals linked to serious conditions. Nicotine is particularly dangerous, as exposure can lead to addiction, cognitive impairment, and increased risk of mental health disorders, cardiovascular, and respiratory conditions.

The design of vaping devices also contributes to their risk. These devices are engineered to deliver higher, more addictive doses of nicotine. Many products on the market today contain nicotine levels equivalent to 13-30 cigarettes in a single pod, a small cartridge filled with vaping e-liquid. The ease with which these devices can be concealed allows youth to vape discreetly in places like classrooms, leading to more frequent use and a greater risk of addiction.

Several factors contribute to the persistent popularity of vaping among young people. Flavored e-cigarettes are a major draw, as they mask the harsh taste of nicotine with appealing flavors. Marketing and accessibility also play a role in the rise of youth vaping. Despite regulatory efforts, many e-cigarette products remain easily accessible to minors. Additionally, social influences such as peer-pressure and social media, further encourage experimentation and regular use among adolescents.

Efforts to reduce youth vaping have seen some success, as evidenced by decline in e-cigarette use among high school students between 2022 and 2023. These efforts include the implementation of tobacco control strategies at national, state, and local levels, as well as FDA regulatory actions aimed at restricting the availability of flavored e-cigarettes.

However, more work is needed to address the issue comprehensively. As earlier initiation may become an issue as shown by the increase in use of tobacco products among middle school students from 2022 to 2023.

Continued surveillance is crucial to understanding the prevalence and frequency of vaping among youth, as well as the popularity of specific brands and flavors. Educational campaigns targeting both parents and students are also essential in dispelling myths about vaping while highlighting its risks.

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References:

  • Centers for Disease Control and Prevention. (2024). About e-cigarettes (vapes). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/e-cigarettes/about.html
  • Prochaska, J. J., Vogel, E. A., & Benowitz, N. (2022). Nicotine delivery and cigarette equivalents from vaping a JUULpod. Tobacco control, 31(e1), e88–e93. https://doi.org/10.1136/tobaccocontrol-2020-056367
  • Food and Drug Administration (FDA) (2024). Results from the annual National Youth Tobacco Survey (NYTS). U.S. Food and Drug Administration. https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey#2023%20Findings%20on%20Youth%20Tobacco%20Use