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Students' e-cigarette use continues troubling rise

Nov. 5, 2019
The 2019 National Youth Tobacco Survey says 27.5% of high school students identified themselves as current users of e-cigarettes.

E-cigarette use continues its sharp rise among U.S. high school students, the latest National Youth Tobacco Survey says.

An estimated 27.5% of high school students say they are current users of e-cigarettes, according to the survey results, published in today's Journal of the American Medical Association (JAMA).

The numbers indicate a continuing rise in students' using e-cigarettes. Surveys from earlier years found that 20.8% of high school students were current e-cigarette users in 2018, an alarming jump from the 11.7% of high school students identified as current e-cigarette users in 2017.

In light of the 2018 numbers, the Food and Drug Administration Commissioner and the U.S. Surgeon General declared youth e-cigarette use an epidemic in 2018. A 2018 Surgeon General’s Advisory called for aggressive steps to reduce e-cigarette use among youth.

The 2019 survey, conducted by the Food and Drug Administration and the Centers for Disease Control and Prevention, also found that student e-cigarette users favor vaping products flavored with fruit, mint and menthol.

Current use of e-cigarettes is defined in the survey as use on one or more days of the past 30 days.

In middle schools, 10.1% of students in the 2019 identified themselves as current e-cigarette users.

A total of 19 ,018 high school and middle school students participated in the 2019 survey. Among current e-cigarette users, an estimated 34.2%  of high school students and 18.0% of middle school students reported that they were frequent users (using e-cigarettes on 20 or more days in the past 30 days).

Assuming the survey is nationally representative, the numbers translate to an estimated 4.1 million high school students and 1.2 million middle school students that currently use e-cigarettes. An estimated 1.6 million students would be considered frequent users of e-cigarettes, and an estimated 970, 000 students use e-cigarettes daily.

The data also would suggest that among these e-cigarette users, an estimated 1.6 million 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.

"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," the survey report says. "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."

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