Though the overall prevalence of electronic cigarette (e-cigarette) use among teens has dropped since 2019, those who begin vaping appear to be starting at a younger age and vaping more frequently, according to a report published today in JAMA Network Open.
“These changes may reflect the increased addictive potential of [electronic] nicotine delivery products that make it easier to inhale nicotine than from cigarettes or other combustible tobacco products,” wrote Jonathan P. Winickoff, M.D., M.P.H., of Massachusetts General Hospital for Children and colleagues. “The fact that e-cigarette addiction trends are continuing to increase despite the 2019 federal legislation raising the tobacco sales age to 21 years suggests that tighter regulation, additional legislative action, or both may be necessary to protect adolescents.”
Winickoff and colleagues looked at data collected from middle and high school students who participated in the 2014 to 2021 National Youth Tobacco Surveys (NYTS). The final analysis included data from 151,573 respondents, who were on average 14.5 years.
The researchers found that among teens who currently use tobacco or nicotine products, those who first used e-cigarettes rose from 27.2% in 2014 to a peak of 78.3% in 2019 and remained high at 77.0% in 2021. During the same period, the age of first e-cigarette use dropped by about two months each calendar year. Additionally, the average frequency of vaping among users steadily rose from three to five days/month between 2014 and 2018 to six to nine days/month in 2019 to 2020 and 10 to 19 days/month in 2021. Similar patterns were not seen in the use of cigarettes, cigars, and smokeless tobacco, the authors noted.
The researchers also examined data on youth’s addiction to e-cigarettes, which they characterized as use of an e-cigarette within the first five minutes of waking. From 2014 to 2017, only 1% of youth who used only e-cigarettes reported doing so, but this rose to 4% in 2019, and over 10% in 2021. During this same time, addiction did not change for youth who smoked only cigarettes or used smokeless tobacco but increased among youth who used cigars only.
“Because tobacco addiction is a chronic disease, clinicians should be ready to address youth addiction to these new high-nicotine products during the course of many clinical encounters,” they concluded.
To read more on this topic, see the Psychiatric News article “FDA Bans Some Flavored E-Cigarettes, but Advocates Say Policy Falls Short.”
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