The Monitoring the Future Survey (MTF) published today in JAMA Pediatrics shows that nicotine vaping among youth remained high in 2020 with 22% of 10th and 12th graders using e-cigarettes in the last 30 days, essentially unchanged from 22.5% in 2019. These data are consistent with those from the National Youth Tobacco Survey (NYTS) released in September 2020, that showed nearly 20% of high school students, one in five, use e-cigarettes underscoring that youth tobacco use remains at epidemic levels and much more needs to be done.
Both the NYTS and MTF surveys reinforce stronger federal policies must be put in place immediately that are clear, comprehensive, and consistently enforced with no loopholes. Ad hoc policy responses to date, like warning letters to vaping companies such as Puff Bar or partial flavors bans, have resulted in product substitution, failures to comply, and new illegal products continuing to enter the market. A nation-wide policy without exceptions is needed to significantly reduce the youth vaping epidemic. As the survey results released today show, although use of JUUL decreased between 2019 and 2020, JUUL remained the most popular e-cigarette brand among 10th and 12th graders who were current vapers at 41%, and new, unregulated flavored disposable products such as Puff Bar (8%) and Smok (13.1%) have stepped in to fill whatever void was left by JUUL’s partial flavored pod removal. Flavors remain the overwhelming preference for youth vapers, with fruit and mint flavors the most popular, and menthol more than twice as popular as tobacco flavor. The FDA and incoming Biden Administration have a window of opportunity to accelerate progress by clearing the market of all flavored tobacco products (including menthol) and to stop playing whack-a-mole with loophole ridden policies so that we protect our youth before these addictive products make their way into kids’ hands – not after.
If there is good news to be taken from this year’s survey, it’s that the sharp growth in youth e-cigarette use has been stemmed. One reason suggested from the data is that teens are getting the message that vaping nicotine is not just fun and flavors. Among all youth surveyed, perceived risk of both occasional and regular nicotine vaping increased. According to the 2020 data, the percentage of 10th and 12th grade students who perceived “great harm” from occasional nicotine vaping significantly increased from 21% in 2019 to 27% in 2020. Perceived risk of regular nicotine vaping also significantly increased from 39% in 2019 to 49% in 2020, continuing increases that began in 2018.
This underscores that the efforts of Truth Initiative and our public health partners are starting to work. Since the fall of 2018, youth vaping prevention and education have been the primary focus of Truth Initiative’s proven-effective national truth campaign. Most recently, and in response to the pandemic, truth launched an effort titled Vaping vs. Immune Systems with Dr. Rutland to educate youth on the connection between COVID-19 and vaping, change misperceptions, and help them stay healthy by explaining how vaping can damage lungs and weaken immune systems.
This is Quitting, truth’s first-of-its-kind, free text message quit vaping program designed specifically for teens and young adults already has more than 225,000 young people enrolled to date. According to preliminary data published in Nicotine & Tobacco Research, after just two weeks of using the program, more than half (60.8%) reported that they had reduced or stopped using e-cigarettes.
And most recently, Truth Initiative and Kaiser Permanente, in collaboration with the American Heart Association launched a national vaping prevention curriculum called Vaping: Know the truth to guide teachers and empower teens who vape to quit, or to never start in the first place. This free digital program is unique in that is written and delivered in truth’s peer-to-peer voice, self-led, available digitally or in the classroom and directly links students who are vaping to our proven-effective This is Quitting program.