Youth vaping rates appear to be dropping, but regulators and advocates aren’t satisfied

WASHINGTON — A new survey from the CDC and the FDA suggests that youth vaping rates appear to be dropping, compared to pre-pandemic levels.

Just over 9% of middle and high schoolers surveyed earlier this year reported currently using e-cigarettes, according to data published Thursday afternoon. Scientists caution against comparing the last few years too directly, given the disruptive effects of the coronavirus pandemic, but in 2019, 20% of middle and high school students reported current youth vaping. In 2020, that number was 13.1%.

“From a public health perspective, this is very good news,” said Jasjit Singh Ahluwalia, a professor at Brown University and tobacco industry expert, who added he is still concerned about the rates of youth vaping.


These data were collected as part of the National Youth Tobacco Survey, a survey conducted each year in schools around the country and then analyzed by the Centers for Disease Control and Prevention and the Food and Drug Administration.

The CDC said in a press release that “the ability to compare estimates from 2022 with those from prior [survey years] is limited,” because the Covid-19 pandemic forced the administrators of the survey to alter their methodology. It has also said explicitly that results from the 2021 survey, which found that 7.6% of respondents currently vaped, “cannot be compared” to previous years because of major methodological changes, including that the survey was conducted online.


However, outside experts argued that there does appear to be a clear downtrend in vaping rates over the last several years, even when the numbers can’t be directly compared.

“We’re still seeing a decrease in the number of kids who are using e-cigarettes,” said Rafael Meza, a scientist at the BC Cancer Research Institute, who added that despite the methodology challenges, “we can make some conclusions, but it’s better to look at a few years, and the … trends, and not get so hung up on one year versus another.”

Regardless of the apparent progress, both the FDA and the CDC used Thursday’s data as further evidence of unacceptably high levels of youth vaping in the U.S.

“This study shows that our nation’s youth continue to be enticed and hooked by an expanding variety of e-cigarette brands delivering flavored nicotine,” said Deirdre Lawrence Kittner, director of the CDC’s Office on Smoking and Health, in a statement. “Our work is far from over.”

Tobacco control advocates also said current levels of youth vaping are too high, despite the downward trends.

“It is unacceptable that over 2.5 million kids still use e-cigarettes,” said Matthew Myers, the president of the Campaign for Tobacco-Free Kids, in a statement, and he added that “there has been important progress since 2019, when youth use peaked at 27.5% of high school students.”

Now advocates are ratcheting up pressure on the FDA, in particular, to increase enforcement against e-cigarette companies, especially the makers of cheap disposable flavored e-cigarettes.

The Campaign for Tobacco-Free Kids is renewing calls for the FDA to ban all flavored e-cigarette products, which are overwhelmingly the most popular products with young Americans. (The Campaign, like STAT, receives funding from Bloomberg Philanthropies.)

Erika Sward, the assistant vice president of national advocacy for the American Lung Association, told STAT her group is now calling on the FDA to crack down on manufacturers, distributors, and wholesalers of illegal vaping products, because, she said, the FDA’s approach of going after retailers “clearly has failed.”

“It is now time to cut off the source of these products,” said Sward, who added there is “no acceptable [rate of] youth use of e-cigarettes.”

The survey is likely to increase pressure on the FDA to take on two brands in particular: Puff Bar and Hyde, both disposable e-cigarettes that are currently being sold illegally.

Puff Bar was, for the second year in a row, the most popular brand of e-cigarettes among young people. It was the preferred brand for 14.5% of those who reported currently vaping.

This year’s survey marked the first time Hyde, which sells disposable vapes in flavors like Watermelon Icecream and Rainbow, as well as merchandise like iPhone cases, was listed as a top brand among young people who vape. It was the choice of 5.5% of the young people surveyed.

The FDA, to date, has taken no actions against Hyde. The agency sent one formal warning to Puff Bar in July 2020.

The survey also provides the latest evidence that Juul, once a major driver of e-cigarette use, is no longer the preferred brand among kids. The number of kids who vape who identified Juul as their preferred brand was so low that the CDC was unable to estimate what percentage of those surveyed currently prefer that product.

STAT’s coverage of the commercial determinants of health is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.

Source: STAT