CDC: 2.5 million middle and high schoolers use e-cigarettes

New data show that more than 2.5 million middle and high school students in the U.S. report using e-cigarettes, and the FDA has announced additional steps it is taking to help curb the pervasive use.

Maria Cooper, PhD, a health scientist at the FDA’s Center for Tobacco Products; and colleagues found that more than 25% of students who reported using e-cigarettes use them daily, while 42.3% reported using them on 20 or more of the past 30 days.

The researchers analyzed data from the 2022 National Youth Tobacco Survey — a cross-sectional, self-administered survey of middle and high school students in the U.S. — and published their findings in the MMWR.

“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,” Deirdre Lawrence Kittner, PhD, MPH, director of CDC’s Office on Smoking and Health, said in a press release from the CDC. “Our work is far from over. It’s critical that we work together to prevent youth from starting to use any tobacco product — including e-cigarettes — and help all youth who do use them, to quit.”

Trends in e-cigarette use

The study also revealed that more than half of those who reported e-cigarette use in the past 30 days used disposable e-cigarettes, and 85% used flavored e-cigarettes. The most common flavors were:

• fruit, at 69.1%;
• candy, desserts or other sweets, at 38.3%;
• mint, at 29.4%; and
• menthol, at 26.6%.

The researchers also noted that, after disposable e-cigarettes, the most common device type was refillable or prefilled cartridges, at 25.2%, and tanks or mod systems, at 6.7%. The most common brands were Puff Bar, at 14.5%, Vuse, at 12.5%, Hyde, at 5.5%, SMOK, at 4% and 21.8% were classified as “other.”

Previous evidence suggests that vaping causes adverse cardiovascular and respiratory effects, according to the American Heart Association. Other studies have also shown that e-cigarette use among teenagers is associated with increased odds of asthma and can be a predictor of adult cigarette use.

“Adolescent e-cigarette use in the United States remains at concerning levels, and poses a serious public health risk to our nation’s youth,” Brian King, PhD, MPH, director of the FDA’s Center for Tobacco Products, said in the release. “Together with the CDC, protecting our nation’s youth from the dangers of tobacco products — including e-cigarettes — remains among the FDA’s highest priorities, and we are committed to combatting this issue with the breadth of our regulatory authorities.”

Last year’s report on e-cigarette use revealed similar findings. While only an estimated 2.06 children and adolescents reported using e-cigarettes in 2021, differences in the estimates could be due to changes in behavior, methodology or both, so “the ability to compare estimates from 2022 with those from prior ... waves is limited,” according to the release.

FDA response

In light of the findings, the FDA announced in a press release that it issued marketing denial orders for 32 Hyde e-cigarette premarket tobacco applications, stating that “the applications lacked sufficient evidence demonstrating that these flavored e-cigarettes would provide a benefit to adult users that would be adequate to outweigh the risks to youth.”

Now, the company is forced to stop distributing the products, and any currently on the shelves must be removed.

Additionally, the FDA issued warning letters to two brands “doing business as Puff Bar, for receiving and delivering e-cigarettes in the U.S. without a marketing authorization order.”

The FDA’s response is “a continuation of the FDA’s efforts to address e-cigarettes that appeal to youth,” according to the release.

“The FDA remains deeply concerned about e-cigarette use among our nation’s youth. It’s clear that we still have a serious public health problem that threatens the years of progress we have made combatting youth tobacco product use,” FDA Commissioner Robert M. Califf, MD, said in the release. “We cannot and will not let our guard down on this issue. The FDA remains steadfast in its commitment to using the full range of our authorities to address youth e-cigarette use head-on.”

References:

• Cooper M. MMWR Morb Mortal Wkly Rep. 2022;doi:10.15585/mmwr.mm7140a3.
• New data show more than 2.5 million U.S. youth currently use e-cigarettes. https://www.fda.gov/news-events/press-announcements/new-data-show-more-25-million-us-youth-currently-use-e-cigarettes?utm_medium=email&utm_source=govdelivery. Published Oct. 6, 2022. Accessed Oct. 6, 2022.