High School Vaping: There’s Good News & Bad in the 2020 NYTS Data

Data from the 2020 National Youth Tobacco Survey (NYTS) (charted at the left) confirms the CDC finding that “19.6% of high school students (3.02 million) … reported current (past 30 day) e-cigarette use.” (here).  This is a reduction in high school vaping from peak prevalence of 26.3% (or 4.1 million) in 2019.  The survey also indicates that high school cigarette smoking declined to 4.6%.  That’s good news, but there’s also some bad in the following table.

 

High School Vaping, 2018-2020
	2018	2019	2020
High School Students	14.8 million	15.0 million	15.5 million
Vaped Past 30 Days	3.1 million	4.1 million	3.02 million
Legal (18+ years)	600,000	779,000	546,000
Underage	2.5 million	3.32 million	2.47 million
Other Tobacco	1.7 million	2.17 million	867,000
Virgins	807,000	1.15 million	1.61 million
Infrequent (1-19 days)	712,000	978,000	1.12 million
Frequent (20+ days)	95,000	171,500	486,500

 

The table documents that there was a 40% increase in underage “virgin” (i.e., not using any other tobacco products) high school vapers, from 1.15 million in 2019, to 1.61 million in 2020.  There was also a three-fold increase in frequent underage high school vapers – those who vaped for 20 or more days in the past month – from 171,500 to 486,500. 

The increase in frequent vaping, which is suggestive of dependence, is likely to be exploited by anti-vaping activists, but the NYTS data must be viewed in context.  For comparison, let’s run similar numbers for high school cigarette smokers.  In 2018, there were 1.31 million of the latter, 973,000 of whom were underage. Of that subgroup, 234,000 smoked frequently (20-30 days in the past month).  In 2020, there were only 714,029 current high school smokers, 561,375 of whom were underage, and only 93,000 of the latter group smoked frequently. 

The substantial drop in all of these smoking numbers, even as frequent vaping increased, is positive from a public health perspective.  Health risks for any high-schoolers who become addicted to vaping nicotine will be a tiny fraction of the risks associated with smoking.

Another major finding from the new NYTS is that high school vapers may not be vaping tobacco/nicotine.  As I noted before, most public health officials ignored the important disclosure in the 2018 NYTS of high rates of marijuana vaping.  This oversight was highly irresponsible in view of the fact that contaminated illegal marijuana vapes caused considerable lung injuries and deaths.  Marijuana wasn’t mentioned at all in the 2019 NYTS questionnaire, but it reappeared in the 2020 survey.  The next chart shows that marijuana vaping has become even more popular; for example, 83% of 1.17 million frequent high school vapers used marijuana in 2020.   

 

While no one should be comfortable with any underage teen drug use, moral outrage about nicotine use is entirely misplaced.  Instead, it should be directed at the use of alcohol and marijuana, addictive substances that are clearly associated with teen injuries and deaths.