Wednesday, April 6, 2022

Why Do High Schoolers Vape? National Youth Tobacco Surveys Suggest Answers




Federal officials blame vape manufacturers and retailers for teen vaping, focusing in particular on the industry’s use of flavoring, but government surveys indicate the truth is more nuanced.

The government’s National Youth Tobacco Surveys (NYTS) routinely collect information on teenage e-cigarette use.  I examined survey data for the years when vaping accelerated (2018 and 2019), and when it declined (2020 and 2021).  In the first three years, the survey asked, “What are the reasons that you have used e-cigarettes?”  In 2021, the question changed to, “Why do you currently use e-cigarettes?”  Other survey modifications occurred, as noted in the Table footnotes.


High School Vapers: Percentage Reporting Why They Have Used [Currently Use*] E-cigarettes, NYTS 2018-2021


Used by friend30%*21%*37%27%
Used by family member

To quit other tobacco11984
Costs less than other tobacco6634
Easier to get than other tobacco6655
Used by people on TV, online, movies1432
Less harmful than other tobacco25181410
Use unnoticed8181714
Other reason30182519
Peer pressure---8------
Used to do tricks---232419
Use when anxious, stressed, depressed---------42
Nicotine buzz---------44
*Friend and family member combined
--  Reason not asked
Participants could choose multiple reasons


Let’s look at some of the bigger trends.  First, among reasons measured in all four years, “friends’ use” is consistently the most important, which jibes with the common observation that most teens obtain e-cigarettes from friends rather than retail stores.  “Other” reasons ranks second, followed by “flavors”, “less harmful”, and “use unnoticed at home or school”.  Note that the percentage of respondents mentioning flavors fell from 36% in 2018, to 13% in 2021, undercutting activist arguments to ban them.  The percentage mentioning less harmful also declined, from 25% to 10%, likely reflecting the success of the FDA’s grossly misleading “Real Cost” campaign that asserts that e-cigarettes are equally or more harmful than cigarettes.

Additional reasons for vaping, offered in NYTS after 2018, were also selected at high rates; these included “performing tricks” and “curiosity”.  In 2021, 42% of vapers said they vaped because they were anxious, stressed or depressed, and 44% were trying to get a nicotine buzz.

Also of note: “Quitting other products”, “costing less”, “easier to get”, and “celebrities” were not frequently cited as important reasons to vape. 

Why, one might ask, was there so much variation across the four years?  The answer may well lie with the inherent variability of self-reporting by teenage respondents.


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