A Deeper Dive into High School Vaping from the 2023 National Youth Tobacco Survey

 

The Centers for Disease Control and Prevention (CDC) reports that about 1.56 million U.S. high school students were current users (i.e., past 30 days) of e-cigarettes or other vaping products in 2023.  Although this number is substantially lower than at vaping’s peak in 2019 (here), it is still represented as a public health crisis by anti-tobacco crusaders.  This post takes a closer look at this number by examining other factors that were ignored by the CDC. 

The chart on the left breaks down the report’s 1.56 million vapers to calculate the actual number of exclusive, or “virgin” vapers.  I use a sequential subtraction method to isolate factors integral to vaping.  The chart reflects CDC weighting to estimate the numbers in detail, but in the following text, acknowledging real world facts, I’ll use abbreviated estimates.

According to the CDC, there were 15.8 million high schoolers in 2023, so about 9.9% of those were current vapers, that is, they had used the product at least once in the past 30 days.  About 204,000 of the 1.56 million current vapers were also current smokers, which leaves 1.36 million. 

Of these remaining vapers, 397,000 “ever” smoked a cigarette, even one puff, leaving 963,000.

After subtracting another 192,600 “ever” cigar smokers, we have 770,600 current vapers.

Finally, we have a factor that the CDC completely ignores, despite its coverage in the NYTS: “ever” vaping marijuana, tetrahydrocannabinol (THC) or cannabidiol (CBD).  There were 535,500 current vapers who had also vaped those marijuana-related products.

Now we have a reasonable estimate for virgin vapers, or those high schoolers who have not had any other exposure to similar tobacco or marijuana products.  The grand total is 235,021, representing only 1.5% of all high school students.

For further context, consider the frequency of vaping among virgin vapers: 63% had vaped only 1-9 days in the past month, 6% had vaped 10-19 days, and 31% had vaped 20-30 days.  While the latter group is at risk for being addicted to nicotine and vaping, these 73,092 frequent vapers represent just 4.7% of all high school vapers.  Even more importantly, they represent only 0.5% of all U.S. high school students.

Vaping among high school students is a legitimate concern, but vaping is not a new, isolated epidemic or crisis threatening to enslave a generation of teens to nicotine.  The NYTS demonstrates that vaping is connected with smoking cigarettes and cigars, and particularly with the use of THC/CBD. 

The FDA refuses to recognize that teen vapers also smoke and toke.  When the government obsesses over an imaginary “teen vaping epidemic” and denies its actual modest scope, it ignores the 480,000 adult tobacco smokers who die each year.

 

Smoking and Vaping Prevalence Charts That the FDA and CDC Don’t Want You to See

 

My colleague and I have published a new article in Harm Reduction Journal entitled “Joint Smoking-Vaping Prevalence Rates Among American Youth and Young Adults 2011-2022.”  This post is dedicated to U.S. federal government officials, especially at the FDA Center for Tobacco Products and the CDC Office of Smoking and Health.  Despite having smoking and vaping data from federal surveys for the past thirteen years, those officials have never published joint prevalence rates.

 

 

I present two charts on the left, but please read the full article for more information (here).  The charts speak for themselves, so I won’t bore you with unnecessary details.  The first shows that smoking among high schoolers has basically disappeared at the same time that vaping skyrocketed up…then down.  Note that the vertical axis is the same for both charts, topping out at 30%.  So while the high school vaping rate was very volatile with sharp increases and declines, vaping in young adults age 18-20 was much more stable.  But the smoking rate went down and stayed there, suggesting that these general trends are likely to continue.  Which means that in 25 to 30 years, smoking-related diseases will disappear too. 

 

 

My final chart, below, shows quit ratios (QRs) for all adult age groups in our study.  QRs, which are the prevalence of former smoking divided by the prevalence of ever smoking X 100, are a well-established and meaningful measure of quitting success among a population.  Once again, very little explanation is needed.  Whereas QRs among the younger age groups were low in 2011, all are above 50% now.  Note especially the extraordinary one-year increase in the QR among emerging young adults, from 53% in 2022 to 73% in 2023. 

 

Nota Bena.  Discerning readers will notice that the figures in this blog contain one more year (i.e. 2023) than our HRJ article.  The reason is that the article was in review for over 12 months, during which time the 2023 data was released by the CDC.  My colleague and I considered updating the article, but we feared that it would prompt more months of delay.