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.

 

Where are the Crusades to Ban Alcohol, Marijuana & Caffeine – For the Children?

 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) just introduced a program to discourage underage drinking, aimed specifically at middle schoolers (here). It’s called “Too Soon = Too Dangerous.”  The chart at left, based on data from the government’s Monitoring the Future Survey (MTFS), shows that attention to early substance abuse is timely.

There’s long been a broad crusade to prohibit all tobacco and nicotine products. Local and state governments are banning vaping and e-cigarette flavors (examples here, here and here), and the FDA has rejected thousands of flavored products that were already on the market (resulting in a todal wave of illicit products).

In contrast, 6% of eighth graders say they consume alcohol.  Of course, all alcoholic drinks are flavored. 

Where is the crusade against alcohol, which is inarguably much more dangerous than nicotine?  According to the CDC, “Underage drinking is a significant public health problem in the U.S.  Excessive drinking is responsible for more than 3,900 deaths and 225,000 years of potential life lost among people under age 21 each year.”  The same potential danger exists with marijuana, which is also consumed by eighth graders. 

Like alcohol and marijuana, nicotine is addictive, but no teenagers have died from using it.  Nicotine is more like caffeine, which is also represented in the chart by the 14% of eighth graders who currently consume energy drinks or shots.  Some health professionals (here, here, here, here and here) and federal agencies (here) have expressed concern, and there is at least one study claiming, “Teens who drink high-caffeine energy beverages such as Red Bull or Monster may be more likely to use alcohol, drugs and cigarettes.”  There is even a report of “a 16-year-old [who] tragically lost his life after consuming an energy drink, a soda and a latte — drinks routinely consumed by and often intensively marketed to youths — all within a few hours.”

Where is the crusade to ban energy drinks and shots?  Tobacco harm reduction advocates will be interested to know that Senators Richard Durbin (D-IL), Richard Blumenthal (D-CT) and Edward Markey (D-MA) have agitated about the marketing and advertising of these products, but no one is talking about banning them.

Let me remind you about the stakes here.  While nearly half-a-million American smokers needlessly die each year because they are unable or unwilling to quit nicotine and tobacco, there is a crusade, mostly in the name of protecting children, to ban effective and vastly safer tobacco substitutes.  In contrast, there is no organized movement to ban far more dangerous alcohol and marijuana, nor addictive caffeine, all of which are frequently consumed by American adolescents.    

 

2022 High School Seniors: Little Change in Tobacco Use, But Significant Increases in Current Marijuana Vaping & Flavored Alcohol Consumption

 

As my readers know, I have been following the results of the annual Monitoring the Future Survey for many years, focusing on alcohol, marijuana and tobacco use among high school seniors.  Just-released 2022 MTF results (here) indicate that past 30-day (i.e., current) use of these products was fairly stable from the prior year (as seen in chart at left), with the exception of vaping marijuana, which significantly increased.    

While current smoking bottomed out at 4%, past-month alcohol drinking remained at the top of this list at 28%, with 17% having been drunk.  Marijuana use comes in at 20%, with 15% of seniors vaping that substance in the past 30 days. 

Two other MTF topics not in my chart deserve attention: JUUL and flavored alcohol.  MTF reported current JUUL use for the first time in 2019, noting that it was used by 21% of high school seniors.  By 2021, the rate was 6.8%.  This year, MTF dropped JUUL from the survey, which is strange because they kept many other drugs with less than 1% current use.  The reason may be that the sharp decline in JUUL use conflicted with the MTF narrative, highlighted in this year’s press release header: “Nicotine vaping now one of the top forms of substance use among teens.” 

Current drinking of flavored alcohol was another fascinating finding; it significantly increased from 15% in 2021 to 21% this year, identical to vaping nicotine and eclipsing vaping flavors (8.3%).  The FDA Tobacco Center supports the banning all flavored vapes, even in the absence of a scientific rationale.  These products are being banned in jurisdictions across the country.  While it’s hard to conceive a scenario in which flavored alcohol comes under the same attack, one shouldn’t underestimate the power of American prohibitionist thinking.