Data released Feb. 11 from the joint FDA/Centers for Disease Control and Prevention (CDC) National Youth Tobacco Survey (NYTS) for 2018 elaborate on initial results from November 2018 showing a steep rise in youth use of tobacco products. According to the data, published in the Morbidity and Mortality Weekly Report article “Vital Signs: Tobacco Product Use Among Middle and High School Students—United States, 2011–2018,” approximately 4.9 million middle and high school students were current users of any tobacco product in 2018, up from 3.6 million in 2017. From 2017 to 2018,there was a 78 percent increase in current e-cigarette use among high school students and a 48 percent increase among middle school students. “The epidemic use of e-cigarettes among children is one of the biggest public health challenges currently facing FDA,” the agency’s commissioner said in a statement on the day the findings were released.
To address the youth e-cigarette use epidemic, FDA is taking forceful steps under its Comprehensive Plan for Tobacco and Nicotine Regulation and Youth Tobacco Prevention Plan. The agency’s actions are designed to significantly reduce tobacco-related disease and death in the U.S., by protecting youth while the agency also works to help addicted smokers quit. “FDA has repeatedly affirmed our collective view that e-cigarettes may have promise for helping currently addicted adult smokers quit smoking,” Commissioner Gottlieb said. But, he added, “I simply won’t allow their sale to come at the expense of addicting a generation of kids to nicotine.”
According to the NYTS findings, the increase in youth tobacco use from 2017 to 2018 was driven by a surge in e-cigarette use. More than 3.6 million middle and high school students were current e-cigarette users in 2018, a dramatic increase of more than 1.5 million students in a single year. Data from the recent National Institutes of Health “Monitoring the Future” study found comparable results.
The NYTS authors suggest the rise in e-cigarette use between 2017 and 2018 is likely due to the recent popularity of certain types of e-cigarettes such as JUUL. Youth who use e-cigarettes have also been found to be using them more frequently and using flavored products more often. And many youth tobacco product users are using multiple products.
What’s more, research recently published in JAMA Network Open sheds additional light on potential risks to youth e-cigarette users. The research showed that, compared to non-users, youth who use e-cigarettes are more likely to start smoking conventional cigarettes—risking a lifetime of addiction to smoking and, in turn, facing potential smoking-related disease and death.
The agency has ramped up enforcement efforts related to e-cigarette marketing and sales, and is taking ongoing steps to address youth appeal of, and access to, flavored tobacco products, which appear to be at the heart of the youth tobacco use problem. In a recent step, the agency published a draft guidance, “Modifications to Compliance Policy for Certain Deemed Tobacco Products,” discussing possible changes to compliance policies related to premarket review requirements for certain flavored electronic nicotine delivery system (ENDS) products and flavored cigars.
To stay up-to-date on FDA’s efforts to significantly reduce disease and death from tobacco, visit CTP’s Comprehensive Plan for Tobacco and Nicotine Regulation and Youth Tobacco Prevention Plan webpages.
Center for Tobacco Products – Spotlight on Science — Winter 2019