Teenagers Keep Vaping Despite Crackdowns on E-Cigarettes

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While use among youths has fallen since the peaks of 2018-19, resumption of in-school classes this year shows students still have access to flavored, disposable vapes.

High school students resumed taking the annual National Youth Tobacco Survey in school this year and 14 percent of them reported using e-cigarettes, underscoring how an upstart industry is dodging regulators’ efforts to spare a generation from nicotine addiction.

The number shows a slight change from 11 percent last year, but researchers cautioned against drawing comparisons to 2021’s survey, which was conducted differently because it took place when many schools were closed during the pandemic. The latest results were released by the Centers for Disease Control and Prevention on Thursday.

Though the age-old force of peer pressure may still be encouraging use, the percentage of high school students who reported vaping within the last 30 days was still far lower than record-high levels reached in 2019 of nearly 28 percent.

Overall, the survey found that 2.5 million middle and high school students, or about 9 percent, used e-cigarettes in the last 30 days. That puts their overall rate of use several times higher than that of adults, which is estimated at about 3 percent.

The survey, which was conducted from January through May of this year, showed that 85 percent of adolescent e-cigarette users favored vapes in fruit, dessert and candy flavors. Some mentioned PuffBar, Vuse and Juul as their favorite brand among those on the survey’s list.

But many said their favored e-cigarette brand was not one of the 13 listed. That finding highlights how nimble the industry has been in stamping an array of brand names on vapes with flavors like strawberry ice cream and fresh vanilla that are largely made in China and shipped from warehouses to corner stores and into e-commerce.

“What that shows is that playing Whac-A-Mole with a few products is not going to solve the problem,” said Vince Willmore, a spokesman for the Campaign for Tobacco-Free Kids. “As long as any flavored products are still on the market, kids are going to shift to them. To solve the problem, you have to clear the market of all flavored products.”

One stark finding was that one in four of the high school students who were e-cigarette users reported vaping every day. Groups opposed to e-cigarettes and tobacco products were particularly troubled by one other result that reflected the highest frequency-of-use to date: Nearly half of the high school students who were vaping said they were doing so 20 to 30 days a month.

“That’s a real signal of addiction and setting up young people for a lifetime of addiction which they don’t want, they didn’t choose and they don’t like,” said Robin Koval, president of the Truth Initiative, a nonprofit organization aimed at eliminating youth tobacco use.

Linda Neff, chief of the epidemiology branch in the C.D.C.’s Office on Smoking and Health, said that the sheer number of young people continuing to vape suggested the agency needed to keep working to educate teens about the effects of nicotine addiction, which “harms the parts of the brain that control learning, mood and impulse control.”

“The frequency of use is disturbing,” she said. “It’s alarming.”

The Food and Drug Administration considers e-cigarettes to be generally beneficial to the extent that they provide an alternative to adult users of traditional cigarettes, which coat the lungs in tar. The agency’s hope for health gains, though, has existed in the shadow of a youth vaping crisis that exploded in 2018-19, prompting an outcry from parents, schools, lawmakers and public health experts.

The F.D.A. began to crack down on vape makers in 2019, banning many flavors and ordering manufacturers to apply for marketing authorization to keep their products on the market — an ongoing process. That effort has been challenged by e-cigarette makers who saw a loophole in making e-cigarettes with synthetic nicotine and jumped into the market with blueberry, kiwi and candy-flavored vapes.

This spring Congress gave the F.D.A. the authority to rein in those devices. The agency said it was reviewing about one million applications to sell synthetic nicotine products. In July, the agency gained authority to remove unauthorized non-tobacco products from the market but has said it needs to move methodically as it enforces the law.

On Thursday, the agency announced that it sent new warning letters to two companies that teenagers singled out as go-to brands in the survey. The F.D.A. issued its second warning to the maker of Puff Bar vapes, this time about its flavored synthetic nicotine products that the agency said were being sold illegally.

The F.D.A. also said Thursday that it denied marketing authorization to Hyde, a company that about 5 percent of adolescents wrote in on the survey as a favored brand — suggesting the rate is higher. The company’s website shows flavors including “pink burst” and “lemon drop.”

In a statement, the agency said that Hyde must stop selling its products or “risk enforcement action.”

Juul Labs, which had been widely blamed for fueling the teenage vaping crisis, pointed to the decline in popularity of its products among youths in a statement it released on Thursday. The company is awaiting a decision from the F.D.A. on its marketing application to remain on the market.

To some, the enforcement drive by the F.D.A. appears self-defeating. Amanda Wheeler, president of the American Vapor Manufacturers, said that the flood of denials faced by U.S. vape businesses were opening the door to foreign companies that would be more difficult to regulate.

As the agency’s rejections mount, “we will continue to see black market actors take advantage of F.D.A.’s wholesale destruction of the category,” Ms. Wheeler said.

The health consequences for teenagers who develop a nicotine addiction are just beginning to be understood. Dr. Rose Marie Robertson, science and medicine officer with the American Heart Association, said scientists were seeing toxic effects from the inhaled flavoring ingredients of e-cigarettes. She said researchers were also detecting signs of use on the heart and lungs.

“It took us 40 years to show that women would develop lung cancer more readily if they smoked,” Dr. Robertson said. “The fact that we’re seeing any effects at an early stage is very worrisome.”

The persistent rate of e-cigarette use among teenagers also concerns experts who were thrilled to see youth cigarette smoking rates fall steadily for years and remain in the single digits, with about 3.3 percent of middle and high school students reporting use in 2020.

“To have decades of progress wiped away by e-cigarettes has been astonishing to us who’ve been there all along,” Dr. Robertson said.

The full results of the survey, which will include levels of other tobacco product use, is expected out later this year.

Read full article here.

Christina Jewett – New York Times – 2022-10-06.

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