E-cigarette use high among US children, teens
New data published in JAMA from a nationally representative sample show that self-reported electronic cigarette use was high among high school and middle school students in 2019, with many reporting use of flavored products.
Of the 19,018 U.S. students in sixth through 12th grade who participated in the 2019 National Youth Tobacco Survey, 10,097 were high schoolers with a mean age of 16.1 years and 8,837 were middle schoolers with a mean age of 12.7 years. The overall response rate for the survey was 66.3%.
Results showed that among high schoolers, an estimated 27.5% reported current e-cigarette use, 5.8% reported current cigarette smoking and 31.2% reported current use of any tobacco product. Among current e-cigarette users, 34.2% reported frequent use, which was defined as use on 20 of the last 30 days, and 63.6% reported exclusive use of e-cigarettes.
Among middle schoolers, an estimated 10.5% reported current e-cigarette use, 2.3% reported smoking cigarettes and 12.5% reported current use of any tobacco product. Among those middle schoolers currently using e-cigarettes, 18% reported frequent use and 65.4% reported exclusive use of e-cigarettes.
Students were also asked about their usual brand of e-cigarettes. Among current e-cigarette users, 13.8% of high schoolers and 16.8% of middle schoolers reported not having a usual brand. However, more than half of both high school students (59.1%) and middle school students (54.1%) reported Juul as their usual e-cigarette brand in the past 30 days. Additionally, among exclusive e-cigarette users, 72.2% of high schoolers and 59.2% of middle schoolers reported using flavored e-cigarettes, with the most popular flavors including fruit, menthol or mint, and candy, desserts or other sweets.
In a research letter also published in JAMA, another set of investigators reported more detailed findings on use of flavored products based on data from the Monitoring the Future survey.
Among 42,531 respondents, including students in eighth, 10th and 12th grades, approximately one-third were asked about Juul products. Overall, 18.8% reported use of e-cigarettes or any nicotine product within the past 30 days and 12.6% reported using Juul products, leaving the analytic sample to include 1,739 past 30-day Juul users with flavor preference data.
The researchers found that the most popular flavors among eighth grade users were mango (33.5%), mint (29.2%) and fruit (16%), whereas 14.8% preferred other flavors. Among 10th graders, however, mint was more popular (43.5%), followed by mango (27.3%), fruit (10.8%) and other flavors (8.4%). Similar results were seen among 12th graders, with mint being the most popular (47.1%), followed by mango (23.8%), fruit (8.6%) and other flavors (6%).
Flavor preferences were generally consistent across frequent and nonfrequent Juul users. The researchers noted, however, that the mint flavor’s popularity was more pronounced among frequent users.
“Some local municipalities have prohibited sales of e-cigarettes in flavors other than mint, menthol and tobacco or prohibited sales of all nontobacco flavors. Juul voluntarily suspended sales of their product in flavors other than tobacco, menthol or mint by some retailers. The current findings raise uncertainty whether regulations or sales suspensions that exempt mint flavors are optimal strategies for reducing youth e-cigarette use,” the researchers wrote. – by Melissa Foster
Disclosures: The authors for both studies report no relevant financial disclosures.