Some 2.55 million middle and high school students currently use tobacco products, including flavored electronic cigarettes, a report out Thursday shows.
The 2021 Youth Tobacco Survey found that e-cigarettes such as Juuls’s and Puff Bar’s disposable devices were the most commonly used tobacco products, with about 1.7 million high school students and 320,000 middle school students reporting use within the previous 30 days. In terms of popularity among young people, e-cigarettes were followed by cigarettes, cigars, smokeless tobacco, hookahs, nicotine pouches, heated tobacco products, and pipe tobacco.
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“The 2021 NYTS findings include important new information about youth tobacco use behaviors and associated factors that will help the FDA evaluate, design, and implement our tobacco regulatory and educational programs,” said Mitch Zeller, director of the Food and Drug Administration’s Center for Tobacco Products.
The sample population of young people in grades six through 12 who were asked about their tobacco use was weighted to represent over 11.9 million middle school students and 15.4 million high school students. Over 5 million high school students and about 1.3 million middle school students reported ever using tobacco products such as e-cigarettes. Among students who currently used each type of tobacco product, frequent use, or on at least 20 days of the prior 30 days, ranged from 17.2% for nicotine pouches to 39.4% for e-cigarettes. Among current users of any tobacco product, 79.1% reported using a flavored tobacco product, most commonly e-cigarettes.
The method for collecting data was different in 2021 due to the coronavirus pandemic. Students who could not attend school in person filled out the online survey from home, which anti- youth tobacco use advocate Matthew Myers worries may have skewed the results to downplay the actual numbers.
“There’s a long line of survey research that actually shows that you would expect that when kids are at home and maybe their parents are nearby the answers have always been different. At-home surveys versus school surveys uniformly produce different results,” said Myers, who serves as president of the advocacy group Campaign for Tobacco-Free Kids.
Many students surveyed, over 65%, reported wanting to quit using tobacco products, a good sign given that nearly 20% reported craving nicotine within 30 minutes of waking up.
“It’s revealing that about two-thirds of current youth users expressed a desire to quit tobacco products and that three-quarters of youth reported having seen or heard a tobacco prevention ad,” Zeller said. “But the 2021 use data are still concerning and will be valuable for policymakers and educators committed to protecting the next generation from tobacco-related disease and death.”
The survey also reported that young people faced a deluge of tobacco advertisements. Nearly 76% of students in high school and middle school were exposed to tobacco marketing campaigns through a wide variety of avenues such as the internet and social media, convenience stores, television, and movies.
The federal government has worked for years to clamp down on tobacco companies’ track record of marketing to young people with mint and dessert-flavored products. For example, the House passed the Protecting American Lungs and Reversing the Youth Tobacco Epidemic Act in early 2020 by a vote of 213 to 195. The bill, which remains stalled in the Senate, would ban all flavored tobacco products, including flavored e-cigarettes, menthol cigarettes, and flavored cigars.
“I was both pleased and disturbed [by the data]. Pleased that we continue to make progress reducing the use of cigarettes, the most deadly tobacco products. And concerned that there are still over 2 million kids using tobacco products. The e-cigarette use has the potential to undermine the progress we’ve been making,” Myers told the Washington Examiner.
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Congress had been making some progress in getting legislation off the ground, with numerous committee hearings about tobacco products’ deleterious effects on children and votes on legislation that would restrict the online sales of tobacco products and impose a vaping tax. At the tail end of his presidency, Donald Trump signed legislation into law that raised the legal age to buy tobacco from 18 to 21, and the FDA conducted compliance checks to ensure that retailers were consistently checking people’s IDs.
The COVID-19 pandemic, which began taking its toll on the U.S. soon after the House passed the flavored tobacco ban, forced lawmakers to prioritize the public health crisis caused by the virus over that caused by tobacco. Now that the pandemic is showing signs of receding, members of Congress have revisited efforts to regulate products such as e-cigarettes and menthol-flavored tobacco. The House included a measure in the $1.5 trillion government spending bill passed Wednesday that would give the FDA clear authority to regulate e-cigarettes and vaping products as tobacco products.
The spending bill still has to clear the Senate, which could potentially remove the measure giving the FDA regulatory authority over those vaping products. Myers said it is crucial that the other chamber maintain that measure.
“From a public health perspective, enactment of legislation giving FDA clear jurisdiction over e-cigarettes with synthetic nicotine is an essential step to reverse the youth e-cigarette epidemic,” he said. “The fact that 65% of the kids say they want to quit is a good sign but it also is a cause for concern because so many of these kids are already highly addicted we need to do more to help them.”
