Why Teenage Vaping Epidemic Concerns May Be Exaggerated

By Clare Wilson

“How Juul Addicted a Generation to Nicotine,” read a 2018 New York Times headline about the new addiction that appears to be gripping US youth. It wasn’t the only media show to cover the rise in e-cigarettes, as a US government poll earlier this year found vaping among teenagers is on the rise.

The full numbers from this survey have now been re-analyzed and suggest that the original coverage does not give the full picture. In some ways, the results could even be considered good news for teenage health.

E-cigarettes are said to be a safer way for people to inhale nicotine without ingesting the numerous harmful substances that are produced by smoking tobacco, such as tar and carbon monoxide.

There has always been a concern that smokers might not only help quit, but also attract non-smokers. However, in recent years there has been concern in the US about small Juul branded vaping devices that deliver a high nicotine hit with a choice of flavors.

Alarming headlines

Juul’s alleged appeal to teenagers was highlighted by the U.S. Centers for Disease Control and Prevention when they released the 2018 figures. The study, based on the annual survey of more than 20,000 middle and high school students, generated a number of alarming headlines.

At the time, Juul said he didn’t want young people to use his products and stopped selling some of his flavors through retail stores. Since then, all non-tobacco or menthol flavors have been removed from the market.

However, an independent analysis of the full set of these numbers released this week is more nuanced than those opening headlines. While 14 percent of teenagers surveyed had actually vaped in the previous 30 days, only 4 percent of the total were regular e-cigarette users, defined as being done for 20 days or more during that period. Less frequent use suggests “curiosity and experimentation,” says author David Abrams of the New York University School of Global Public Health.

And the numbers suggest that comparatively few teenagers who have never smoked are far from engaging a new generation of nicotine: Less than 1 percent of those who vape regularly had never smoked tobacco before. “There was a massive focus on teenagers without making it clear that most of those teenagers would smoke anyway,” Abrams says.

Misguided ban?

But the idea of ​​a new addiction epidemic among the nation’s youth has now caught on. The US recently banned all flavors of vapes except tobacco and menthol. However, this could be counterproductive in terms of protecting people’s health. Research has found that many adults are also into sweet vapes like fruits, candies, and desserts, and this can be part of the appeal of switching from smoking to vaping.

To make matters worse, e-cigarette fear has risen after reports of a strange lung condition related to vaping over the past year that has caused more than 50 deaths to date. Further research has shown that these cases actually affected people using black market cannabis vaping liquid filled with a harmful additive, vitamin E acetate.

However, many media reports have implied that the danger comes from all e-cigarettes, including legal ones that deliver nicotine, which is simply not true. Yes, we need to make sure teenagers don’t start vaping or smoking, but that shouldn’t come at the expense of existing adult smokers who are switching to vaping.

Journal reference: Nicotine and Tobacco Research, DOI: 10.1093 / ntr / ntaa010