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Vaping soars among American teens in 2018 survey


Teenage use of vaping devices jumped significantly in the past year, with 37% of 12th-grade students reporting any vaping in 2018, compared with 28% in 2017, data announced Dec. 17 from the 2018 Monitoring the Future survey show.


In particular, nicotine vaping use in the 30 days prior to the survey nearly doubled among high school seniors, from approximately 11% in 2017 to 21% in 2018. Nicotine vaping also increased by 7.9% (from 8.2% to 16.1%) among 10th graders and by 2.6% (from 3.5% to 6.1%) among 8th graders, according to the survey results.

Vaping involves using a device such as an e-cigarette to inhale a heated aerosol product that usually contains nicotine but can be used to administer other types of drugs, said Nora D. Volkow, MD, director of the National Institute on Drug Abuse at the National Institutes of Health, in a press conference announcing the findings.

The increased prevalence of nicotine vaping in 10th and 12th graders is the largest annual increase in use of any substance recorded by Monitoring the Future, said Richard A. Miech, PhD, MPH, of the Institute for Social Research at the University of Michigan, Ann Arbor, and the principal survey investigator. “Something about this delivery device of vaping seems to really appeal to kids,” he said. The flavorings, concealability of the devices (which can be about the size of a flash drive), and ease of use seem to be contributing to the popularity of vaping, Dr. Miech added.

In addition, marijuana vaping increased significantly across all three grade levels in 2018 from 2017. Within 30 days of the survey, marijuana vaping increased from 4.9% to 7.5% in 12th graders, from 4.3% to 7.0% in 10th graders, and from 1.6% to 2.6% in 8th graders.

A take-home message for clinicians is the need to emphasize to teens that “vaping is not innocuous and not harmless,” said Dr. Miech in a question-and-answer session. Of note, data from multiple studies show that children who vape are about five times more likely to smoke cigarettes, he said.

The vaping devices are manufactured to deliver drugs into the lungs and ultimately high concentrations into the brain – which suggests the use of vaping devices to deliver other types of drugs might increase in the future, Dr. Volkow added.

Use of most other substances, including inhalants, heroin, cocaine, ecstasy, overall marijuana use, alcohol use, and extreme binge drinking remained stable, the researchers said. Cigarette smoking declined slightly among 12th graders but did not change significantly among 8th or 10th graders. Use of prescription opioids and tranquilizers declined in 2018 across all age groups.

“Vaping is reversing hard-fought declines in the number of adolescents who use nicotine,” Dr. Miech said in the news release announcing the results. “These results suggest that vaping is leading youth into nicotine use and nicotine addiction, not away from it.”

The data on vaping and nicotine use among American teens were published in a letter (N Engl J Med. 2018 Dec 17. doi: 10.1056/NEJMc1814130) – with a warning. “These results indicate that the policies in place as of the 2017-2018 school year were not sufficient to stop the spread of nicotine vaping among adolescents,” wrote the authors, led by Dr. Miech. “The rapid entry of new vaping devices on the market ... will require continual updates and modification strategies to keep adolescents from vaping and its associated negative health effects.”

The Monitoring the Future survey tracks annual drug use and drug use attitudes in a nationally representative sample of U.S. students in 8th, 10th, and 12th grades. This year’s survey included 44,482 participants. The survey is funded by a government grant to the University of Michigan, Ann Arbor, from the NIH’s NIDA.

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