New study raises concerns that youth vaping nicotine may reverse declines in other drug use

Statement of Robin Koval, CEO & President, Truth Initiative

The dramatic drop in youth smoking since 2000 has led to declines in other drug use among young people, according to a new study that raises concerns about whether the rise of vaping nicotine could serve as a gateway to other drug use and reverse progress on both these fronts.

New research published in Tobacco Control concludes that the decline in youth smoking between 2000 and 2018 played a “large role” in decreasing nonmedical use of opioids, amphetamines and tranquilizers among middle and high school students. Researchers credit much of the progress to tobacco use prevention campaigns like truth^®, and the growing number of youth who reject smoking entirely.

Researchers found that youth who had never smoked cigarettes had nonmedical drug use rates at least four times lower than those who had tried cigarettes. As the number of youth who had never smoked grew, other nonmedical drug use dropped. Between 2000 and 2018, the percentage of 12th graders who had ever smoked a cigarette declined from 65% to 24%. During the same time, rates of amphetamine, tranquilizer and opioid use among youth each fell by about half.  

The findings suggest that smoking cigarettes primes young people to try other drugs, which can be addictive, and raises questions about whether nicotine consumption from e-cigarettes risks a similar impact. With 27.5% of high schoolers vaping in 2019, overall youth tobacco use is at a rate unseen in nearly two decades. According to the 2019 National Youth Tobacco Survey, 31.2% of high school students are using some type of tobacco product, the highest rate among high school students in 19 years.

A substantial body of research has also found that e-cigarette users have greater odds of going on to try conventional cigarettes. Evidence of this relationship between e-cigarette use and cigarette initiation, which threatens the progress the country has made to decrease the smoking rate, continues to grow.

Nearly all e-cigarettes have nicotine and the most popular pod types (such as JUUL) contain very high levels, with some delivering nicotine to the brain similar to that of traditional cigarettes, according to several studies. In fact, the maker of the most popular e-cigarette, JUUL, says its nicotine salt formulation increases the rate of nicotine delivered into the blood up to 2.7 times faster than other e-cigarettes.

This research provides further evidence of the massive threat e-cigarettes pose to the future of the country’s youth. As evidence of the long- and short-term health effects of these products emerges,  it is imperative that the Food and Drug Administration enhance its recent actions to fully enforce its regulatory powers, including a more comprehensive flavor ban than that announced in the beginning of the year, as well as a swift, transparent and thorough review of marketing authorization applications required  to be submitted by all e-cigarette makers by May 2020. The consequences of not doing so are made even more dire by this research. The e-cigarette epidemic not only risks our nation’s youth to a lifetime of nicotine addiction — it may also serve as an on-ramp to many other serious and life-threatening substance use behaviors, according to this study.

The study examined data from the Monitoring the Future survey, an annual nationally representative survey of more than 1.2 million U.S. students in 12th, 10th and 8th grades.