Teenage E-Cigarette Use Falls While Flavors Remain Popular

(Bloomberg) -- Teenagers’ e-cigarette use declined this year, according to an influential annual survey, marking a positive trend that health officials say still leaves the number of users too high.

In 2020, 19.6% of high-school students and 4.7% of middle-school students said they vaped, according to the National Youth Tobacco Survey, which is co-sponsored by the Centers for Disease Control and Prevention and the Food and Drug Administration. Both figures are down from last year, when more than a quarter of high-school students and about 1 in 10 middle-school students reported using e-cigarettes.

“Although the decline in e-cigarette use among our nation’s youth is a notable public health achievement, our work is far from over,” CDC Director Robert Redfield said in a statement. About 3.6 million youths reported using e-cigarettes within the prior 30 days, down from 5.4 million in the 2019 survey.

Teens who continue to vape appear to be doing so more regularly, a “disturbing” trend, Mitch Zeller, director of the FDA’s Center for Tobacco Products, said on a call with reporters Wednesday. Almost 39% of high-school students who vaped did so 20 or more days in the past month, up from about 28% two years ago, he said. Almost 23% vaped daily compared with 18% two years ago, he said.

Teens overwhelmingly said they vaped flavored e-cigarettes, despite the Trump administration’s efforts to limit their availability. Menthol, which was spared from the administration’s ban on some flavored products, was among the most popular flavors and a second report from the CDC found sales increased this year when mint was barred. More teens reported using disposable devices, a category that proliferated this year due to an exemption in the administration’s policy.

“The evidence couldn’t be clearer: As long as any flavored e-cigarettes are left on the market, kids will get their hands on them and we will not solve this crisis,” Matt Myers, president of Campaign for Tobacco-Free Kids, said in a statement.

(Michael R. Bloomberg, the majority owner of Bloomberg LP, the parent company of Bloomberg News, has given money to the organization and has funded efforts to ban flavored vaping products.)

E-Cigarette Debate

The findings could add pressure on Juul Labs Inc., the market-leading brand that regulators have blamed for igniting a teen vaping epidemic. Juul removed its best-selling mint pods from the market last fall after the federal survey identified the flavor as the most popular among youth. Its menthol pods, which are less sweet than mint, are still available and the company recently filed applications with the FDA to keep selling them.

Youth use of menthol e-cigarettes is concerning, Zeller said on the call. But the regulator cannot definitively say menthol’s popularity increased since this was the first time the survey split it from mint, which was barred from some products earlier this year.

The survey has shaped the debate around e-cigarettes in recent years. While billed as a possibly less harmful alternative for the millions of adults who smoke cigarettes, the high rate of teen vaping has cast doubt on whether the products should be available at all.

This year’s survey was conducted between January and March, and was cut two months short due to the Covid-19 pandemic, Brian King, deputy director for research translation in CDC’s Office on Smoking and Health, said on the call. It’s not clear how shutdowns have affected youth behavior, King said.

The FDA will soon determine which e-cigarettes can stay on the U.S. market and which must come off. Wednesday is the deadline for applications.

The agency will prioritize rooting out illegal disposable e-cigarettes, Zeller said on the call. These easy-to-use products have proliferated over the past year and are available in countless flavors. Those that were recently introduced without first seeking the FDA’s permission are illegal.

The FDA has already started targeting violators, including the popular brand Puff Bar. On Wednesday, the agency sent warnings to three more manufacturers.

©2020 Bloomberg L.P.