Good news: Youth e-cig use dropped in 2020

The CDC recently reported big drops in e-cigarette use between 2019 and 2020 (high school dropped from 27.5% to 19.6% and middle school dropped from 10.5% to 4.7%).

As the figure above (courtesy of CDC.) shows, however, e-cig use is still very high, way above where cigarette smoking and e-cigarette use were nine years earlier in 2011.

Overall combustible product use, while well below e-cig use, also dropped, although many fewer kids were using combustible tobacco products than e-cigs, which dominate the youth market.

These data are from the CDC/FDA National Youth Tobacco Survey which was conducted from January-March 2020 just before the COVID-19 shelter-in-place.

I hope that the FDA will consider these very high levels of youth e-cig use — even after the substantial drop — in assessing whether the thousands of e-cig premarket tobacco applications (PMTA) justify authorizing e-cigs as “appropriate for the protection of public health.” Like the cigarette companies that now control the e-cig industry, the e-cig companies have publicly claimed that that they don’t want kids using them and that they don’t promote them to kids. They are, no doubt, including such claims in their PMTA applications. But the reality, as shown by these new data — collected by the CDC in collaboration with FDA — show that these claims are hollow. FDA needs to look beyond what the applicants say in their PMTAs and consider this reality when assessing the applications.

Given this reality, combined with the reality that, as consumer products, e-cigarettes do not help smokers quit, I don’t see how the FDA Center for Tobacco Products can approve any of the PMTAs.

In addition, another paper, “Underage Youth and Young Adult e-Cigarette Use and Access Before and During the Coronavirus Disease 2019 Pandemic,” by Shivani Mathur Gaiha and colleagues from Stanford and UCSF using data collected in May 2020 found that many youth and young adults stopped using e-cigs or cut down after the shelter-in-place orders, which would amplify the effect the CDC reported.

This is very good news during otherwise dark times.

The full citations of the two papers are:

• Gentzke AS, Wang TW, Jamal A, Park-Lee E, Ren C, Cullen KA, Neff L. Tobacco Product Use Among Middle and High School Students – United States, 2020. MMWR Morb Mortal Wkly Rep. 2020 Dec 18;69(50):1881-1888. doi: 10.15585/mmwr.mm6950a1. PMID: 33332300; PMCID: PMC7745956.
• Gaiha SM, Lempert LK, Halpern-Felsher B. Underage Youth and Young Adult e-Cigarette Use and Access Before and During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open. 2020 Dec 1;3(12):e2027572. doi: 10.1001/jamanetworkopen.2020.27572. PMID: 33270127; PMCID: PMC7716191.