Monitoring the Future Survey Shows Youth E-Cigarette Use is a Public Health Crisis and Must Be Treated As Such
Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
December 17, 2018
WASHINGTON, DC – The 2018 Monitoring the Future survey results released today leave no doubt: Skyrocketing youth use of e-cigarettes has become a public health emergency in the United States and demands the strongest possible action by the FDA and policy makers at all levels, starting with a ban on the flavored products that have made e-cigarettes so popular with kids. The FDA’s actions to date are not enough, and we cannot afford to wait another year to see if they are having an impact.
Like the recently released results of the 2018 National Youth Tobacco Survey, Monitoring the Future shows that youth e-cigarette use has reached epidemic levels. The percentage of students who reported vaping nicotine in the past 30 days increased this year by 90 percent among 12th graders (from 11 to 20.9 percent), by 96 percent among 10th graders (from 8.2 to 16.1 percent) and by 74 percent among 8th graders (from 3.5 to 6.1 percent). This means youth vaping of nicotine nearly doubled in just one year among 12th and 10th graders, representing what the researchers said is the single largest increase in the survey’s 43-year history for any adolescent substance use outcome in the U.S. Vaping of any substance also increased substantially, reaching 26.7 percent among 12th graders.
The responsibility for this epidemic lies squarely with Juul, the e-cigarette that has become wildly popular with young people across the country. Juul cannot be taken seriously when it says it had no idea its product would appeal to kids. Juul is sleek, small and easy for kids to hide, comes in appealing flavors like mango and mint, and delivers a potent dose of nicotine, increasing kids’ risk of addiction. Juul fueled its growth with social media marketing featuring attractive young people in settings similar to what we saw in cigarette ads decades ago. Juul’s response has been to deny responsibility, run ads targeting policy makers to repair its image and hire high-priced lobbyists to fight effective regulation – all strategies right out of Big Tobacco’s playbook.
The FDA took an important first step to address this crisis last month when it announced plans to restrict sales of some flavored e-cigarettes in stores, but it didn’t include mint or menthol e-cigarettes despite the fact that more than half of all high school e-cigarette users report using these two flavors (according to the National Youth Tobacco Survey). The FDA must go further. As we and other public health organizations have repeatedly urged, the FDA should prohibit the sale of all flavored e-cigarettes that have not been subject to public health review by the agency, prohibit online sales of e-cigarettes until stronger safeguards are in place to prevent sales to kids, restrict marketing that appeals to kids, and enforce rules prohibiting the sale of new products without prior FDA review and authorization. Until the FDA acts, states and localities should continue their growing efforts to stop the sale of all flavored tobacco products.
The Monitoring the Future survey provides fresh evidence that Juul and other e-cigarettes are eroding our nation’s enormous progress in reducing youth tobacco use and addicting a new generation. The survey found that the percentage of 12th graders who reported use of any nicotine product in the past 30 days significantly increased to 28.5 percent in 2018 from 23.7 percent in 2017, with the increase driven entirely by vaping. “These results suggest that vaping is leading youth into nicotine use and nicotine addiction, not away from it,” the lead author stated.
It is too soon to tell what impact the increase in youth e-cigarette use will have on youth cigarette smoking rates. Monitoring the Future found that cigarette smoking among 12th graders continued a long decline, falling to 7.6 percent in 2018 from 9.7 percent in 2017 (and down from a high of 36.5 percent in 1997). The researchers said the 2018 decline was “consistent with a cohort effect still working its way up the age spectrum” – that is, the decline is what you would expect given previously reported declines among 8th and 10th graders. The survey found no significant decline in cigarette smoking for 8th and 10th graders in 2018.
E-cigarettes pose serious risks to the health of our children. The U.S. Surgeon General has found that youth use of nicotine in any form, including e-cigarettes, is unsafe, can cause addiction and harm the developing adolescent brain, affecting attention and learning. A January 2018 report by the National Academies of Sciences, Engineering and Medicine concluded, “There is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults.”
The Monitoring the Future survey has been conducted annually since 1975 by researchers at the University of Michigan’s Institute for Social Research and is funded by the National Institute on Drug Abuse. The e-cigarette findings of the 2018 survey were also summarized in The New England Journal of Medicine.