Vaping remained popular among teens across the United States in 2019, according to a new report, and there were significant increases in vaping of marijuana by eighth, 10th and 12th graders.
The annual report, Monitoring the Future , from the University of Michigan's Institute for Social Research , found that while prescription opioid misuse, tobacco cigarettes smoking and alcohol use have declined among teens, the use of e-cigarettes continues to climb.
"The most salient finding, in my brain at least, is the very marked increases in vaping that we're seeing in teenagers, and it's vaping both for nicotine and vaping for THC, which is the active ingredient in marijuana," said Dr. Nora Volkow, director of the National Institute on Drug Abuse , which funded the report.
"The rates of increase in vaping that we have observed in teenagers actually surpasses anything that we have seen in the past, which is basically highlighting that vaping has basically been embraced very, very promptly by teenagers."
The report is based on an annual survey of drug, alcohol and cigarette use and related attitudes among eighth-, 10th- and 12th-graders in the United States. This year's survey included 42,531 students from 396 public and private schools nationwide.
The survey results showed that 20.8% of 12th graders reported vaping marijuana in the past year, as well as 19.4% of 10th graders and 7% of eighth graders.
For the first time, the survey measured the daily vaping of marijuana and found that 3.5% of 12th graders, 3% of 10th graders and 0.8% of eighth graders reported vaping marijuana daily.
The findings come at the same time as an outbreak of vaping-related lung injuries in the United States, with most of the cases associated with THC-containing vape products. There were 2,409 hospitalized cases of lung injury linked to vaping as of December 10, according to the US Centers for Disease Control and Prevention . Vaping injuries have been reported in all 50 states, the District of Columbia, Puerto Rico and the US Virgin Islands.
Among the illnesses, 78% were in people younger than 35, the CDC has reported, with a median age of 24. Patients have been as young as 13.
"We predict that next year that awareness that vaping of THC is associated with these acute lung injuries may lead to actually a reduction of vaping among teenagers," Volkow said. "We will find out."
Illicit drug use, other than marijuana, stays relatively low
Marijuana was the most commonly used illicit drug by adolescents while rates of other illicit drug use remained relatively low, according to the new report.
After remaining mostly steady for many years, the reported daily use of marijuana has climbed significantly since 2018 among eighth and 10th graders, reaching 1.3% and 4.8% respectively, according to the report.
Yet the overall past year marijuana use rates remained steady at 35.7% among 12th graders, 28.8% among 10th graders and 11.8% among eighth graders, the report said.
Among 12th graders, the report found relatively low past year rates of using LSD at 3.6%; synthetic cannabinoids at 3.3%; cocaine and ecstasy at 2.2%; and heroin, at 0.4%.
The percentage of students reporting alcohol use in the past year saw a significant decline among 10th and 12th graders from 2014 to 2019, now at 37.7% and 52.1% respectively.
The report also found that this year 2.4% of 12th graders said they smoked cigarettes daily, marking a significant decline from 3.6% last year -- but when it comes to e-cigarettes, 11.7% of 12th graders said they vaped nicotine daily in 2019, the first year daily vaping use has been measured in the report.
"Now we're seeing it on a daily basis," said Stanton Glantz, a professor of medicine and director of the University of California, San Francisco's Center for Tobacco Control Research and Education , who was not involved in the new report.
He called the report "important" and the findings "very concerning."
"It usually takes years for kids to get from smoking cigarettes every once in a while up to daily use and the new generation of e-cigarettes is really accelerating that process," he said.
The report has some limitations, including that the survey data included only teenagers who are in school and therefore do not include youth who might have dropped out of school. Additionally, the survey results are based on information that teenagers self-reported in surveys, and therefore are subject to bias associated with self-reporting.
'A major concern'
While much progress has been made in reducing the use of alcohol, opioids and some other substances among youth, Dr. Georges Benjamin, executive director of the American Public Health Association , called the growth in vaping and marijuana use among young people "a major concern."
"Of more concern is that the youth often don't know what they are vaping and many believe it is safe. In some ways youth are simply switching from one set of addictive substance to another which is not safer," said Benjamin, who was not involved in the report.
He said that increased public education about what youth are vaping is needed.
"We also should double down our efforts on the other adolescent addictions to ensure they continue to decrease," Benjamin said. "The recently agreed upon increase to age 21 for both combustible tobacco and e-cigarettes included in the appropriations bill being voted on this week is an additional needed step."
Lawmakers have agreed to ban the sale of tobacco products to anyone under the age of 21 as part of the sweeping year-end spending agreement, according to multiple people involved in the talks. The increased age restriction for tobacco purchases is one of several provisions outside the spending measures themselves that will be attached to the broader $1.4 trillion spending agreement and likely become federal law.