U.S. e-cigarette sales jumped 46% from 2020 to 2022, CDC says

E-cigarettes pose a health risk to brain development among youth because of the nicotine found in the e-cigarettes, officials said.

“Most e-cigarettes contain nicotine, and nicotine is highly addictive and can also harm brain development in adolescents,” said Dan Suffoletto, public information manager for Public Health - Dayton and Montgomery County. “The brain continues to develop even into the mid-20s of someone’s age, so you don’t want to do anything that could hinder that development.”

Using e-cigarettes puts people at risk of developing a vaping-associated lung injury, EVALI, which can result in a permanent lung injury or death, officials said. There have been 2,807 cases of EVALI reported in the U.S with many cases directly linked to vaping, said Leah Behler, tobacco cessation grant coordinator at the Clark County Combined Health District.

Youth who use e-cigarettes may be more likely to use cigarettes later in life, the CDC says. Nearly nine out of 10 adults who smoke cigarettes daily first try smoking by age 18, and 99% first try smoking by age 26, according to the CDC.

“This data points to the fact that large numbers of American children will become addicted to nicotine and are at risk for becoming a regular tobacco user,” Suffoletto said.

Using tobacco increases the risk of dying prematurely from tobacco related diseases, said Behler.

“COPD, emphysema, heart disease, stroke and lung cancer occur at higher rates in people who use tobacco products,” Behler said. “Youth who use tobacco before the brain is fully developed at age 25 can experience impacts on learning, ability to focus, and mood regulation.”

Common signs of a teen who might be vaping are drinking more liquids than usual, persistent coughing, nosebleeds and increased irritability, Behler said.

Reported usage

The Clark County Combined Health District conducts its own Youth Risk Behavioral Survey, collecting data from school districts. The middle school results for 2021 showed approximately 16.8% of students had used an electronic vapor product and 10.6% had used one at least once within 30 days.

For high schoolers, approximately 35.8% had tried an electronic vapor product, 21.1% used one at least once within 30 days and 7.3% had used an electronic vapor product 20 or more times.

“We have a concerning rate of youth tobacco use,” Behler said. “Youth between the ages of 11 and 17 are engaging in using vapes. Vaping is considerably problematic within our school districts.”

One in three students are estimated to possess a vaping product according to the resource officer at Tecumseh High School, Behler said. Additionally, hundreds of of vape products are confiscated from students in schools in Clark County.

“Schools are having a difficult time controlling students vaping in school,” Behler said.

Montgomery County Prevention Coalition provided a breakdown of students who had used an e-cigarette in the last 30 days at Montgomery County schools:

The data is from Montgomery County Prevention Coalition’s Panorama survey of students in grades 7-12 in Montgomery County, done through the Montgomery County Educational Service Center. This data, which is also from April 2023, also showed:

Different flavors of e-cigarettes also make them more appealing to youth. Data show that a vast majority of students who use tobacco products reported using a flavored product.

“The tobacco industry is well aware that flavors appeal to and attract kids, and that young people are uniquely vulnerable to nicotine addiction,” said Robin Koval, CEO and president of the Truth Initiative, a nonprofit public health organization.

“While we are encouraged by FDA’s recent actions to curb unlawful marketing of flavored e-cigarettes, we all must work with even greater urgency to protect our nation’s youth from all flavored e-cigarettes, including disposables.”

Preventing use

As of Dec. 31, 2022, seven states including California, Maryland, Massachusetts, New Jersey, New York, Rhode Island, and Utah, along with 378 jurisdictions including counties, cities, towns, and villages, have some type of restriction on flavored e-cigarette sales in place, the CDC said.

Local agencies offer public information campaigns to help discourage use of e-cigarettes or smoking. Public Health - Dayton and Montgomery County offers CATCH My Breath, a youth nicotine vaping prevention program, to local schools to help stop the use of nicotine at an early age. The overall goal of CATCH My Breath is to prevent the initiation of e-cigarette use among preteen and teen adolescents. Suffoletto said 276 area youth participated from July 2022 to January 2023.

Public health experts also encourage parents to talk to their kids about vaping, address peer use, and practice refusal skills.

“Teens are encouraged to choose healthier activities and coping skills. There are a variety of strategies to use that are better ways to deal with stress instead of nicotine products,” Behler said.