The rate of youth use of traditional cigarettes rose in 2020, while e-cigarette use dropped slightly, according to the latest version of a national report on alcohol, drugs and tobacco.
The 2020 Monitoring the Future study, released this week by the University of Michigan, found that 12th-graders’ consumption of traditional cigarettes increased from a record low of 5.7% in 2019 to 7.5%.
Meanwhile, 28.2% of 12th-graders said they vaped at least once during the 30-day period. That’s down from a record high of 30.9% in 2019. Researchers began reviewing vaping in 2015 when the rate was 16.3%.
Smokeless tobacco use remained at a historic low of 3.5% among 12th-graders.
Consumption is considered at least one use of the products in a 30-day period.
Researchers typically survey between 40,000 and 50,000 eighth-, 10th- and 12th-grade students in about 400 secondary schools.
For 2020, because of the COVID-19 pandemic, 11,821 students were surveyed from 112 secondary schools from Feb. 11 to March 14.
On Thursday, the Food and Drug Administration and federal Centers for Disease Control and Prevention released their 2020 National Youth Tobacco Survey report.
Their report found that 23.6% of high schoolers said they had used a tobacco product at least once in a 30-day period during 2019, as well as 8.2% who said they used multiple tobacco products.
Traditional cigarettes were used by 4.6% of high schoolers, along with electronic cigarettes by 19.6%.
"Approximately one in six U.S. middle and high school students, or approximately 4.47 million youths overall, reported current use of any tobacco product," according to the report.
"The comprehensive and sustained implementation of evidence-based tobacco control strategies at the national, state and local levels, combined with tobacco product regulation by FDA, is warranted for continuing progress toward reducing and preventing all forms of tobacco product use among U.S. youths."
On the decline
Youth traditional cigarette smoking has been on a steady decline since topping out at 36.5% in 1997 — the year before the landmark Master Settlement Agreement was reached between 46 state attorneys general and the top U.S. tobacco manufacturers.
Tobacco analysts say traditional cigarette manufacturers are benefiting from anti-tobacco advocates' efforts targeting electronic cigarettes, particularly use by those under age 21.
In February, the Food and Drug Administration limited closed-pod flavors to menthol and tobacco. President Donald Trump signed into law on Dec. 20, 2019, legislation that raised the legal smoking age from 18 to 21.
E-cigarette sales have slumped industrywide, outside of R.J. Reynolds Vapor Co.'s No. 2-selling Vuse, for much of 2020.
"The attacks on alternatives to cigarettes has led to a far more buoyant market for cigarettes, which has given the cigarette companies an opportunity to raise prices this year by an unprecedented level," said David Sweanor, an adjunct law professor at the University of Ottawa and the author of several e-cigarette and health studies.
Interestingly, the dramatic decline in traditional cigarettes has become almost an afterthought to the study’s researchers, as well as many anti-tobacco advocates and the Food and Drug Administration. They are all putting more emphasis on youth vaping and e-cig use.
“The rapid rise of teen nicotine vaping in recent years has been unprecedented and deeply concerning since we know that nicotine is highly addictive and can be delivered at high doses by vaping devices, which may also contain other toxic chemicals that may be harmful when inhaled,” Dr. Nora Volkow, director of National Institute on Drug Abuse, said in a statement.
"It is encouraging to see a leveling off of this trend, though the rates still remain very high."
Matthew Myers, president of the Campaign for Tobacco-Free Kids, said the report "provides fresh evidence that youth e-cigarette use remains at epidemic levels in the United States, and that young people continue to have easy access to the flavored products that have fueled this youth nicotine addiction crisis."
"These results further demonstrate that as long as any flavored e-cigarettes are left on the market, kids will get their hands on them and we will not end this crisis."
One of the largest disputes involving youth consumption of tobacco products is whether vaping serves as a gateway to smoking traditional cigarettes.
Myers said the increase in youths smoking traditional cigarettes is troubling.
"It raises questions about the impact of skyrocketing e-cigarette use on youth smoking, and warrants close attention and strong action to prevent youth use of all tobacco products."
The shifts in youth traditional and electronic cigarette uses "are not game changers, but I also don’t want to see them extended," said Brad Rodu, a professor of medicine at the University of Louisville and an anti-smoking advocate.
"I am reluctant to base the changes in teen vaping on anything the FDA has or hasn’t done, but perhaps on the more general federal campaign on vaping."
Rodu said that youth usage of e-cigarettes may have been affected more by "claims of a teen epidemic, a tsunami of exaggerated and fake scientific/medical studies, and finally the CDC’s failure to acknowledge that (lung injuries in 2019) were caused by tainted THC cartridges, and not nicotine e-cigarettes."
THC is the primary psychoactive component in cannabis.