Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018

Introduction:
This text is a summary of a study on the use of electronic cigarettes (e-cigarettes) and other tobacco products among middle and high school students in the United States from 2011 to 2018. The study, published in the Morbidity and Mortality Weekly Report, highlights the increasing trend of e-cigarette use among youths and the impact on overall tobacco product use.

Key Points:

* The study used data from the National Youth Tobacco Survey, a cross-sectional, voluntary, school-based, self-administered, pencil-and-paper survey of U.S. middle and high school students.
* Current e-cigarette use among high school students increased from 1.5% in 2011 to 20.8% in 2018, representing a 78% increase during 2017-2018.
* Among high school students, the proportion of current e-cigarette users who reported use on ≥20 of the past 30 days increased from 20.0% in 2017 to 27.7% in 2018.
* Current use of any flavored e-cigarettes increased among current e-cigarette users from 60.9% in 2017 to 67.8% in 2018.
* Current e-cigarette use among middle school students increased from 0.6% in 2011 to 4.9% in 2018, representing a 48% increase during 2017-2018.
* Current use of any tobacco product among high school students was 24.2% in 2011 and 27.1% in 2018, while among middle school students, it was 7.5% in 2011 and 7.2% in 2018.
* The study notes that the rise in e-cigarette use during 2017-2018 is likely due to the recent popularity of e-cigarettes shaped like a USB flash drive, such as JUUL, which can be used discreetly, have a high nicotine content, and come in flavors appealing to youths.

Main Message:
The study highlights the concerning trend of increasing e-cigarette use among middle and high school students in the United States. The rise in e-cigarette use is likely due to the popularity of USB flash drive-shaped devices, such as JUUL, which can be used discreetly and come in flavors appealing to youths. The study emphasizes the need for sustained implementation of proven population-based strategies, in coordination with the regulation of tobacco products by the Food and Drug Administration, to reduce all forms of tobacco product use and initiation among U.S. youths. The Surgeon General has concluded that e-cigarette use among youths and young adults is of public health concern as exposure to nicotine during adolescence can cause addiction and harm the developing adolescent brain.

Cullen, Karen A., Bridget K. Ambrose, Andrea S. Gentzke, Benjamin J. Apelberg, Ahmed Jamal, and Brian A. King. “Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018.” MMWR. Morbidity and Mortality Weekly Report 67, no. 45 (November 16, 2018): 1276–77. https://doi.org/10.15585/mmwr.mm6745a5.