The Decline in e-Cigarette Use Among Youth in the United States-An Encouraging Trend but an Ongoing Public Health Challenge.

Introduction:
This text is a commentary on the decline in e-cigarette use among youth in the United States, highlighting the encouraging trend but also the ongoing public health challenge. The authors analyze the potential factors leading to this decline, including changes in the perception of accessibility and harm associated with e-cigarettes. Furthermore, the text discusses the impact of the COVID-19 pandemic on e-cigarette use patterns.

Key Points:

* The 2014 Surgeon General's report warned that 5.6 million youth in the US would die prematurely from smoking-related illnesses.
* E-cigarette use among middle and high school students has been an epidemic, with high proportions preferring flavored, especially fruit-flavored, products.
* From 2019 to 2020, e-cigarette use declined by approximately one-quarter in high school students and by approximately half in middle school students.
* Among those who used e-cigarettes, a significant proportion used them on 20 or more days in the past 30 days, including daily use.
* The perception of e-cigarettes being easily accessible decreased from 2019 to 2020, and the perception of great harm from occasional and regular nicotine vaping increased.
* The COVID-19 pandemic may have accelerated the decline in e-cigarette use among youth, with 56.4% of respondents changing their e-cigarette use patterns.
* Despite the decline, the prevalence of e-cigarette use among youth remains high, and e-cigarette use may be associated with short- and long-term health risks across different racial and ethnic groups.

Main Message:
The main message conveyed in this text is that while the decline in e-cigarette use among youth is encouraging, it is crucial to sustain this positive trend through continued public health programs. These programs should raise awareness about the harmful effects of e-cigarettes and ensure enforcement of age restrictions on e-cigarette sales. The COVID-19 pandemic has provided an opportunity to further decrease e-cigarette use among students and extend these efforts to young adults and the general adult population. Moreover, the text emphasizes the potential racial and ethnic disparities in e-cigarette use and associated health risks, which warrant further investigation.

Choi BM, Abraham I. The Decline in e-Cigarette Use Among Youth in the United States-An Encouraging Trend but an Ongoing Public Health Challenge. JAMA network open. 2021;4(6):1. doi:10.1001/jamanetworkopen.2021.12464