U.S. youth continue to be enticed and hooked by expanding variety of e-cigarettes, study shows

Reviewed by Emily Henderson, B.Sc.Oct 12 2022

A study released today from the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention (CDC) found that 2.55 million U.S. middle and high school students reported current (past 30-day) e-cigarette use in 2022, which includes 14.1% of high school students and 3.3% of middle school students. Nearly 85% of those youth used flavored e-cigarettes and more than half used disposable e-cigarettes.

Among youth who currently used e-cigarettes, 14.5% reported their usual brand was Puff Bar, followed by Vuse (12.5%), Hyde (5.5%), and SMOK (4.0%); more than one fifth (21.8%) reported their usual brand was a brand other than the 13 listed in the survey.

The findings, published in the Morbidity and Mortality Weekly Report, are based on data from the 2022 National Youth Tobacco Survey (NYTS), a cross-sectional, self-administered survey of U.S. middle (grades 6–8) and high (grades 9–12) school students, which was administered January 18–May 31, 2022. The study assessed current use (on one or more of the past 30 days) of e-cigarettes; frequency; and use by device type, flavors, and usual brand.

This study shows that our nation's youth continue to be enticed and hooked by an expanding variety of e-cigarette brands delivering flavored nicotine. Our work is far from over. It's critical that we work together to prevent youth from starting to use any tobacco product – including e-cigarettes – and help all youth who do use them, to quit."

Deirdre Lawrence Kittner, Ph.D., M.P.H., Director of CDC's Office on Smoking and Health

Other key findings

• Frequency of Use: Among youth who currently used e-cigarettes, more than one in four (27.6%) used them daily and more than four in 10 (42.3%) used them on 20 or more of the past 30 days.
• Device Type: Among youth who currently used e-cigarettes, the most commonly used e-cigarette device type was disposable (55.3%), followed by prefilled or refillable pods or cartridges (25.2%), and tanks or mod systems (6.7%). Additionally, 12.8% reported not knowing the type of device used.
• Flavored E-cigarettes: Among youth who currently used e-cigarettes, 84.9% used flavored e-cigarettes, i.e., with flavors other than tobacco, including 85.5% of high school and 81.5% of middle school students reporting use. Overall, the most used flavors were fruit (69.1%); candy, desserts, or other sweets (38.3%); mint (29.4%); and menthol (26.6%).

"Adolescent e-cigarette use in the United States remains at concerning levels, and poses a serious public health risk to our nation's youth," said Brian King, Ph.D., M.P.H., director of the FDA's Center for Tobacco Products. "Together with the CDC, protecting our nation's youth from the dangers of tobacco products-;including e-cigarettes-;remains among the FDA's highest priorities, and we are committed to combatting this issue with the breadth of our regulatory authorities."

Due to changes in methodology, including differences in survey administration and data collection procedures in recent years due to the COVID-19 pandemic, the ability to compare estimates from 2022 with those from prior NYTS waves is limited; differences between estimates might be due to changes in methodology, actual behavior, or both.

Addressing youth tobacco product use

Youth use of tobacco products in any form, including e-cigarettes-;is unsafe. Such products contain nicotine, which is highly addictive and can harm the developing adolescent brain. Using nicotine during adolescence might also increase risk for future addiction to other drugs.

Since 2014, e-cigarettes have been the most used tobacco product among U.S. youth. As the tobacco product landscape continues to change, the sustained implementation of comprehensive tobacco prevention and control strategies at the national, state, and local levels, coupled with FDA regulations, is critical to prevent and reduce youth access to and use of e-cigarettes.