First Decline Seen in 'Vaping' Among U.S. Teens: CDC

Drop fueled a decrease in use of all tobacco products, report finds

Thursday, June 15, 2017

THURSDAY, June 15, 2017 (HealthDay News) -- For the first time since the U.S. government began tracking e-cigarette use among American youth, a new report shows fewer teens are vaping.

The drop was significant, falling from 3 million in 2015 to 2.2 million in 2016, according to the U.S. Centers for Disease Control and Prevention.

And that trend largely fueled a decrease in overall tobacco use by high school and middle school students, health officials added. In 2015, 4.7 million teens used tobacco products, but that number dropped to 3.9 million in 2016.

However, that means nearly 4 million middle and high school students are still using tobacco products, the CDC researchers said.

"We have some good news, and we have some bad news," said Brian King, deputy director of research translation in CDC's Office on Smoking and Health. "The good news is that the use of any tobacco product has declined in 2015 to 2016. This is a good thing, it's a public health win.

"However, on balance the bad news is that we've still got 4 million teenagers that are still using tobacco," he said.

But the news on the e-cigarette front remained a bright spot in the findings.

"This is the first time we have seen a decline in e-cigarette use since we started measuring it in 2011," King said. "We believe the decline is the result of many things, the most notable of which is the effort by the public health community to educate the general public about the harms of e-cigarettes to youth and young adults."

The vapor produced by e-cigarettes is not harmless, King noted. It contains nicotine, which is highly addictive and can harm the developing adolescent brain. "But it also includes other ingredients, such as ultra-fine particulates that go deep into the lungs and heavy metals and volatile organic compounds," he said.

Despite the decline in e-cigarette use, King said it is essential to reduce all tobacco use.

"We don't want to get to a point where we're playing public health whack-a-mole, where we are allowing certain products to go up and others to go down. The goal is to reduce all forms of tobacco products," he said. "Youth use of any tobacco product is unsafe, irrespective of whether it's smoked, smokeless or electronic."

King is also concerned about the array of new tobacco products that may make their way to the market. There is a need to modernize tobacco control strategies to address the diversity of products, he said.

"We have made strides in the past decades to denormalize cigarette smoking, but the landscape is rapidly diversifying with a lot of new products," King said. "There is a lot of uncertainty and lack of knowledge in terms of what the health risks of these products are."

The researchers did find that the number of teens who used one or more tobacco products also declined from 2015 to 2016. This decline included smoking cigarettes or cigars or using hookahs.

But nearly half of those using tobacco products said they used several of them, the researchers reported.

Nearly 2 million middle and high school students said they had used two or more tobacco products in the past 30 days. In 2016, of all teens who currently used tobacco, 47 percent of high school students and 42 percent of middle school students said they used two or more products.

E-cigarettes were the most commonly used tobacco product, King said. That has been the case for three consecutive years, he said. Among high school students, 11 percent said they used e-cigarettes, as did a little more than 4 percent of middle school students, according to the report.

Key findings in the report include:

In 2016, the most commonly used products among high school students after e-cigarettes were: cigarettes (8 percent), cigars (7.7 percent), smokeless tobacco (nearly 6 percent), hookah (4.8 percent), pipe tobacco (1 percent), and bidis (0.5 percent).
In 2016, the most commonly used products among middle school students after e-cigarettes were: cigarettes (2 percent), cigars (2 percent), smokeless tobacco (2 percent), hookah (2 percent), pipe tobacco (0.7 percent), and bidis (0.3 percent).
Among white and Hispanic high school students, e-cigarettes were the most commonly used product. Among black high school students, cigars were the most commonly used product.
More whites than blacks smoked cigarettes, and whites used more smokeless tobacco than others.

Matthew Myers is president of the Campaign for Tobacco-Free Kids. "This report comes at a time when the programs that are driving a decline in tobacco use are in jeopardy in Congress," he said.

The decline in smoking and the use of e-cigarettes shows that efforts to reduce tobacco use are paying off, Myers said. "It's making a lifesaving impact," he stressed.

These programs, however, are in danger of disappearing, Myers said. President Donald Trump's budget proposes to eliminate the CDC's office on tobacco and zero out all tobacco-related funds, while proposals in Congress would curtail the FDA's authority over both cigars and e-cigarettes, he said.

"The decline in tobacco use among our nation's children is going to pay dividends in terms of reduced death and disease in the decades to come," Myers said. "But only if we keep doing what we've been doing. If we backslide, these gains will only be temporary."

However, FDA Commissioner Dr. Scott Gottlieb noted that the agency is taking a hard line against those who sell tobacco products.

"Another pillar of our efforts is to make sure retailers understand and take seriously their responsibility of keeping harmful and addictive tobacco products out of the hands of children," Gottlieb said in a statement.

"In particular, the FDA has issued more than 4,000 warning letters to brick-and-mortar and online retailers for selling e-cigarettes, cigars or hookah tobacco to minors since new youth access restrictions went into effect in August 2016," he noted.

The report was published June 16 in Morbidity and Mortality Weekly Report, a CDC publication.

SOURCES: Brian King, Ph.D., deputy director, research translation, Office on Smoking and Health, U.S. Centers for Disease Control and Prevention; Matthew Myers, president, Campaign for Tobacco-Free Kids; June 16, 2017, Morbidity and Mortality Weekly Report

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