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Tag: National Youth Tobacco Survey

  • Vapers Starting Younger: Study

    Vapers Starting Younger: Study

    Photo: eldarnurkovic

    Although the prevalence of teen vaping has declined in recent years, those who do vape are starting younger and using e-cigarettes more intensely, according to a new study published in JAMA Network Open by investigators at Massachusetts General Hospital (MGH) in collaboration with Stanton A. Glantz, a retired professor from the University of California at San Francisco.

    In the analysis of data from the annual National Youth Tobacco Survey, a nationally representative survey of middle school and high school students in grades 6–12, researchers found that e-cigarette prevalence among youth peaked in 2019 then declined, but e-cigarette initiation age dropped between 2014 and 2021, and intensity of use and addiction increased after the introduction of protonated nicotine products.

    Protonated nicotine is created by adding acid to the e-cigarette liquid, which makes the nicotine easier to inhale. Since Juul pioneered protonated nicotine, it has been widely adopted by other e-cigarette companies.

    Age at first use of e-cigarettes fell by 1.9 months per year while age at first use of cigarettes, cigars and smokeless tobacco did not change significantly. By 2017, e-cigarettes became the most common first tobacco product used.

    E-cigarette nicotine addiction, measured as the odds of use within five minutes of waking, an indicator of addiction, increased over time. By 2019, more youth e-cigarette users were using their first tobacco product within five minutes of waking than for cigarettes and all other products combined. The percent of sole e-cigarette users who used e-cigarettes within five minutes of waking was around 1 percent through 2017, but then it increased every year, reaching 10.3 percent youth using their first e-cigarette within five minutes of waking by 2021.

    Median e-cigarette use also increased from three days to five days per month in 2014–2018 to six days to nine days per month in 2019–2020 and 10 days to 19 days per month in 2021.

    The recently released 2022 National Youth Tobacco Survey data show that 2.55 million adolescents use e-cigarettes and 27.6 percent of adolescents use e-cigarettes daily. The comparable numbers reported in this paper for 2021 were 2.1 million and 24.7 percent.

    “The increasing intensity of use of modern e-cigarettes highlights the clinical need to address youth addiction to these new high-nicotine products over the course of many clinical encounters,” said senior author Jonathan P. Winickoff, a pediatrician at MGH and a professor of pediatrics at Harvard Medical School, in a press note.

    “In addition, stronger regulation including state and local comprehensive bans on the sale of flavored tobacco products, such as voting YES on Proposition 31 on California’s November ballot, should be implemented,” said first author Glantz.

  • VTA Questions FDA’s Youth Vaping Analysis

    VTA Questions FDA’s Youth Vaping Analysis

    Tony Abboud (Photo: Taco Tuinstra)

    The U.S. Food and Drug Administration misrepresents the latest data on youth vaping, according to Vapor Technology Association (VTA) Executive Director Tony Abboud.

    On Oct. 6, the FDA and the U.S. Centers for Disease Control and Prevention released new data from the 2022 National Youth Tobacco Survey (NYTS) on e-cigarette use among U.S. youth.

    “The FDA represents the NYTS data to show that youth vaping ‘remains high,’ yet a deeper dive into the data show[s] only a small uptick in experimental or infrequent use while regular use remains flat or is slightly down,” said Abboud in a statement.

    Abboud notes that since 2019, according to the CDC, the number of high school students who have tried vaping (one time in the last 30 days) has dropped by 50 percent, and the number of middle school students has plummeted by 70 percent. During that same time period, the number of high school students who “frequently” vape dropped by 37 percent, and the number of middle school students dropped by 65 percent.

    “FDA’s near single-minded focus on youth who experiment with vaping versus those who are frequent users ignores what clearly is a consistent trend of youth away from vaping products. Rather than focusing on removing products from the market in an attempt to impact youth vaping, the FDA should instead support common sense regulatory reforms that would better restrict access to products instead,” said Abboud. “Simply removing products from the market is not the answer when those products are also proven to help adult smokers quit.”

    According to Abboud, it is well documented that flavored vapor products help adult smokers switch to less harmful vaping and “study after study after study” has confirmed the data. Since 2010, when e-cigarettes became widely available in the U.S., smoking rates have declined by more than half, he noted.

    “Tobacco use is down. Youth vaping is down. These are both good things and are not in dispute. Unfortunately, there are still 40 million Americans addicted to cigarettes,” Abboud said. “Every year, 500,000 die from smoking-related diseases and yet less than 3 percent of our kids are using vapes on a regular basis. The FDA’s failure to acknowledge this reality ignores the role vaping plays in harm reduction and smoking cessation and puts more lives at risk.”

  • FDA Issues Warning to Puff Bar, MDOs to Hyde

    FDA Issues Warning to Puff Bar, MDOs to Hyde

    Credit: Puff Bar

    New data from the 2022 National Youth Tobacco Survey (NYTS) shows that 2.5 million U.S. youth use e-cigarettes, according to the published findings in the Morbidity & Mortality Weekly Report released by the U.S. Food and Drug Administration in conjunction with the Centers for Disease Control and Prevention.

    “The FDA remains deeply concerned about e-cigarette use among our nation’s youth. It’s clear that we still have a serious public health problem that threatens the years of progress we have made combatting youth tobacco product use,” said FDA Commissioner Robert M. Califf. “We cannot and will not let our guard down on this issue. The FDA remains steadfast in its commitment to using the full range of our authorities to address youth e-cigarette use head-on.”

    The study shows that about one in 10 middle school (3.3 percent) and high school (14.1 percent) students reported current e-cigarette use; current use is defined as use within the past 30 days. About 85 percent of surveyed students reported using flavored e-cigarettes while 27.6 percent reported daily use. Respondents most commonly used disposables, with Puff Bar being most common (14.5 percent) followed by Vuse (12.5 percent) and Hyde (5.5 percent). Puff Bar and Vuse were pre-specified options on the survey, but Hyde was written in by students as their preferred brand.

    Since methodology changes occurred, including in survey administration and data collection procedures due to the Covid-19 pandemic, comparisons between the 2022 NYTS and previous years is limited.

    Following the release of this data, the FDA has issued a warning letter to Puff Bar for receiving and delivering e-cigarettes in the U.S. without a marketing authorization order. The FDA has requested a response within 15 working days of receiving the letter, detailing how the company intends to address the FDA’s concerns, including the dates on which they discontinued the sale and/or distribution of these tobacco products and plans for maintaining compliance with the Federal Food, Drug and Cosmetic Act. Failure to address the violations puts the manufacturer at risk of regulatory action, such as a civil money penalty, product seizure and/or injunction.

    The Puff products subject to this warning letter are nontobacco nicotine products.

    After reviewing premarket tobacco product applications for 32 Hyde e-cigarettes, the FDA issued marketing denial orders (MDOs) for these applications submitted by Magellan Technology Inc. In conducting its scientific review, the FDA determined that the applications lacked sufficient evidence demonstrating that the products would provide a benefit to adult users that would be adequate to outweigh the risks to youth. No Hyde products have received marketing authorization orders from the FDA.

    “Congress gave the FDA authority to hold manufacturers and retailers who violate the law accountable,” said Brian King, director of the FDA’s Center for Tobacco Products. “FDA is actively working to identify violations and to swiftly seek corrective actions, particularly for products popular among youth. We will use all compliance and enforcement tools available to us, as appropriate, to protect our nation’s youth.”