Vaping Facts and Myths

Keeping Glen Cove SAFE: Vaping Facts and Myths

The SAFE Glen Cove Coalition is concerned about youth vaping use and its consequences. In vaping, a battery powered device called an e-cigarette heats a liquid into a vapor that can be inhaled. The vapor may contain nicotine (the addictive drug in tobacco), flavoring, and other chemicals. E-cigarettes can also be used with marijuana, hash oil, or other substances. Vaping may pose serious and avoidable health risks. Exposure to nicotine during youth can lead to addiction and cause long-term harm to brain development. The vapor can also contain toxins (including ones that cause cancer) and tiny particles that are harmful when breathed in.

Monitoring the Future (MTF) is one of the nation’s most relied upon scientific sources of valid information on trends in use of licit and illicit psychoactive drugs by U.S. adolescents, college students, young adults, and adults up to age 60. MTF is conducted each year by researchers at the University of Michigan, Ann Arbor, and funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

The MTF survey is given annually to students in eighth, 10^th, and 12^th grades who self-report their substance use behaviors over various time periods, such as past 30 days, past 12 months, and lifetime. The survey also documents students’ perception of harm, disapproval of use, and perceived availability of drugs and has been doing so since 1975.

In 2023 7,584 12th grade students in 83 schools distributed throughout the US. Data collection took place in both public and private high schools. MTF used an electronic questionnaire format for the fifth consecutive year. Starting in 2021, students in 8th, 10th, and 12th grades completed a web-based questionnaire on their own electronic devices during class time (which may have been at home if they were schooling remotely, for example as a result of the pandemic). In both 2019 and 2020 students also completed an electronic questionnaire that was connected to the internet, although they completed the survey on electronic tablets that MTF brought to schools. It is no longer necessary for MTF to bring tablets to schools because practically all schools now have internet access and almost all students have electronic devices to complete the MTF questionnaires. In rare cases when these resources are not available at a school, MTF brings electronic devices for students, as well as a mobile server to collect their survey responses.

The survey results divide neatly into the time periods before and after the onset of the pandemic. All surveys in 2020 were completed before March 15, when national social distancing policies were enacted, and data collection was halted due to pandemic concerns. Consequently, results from 2020 and previous years are pre-pandemic, while results from 2021 and afterwards took place after the onset of the pandemic and the associated national response. The COVID-19 pandemic is a historical event of particular interest for the 2023 results. From 2020 to 2021 MTF documented some of the largest one-year declines ever recorded by the survey across a wide variety of drugs from. It is possible that these decreases will hold for future years going forward, or, instead, drug prevalence levels may bounce back to where they were before the pandemic, as recorded by MTF with the 2020 results.

The percentage of students who vaped nicotine in 2023 decreased in all grades for lifetime, past 12-month, and past 30-day use.

In 12th grade the declines were statistically significant for all three reporting intervals.

In 10th grade the declines were statistically significant for past 12- month and past 30-day use.

These declines reflect the lasting effect of processes set into place three years earlier. The 12th grade students of 2023 were in a cohort that started high school in 9th grade during 2020, when most U.S. school buildings closed because of the pandemic. While in 9th grade these students 49 initiated nicotine vaping at record low levels, 3 which had a lasting effect. When these students were in 12th grade in 2023 the percentage who vaped nicotine in the past 12 months and first ever vaped in 9th grade was a striking 36% lower than in it had been for 12th grade students in 2022, whose 9th grade experience was not disrupted by the pandemic.

These low levels of initiation in 9th grade for the 2023 12th grade cohort accounted for most of their decline in nicotine vaping. Similarly, most of the decline in past 12-month nicotine vaping for 10th grade students in 2023 resulted from lasting, lower levels of initiation three years earlier in 7th grade, which is the start of junior high school.

Despite the recent declines in use, the prevalence of nicotine vaping remains one of the highest among all adolescent substances. In 2023 its past 12-month prevalence levels of 11% in 8th grade and 18% in 10th grade are second only to alcohol.

Nicotine vaping’s prevalence of 23% in 12th grade ranks third behind alcohol and marijuana use. These high rankings are largely due to the very sharp increases in the prevalence of nicotine vaping between 2017 and 2019. All results from 2020 are from surveys completed before March 15, 2020, when national social distancing policies were implemented and the survey halted due to pandemic concerns.

Vape Marijuana (Cannabis) In 2023 the percentage of students who vaped marijuana changed little in all three grades. As a result, the substantial decreases in prevalence that took place during the pandemic onset in 2021 in 8th and 10th grade largely persisted into 2023. This pattern was apparent for lifetime, past 12-month, and past 30-day use. In 12th grade prevalence levels did not decline as much as they did in the lower grades during the pandemic in 2021, and annual use levels in 12th grade have hovered at around 20% since 2019. This pattern differs from overall marijuana use, for which prevalence levels decreased in 2021 and this decrease persisted into 2022 and 2023. Large increases in marijuana vaping in previous years were not accompanied by increases in overall marijuana use. These results suggest that marijuana vaping is not increasing the pool of adolescent marijuana users. It could substitute for combustible marijuana use, it could serve as a way for marijuana users to avoid detection by adults (because vaped marijuana does not have the distinctive smell of combustible marijuana), and/or it could be a way for users to supplement their combustible marijuana use. All results from 2020 are from surveys completed before March 15, 2020, when national social distancing policies were implemented and the survey halted due to pandemic concerns.

The percentage of youth who report that they vaped “just flavoring” in their lifetime and in the past 12 months did not return to 2020 levels by 2023. This behavior remains somewhat common, with nearly one in five 12th graders reporting that they vaped ‘just flavor’ in their lifetime and more than one in ten reporting having done so in the last 12 months.

Practically all youth who report vaping ‘just flavoring’ also report vaping nicotine (as indicated by very low prevalence in the “Vape flavoring without nicotine” tables and graphs). Most adolescents who vape “just flavoring” are doing so as a supplement to their nicotine vaping and not as a substitute for it.

All results from 2020 are from surveys completed before March 15, 2020, when national social distancing policies were implemented, and the survey halted due to pandemic concerns. Vape Flavoring Without Nicotine In 2017 MTF started asking students if they vaped “just flavoring.”

A substantial prevalence of this outcome could raise at least two potential scenarios. First, it could be possible that a portion of youth believed they were not vaping nicotine when in fact they were. Second, if students truly were vaping only flavoring, then the recent large increases in adolescent vaping may be less alarming than it first appeared—to the extent that adolescents are not being exposed to the addictive chemical nicotine. These two potential scenarios are not supported by the results.

The finding that in 2023 1% of students or less in all grades report vaping flavoring exclusively without nicotine in the past 30 days indicates that practically all students who report vaping “just flavoring” are also vaping nicotine.

Resources and Data

Please see the following helpful links for information about the dangers of vaping:

American Lung Association: Tobacco Cessation Resources for Teens

United States Department of Health and Human Services: 2020 Smoking Cessation: A Report of the Surgeon General

This report is the latest of a longstanding tradition of tobacco prevention and control efforts by USDHHS. Our work includes a comprehensive tobacco control strategic action plan, Ending the Tobacco Epidemic, and coordination of tobacco control efforts with related efforts by other federal agencies through the Interagency Committee on Smoking and Health. Reports such as this one from the U.S. Surgeon General give the latest data on tobacco and health to scientists, healthcare professionals, and the public.

Child Mind Institute: Teen Vaping: What Parents Need to Know

Know the Risks: E-Cigarettes & Young People

The Surgeon General declares Vaping a Pediatric Epidemic

National Center for Health Research: Is Vaping Safer than Smoking Cigarettes?

National Institute on Drug Abuse (NIDA): Teens and E-Cigarettes

National Institute on Drug Abuse (NIDA): Electronic Cigarette Facts

FDA Center for Tobacco Products: Vaping Misperceptions (Spanish Edition)

The Monitoring The Future (MTF) survey 2020 was released by the National Institute of Drug Abuse (NIDA). The MTF survey has measured drug and alcohol use and related attitudes among adolescent students nationwide since 1975. Survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. The survey is funded by the NIDA and conducted by the University of Michigan.

NYS Department of Health Bureau of Tobacco Control: Percent of NYS HS Students Open to Smoking and Using e-Cigarettes

The New York State Department of Health released of a new BRFSS Brief: Electronic Cigarette Use. New York State Adults, 2017. In New York State (NYS) an estimated 541,000 adults, or 3.8% of the state’s adult population aged 18 years and older, currently use e-cigarettes every day or some days. Among NYS adults, current use of e-cigarettes is highest among:

Adults who are current smokers (12.8%)
Young adults 18-24 years of age (9.7%)
Adults enrolled in Medicaid (6.5%)
Adults reporting frequent mental distress (6.4%), defined as adults who report problems with stress, depression, or emotions on at least 14 of the previous 30 days (formerly referred to as poor mental health)
Adults who are unemployed (6.3%)

New York State Department of Health:

The New York State Department of Health has provided an update regarding the investigation into the outbreak of vaping-associated pulmonary illness. This includes a new health advisory for healthcare providers, a breakdown of cases by county and collaboration on a study published. The advisory can be found on the NYSDOH website.
Behavioral Risk Factor Surveillance System (BRFSS) Cigarette Smoking NYS Adults 2020

Partnership for Drug Free Kids: What You Need to Know and How to Talk to Your Kids About Vaping

Centers for Disease Control: Electronic Cigarettes- What’s the Bottom Line? Factual information regarding what vaping is and its negative consequences (PDF)

American Lung Association: Parents can play a significant role in protecting their child from the dangers of vaping and nicotine dependence. Please use the tips and suggestions in this guide as a framework for having a productive conversation with your child.

American Lung Association: E-cigarette or Vaping Use-Associated Lung Injury (EVALI)

American Lung Association: Marijuana and Lung Health

American Lung Association: Health Risks of E-Cigarettes and Vaping

American Lung Association: E-Cigarettes Vapes and JUULs-What Teens Should Know

Centers for Disease Control: Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults

E-cigarettes Outpace Cigarettes, Alcohol and Marijuana in Usage Among Teens

Dartmouth-Hitchcock Medical Center: Study – E-cigarettes May Be More Harmful Than Beneficial

Community Anti Drug Coalitions of America (CADCA): What’s Trending? E-Cigarettes

Community Anti Drug Coalitions of America (CADCA): This Practical Theorist is part of a series of publications designed to summarize field research on key drug abuse issues, and to present it in a concise, practical format, with strategies for using the data to mobilize communities and support the mission of coalitions. CADCA is proud to release their latest Practical Theorist Practical Theorist 11 – Electronic Nicotine Delivery Systems: Juuling, Other Trends, and Community Prevention

The publication covers important topics related to the Vaping epidemic: Smoking is the leading cause of preventable disease and death in the United States. Despite a decline in smoking in the past 50 years, (Centers for Disease Control and Prevention (CDC), 2016) 40 million adults and more than three and a half million adolescents (CDC, 2018) continue to smoke. As a result, 16 million Americans are living with a disease caused by tobacco use and about 1,300 people die each day of smoking-related illnesses (CDC, 2018).

Centers for Disease Control (CDC): Quick Facts on the Risks of E-Cigarettes for Kids, Teens and Young Adults

Centers for Disease Control (CDC): Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021

Centers for Disease Control (CDC):E-cigarette Use Among Middle and High School Students — United States, 2020

Centers for Disease Control (CDC):Scientific Study on Vaping

Centers for Disease Control and Prevention (CDC): Behavioral Risk Factor Surveillance System brief on E-cigarette use in New York adults ages 18 and over (PDF)

Centers for Disease Control and Prevention (CDC): Knowing the Risks of E-cigarettes and Vaping. Teaching and student resources that includes a PowerPoint presentation and talking points. Appropriate for ages 11-18. Includes an educator’s user information fact sheet.

E-Cigarettes – NY SmokeFree

Johns Hopkins Medicine: 5 Vaping Facts You Need to Know

University of California, Riverside: Study Finds Electronic Cigarettes Damage Brain Stem Cells

American Journal of Respiratory and Critical Care Medicine: Another Gross Reason to Put Down the E-Cigarettes

Vaping and Marijuana Concentrates: What is Vaping?

Resources for Parents and Educators

Get the Facts: Electronic Cigarettes (E-cigarettes) and Similar Vapor Products

Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults (Centers for Disease Control and Prevention)

Electronic Cigarettes Downloadable Infographics and Fact Sheets (Centers for Disease Control and Prevention)

Public Health and Tobacco Policy Center: E-Cigarette Myths

Youth e-cigarette use is soaring to unprecedented and epidemic rates. Youth and young adults are far more likely than older adults to use e-cigarettes, including adults using e-cigarettes to quit smoking. The U.S. Surgeon General has issued a call to action, urging state and local governments to respond to this epidemic with evidence-based tobacco controls.

Tobacco and E-Cigarettes (Department of Health)

Teachers and Parents: That USB Stick Might Be an E-cigarette (Centers for Disease Control and Prevention)

E-cigarettes Shaped Like USB Flash Drives: Information for Parents, Educators, and Health Care Providers

Talk with Your Teen About E-cigarettes: A Tip Sheet for Parents (Centers for Disease Control and Prevention)