New survey shows progress on curbing teen vaping, but e-cigarette use remains high as access to flavors, risk of nicotine addiction, and impact on youth mental health concerns grow

Statement of Robin Koval, CEO & President, Truth Initiative

The 2021 Monitoring the Future (MTF) survey data released today show progress in the fight to curb youth nicotine vaping, signaling efforts to provide education to prevent e-cigarette use and quitting resources are starting to work. However, more is needed to accelerate progress to end the ongoing youth e-cigarette epidemic amid growing concerns over continued, easy access to flavored products, risk of nicotine addiction, and the impact on youth mental health. While there have been declines across the board among surveyed students in all three grades, according to the 2021 MTF data 19.6% of 12th graders, 13.1% of 10th graders and 7.6% of 8th graders used e-cigarettes in the last 30 days (considered current use).

When it comes to youth use, today’s Monitoring the Future results follow those of the September 2021 National Youth Tobacco Survey (NYTS), which showed that more than 2 in 5 high school students who vape, do so frequently. Together, these findings suggest that far too many young people are highly dependent and continue to be at risk for a lifetime of nicotine addiction. This is especially troubling given the U.S. Surgeon General’s recent advisory about our nation’s youth mental health crisis exacerbated by the pandemic and the fact that nicotine can worsen symptoms of anxiety and depression. Today’s MTF findings also show significant increases in mental health issues among teens across all measures. Furthermore, a recent Truth Initiative survey shows 81% of respondents who had ever vaped reported they started vaping nicotine to decrease anxiety, depression, or stress. Yet, the very thing that young people are turning to relieve stress can actually make it worse.

These MTF numbers underscore the urgent need for stronger regulatory action on high nicotine, youth-appealing flavored tobacco products, including menthol. As the pandemic has shown, less access equals less use among teens, yet the FDA has failed to complete premarket review of the top e-cigarette brands - JUUL, Puff Bar and Vuse Alto - that make up 75% of the market and are most popular among youth, despite the September 2021 deadline to do so. Stronger federal policies must be put in place immediately to restrict youth access and remove flavored tobacco products. The policies must be clear, comprehensive, and consistently enforced with no loopholes. Delayed rulings and ad hoc policy responses to date, like warning letters to vaping companies or partial flavor bans, have resulted in product substitution, failures to comply, and new illegal products continuing to enter the market. The number one brand used by youth, Puff Bar, not only comes in a wide variety of flavors, but has also recently indicated that it will now be manufactured with synthetic nicotine in a brazen attempt to thwart FDA oversight. Without effective federal regulation, local and state policies must continue to play a crucial role in curbing flavored tobacco sales and use among youth given inconsistent national regulations.

While the FDA continues to delay progress, Truth Initiative and our public health partners continue to increase efforts to end youth nicotine vaping with encouraging results. Truth Initiative’s proven-effective national truth campaign is focused on giving young people the facts on the risks of e-cigarette use and the connection between vaping nicotine and its impact on mental health. Our research shows that strong truth brand awareness is significantly associated with a lower likelihood of current vaping. This is Quitting from truth, a first-of-its-kind, free text message quit vaping program designed specifically for teens and young adults already has nearly 400,000 young people enrolled to date. A recent randomized clinical trial published in JAMA Internal Medicine found that young adults aged 18-24 who used This is Quitting had nearly 40% higher odds of quitting compared to a control. truth also offers a free, comprehensive digital high school curriculum, Vaping: Know the truth, that gives students the facts about the health dangers of e-cigarettes and helps those already vaping to quit with a direct link to This is Quitting built into the course.