The number of teenagers who reported using e-cigarettes in 2024 has tumbled from a worrisome peak reached five years ago, raising hopes among public health officials for a sustained reversal in vaping trends among adolescents.
In an annual survey conducted from January through May in schools across the nation, fewer than 8 percent of high school students reported using e-cigarettes in the past month, the lowest level in a decade.
That’s far lower than the apex, in 2019, when more than 27 percent of high school students who took the survey reported that they vaped — and an estimated 500,000 fewer adolescents than last year.
The data is from the National Youth Tobacco Survey, a questionnaire filled out by thousands of middle and high school students that is administered each year by the Food and Drug Administration and the Centers for Disease Control and Prevention.
Overall, it found that just under 6 percent of middle and high school students reported vaping in the last month, down from nearly 8 percent among those surveyed last year. Use among high school students largely accounted for this year’s decline; middle school use stayed fairly steady with 3.5 percent reporting they had vaped compared to 4.6 percent the year before.
“I want to be unequivocally clear that this continued decline in e-cigarette use among our nation’s youth is a monumental public health win,” Brian King, the director of the F.D.A.’s tobacco division, said during a news briefing on Wednesday.
Public health experts said several factors may have contributed to the decline in teenage vaping, including city and state flavored tobacco bans, a blitz of enforcement against sellers of flavored vapes and three public messaging campaigns aimed at young people about the dangers of vaping.
Some compared the news to the decline in smoking traditional cigarettes, which at about 1.6 percent of teenagers, has reached a notable low.
Many public health groups have raised alarms about the potential effects of e-cigarettes on young people, including exposure to toxins and carcinogens — some of which are still unknown. Nicotine levels in these products can be very high, raising the risk of addiction and injury to the developing brains of adolescents.
“Definitely, risk perceptions of vaping have increased,” said Kathy Crosby, president of the Truth Initiative, a nonprofit group that campaigns against youth vaping. “And as you see the increase in risk perceptions, you also see decreasing behaviors.”
But some experts tempered the encouraging news with the stubbornly higher level of e-cigarette use among young adults. An unrelated survey suggests that many of the teenagers who vaped in earlier years have continued the habit. The survey, which is called Monitoring the Future and conducted by the University of Michigan and the National Institutes of Health, found high levels of vaping nicotine products among young adults ages 19 to 26. About 20 to 24 percent of that group reported that they had vaped in the last month.
There are worldwide campaigns to ban disposable vapes or limit access considerably to reduce teenage use. A dozen countries in the European Union have pushed for a ban on flavored vapes and a limit on nicotine levels. Congress has pressured the F.D.A. in recent years to step up enforcement, especially against illicit imports of e-cigarettes in flavors like Banana Taffy Freeze and Peach Blue Slushy.
One major tobacco company, Reynolds American, has also petitioned the F.D.A. to crack down on the disposable, flavored vapes pouring into the country from China. Legacy cigarette companies are aiming to replace lost cigarette revenues with e-cigarette income.
The F.D.A. has emphasized that many brands, like the Elf Bar vapes that have been popular among teenagers, are not authorized for sale.
Dr. King of the F.D.A. also said that the agency’s efforts in leading a series of e-cigarette seizures and fines helped drive the decline in teenage use. That included “pummeling” companies selling Elf Bar vapes, he said. This year’s student survey showed that teenagers still favored Elf Bar, with more than a third ranking the brand as most liked.
The F.D.A. and other agencies impounded millions of dollars of e-cigarettes at Los Angeles International Airport and at the port in Chicago in the last year and late in 2023. The agency also sent warning letters to outlets of major retailers, such as Exxon and Circle K, and issued fines to Citgo and Shell stores.
Deirdre Lawrence Kittner, director of the C.D.C.’s Office on Smoking and Health, said other factors may have driven down the teen vaping rate, including a campaign in 2023 encouraging middle and high school educators to talk to students about vaping.
The F.D.A. also released an award-winning ad campaign on YouTube, Snapchat and Instagram warning about the heavy metals and formaldehyde in e-cigarettes that can be delivered to the lungs and one teen’s struggle to quit.
Another factor that may have reduced teen vaping include bans on flavored tobacco in California and Massachusetts. Among teens who reported vaping, nearly 90 percent reported that they used flavored products, with fruit, candy and mint flavors ranking as favorites. Top brands included Elf Bar, Breeze, Mr. Fog, Vuse and Juul.
Measuring the declining trend in teenage vaping use over the years from its peak was a bit complicated during the pandemic, with experts cautioning against drawing direct comparisons year to year in the public health crisis when schools were closed.
Some health officials also cautioned that problems are still cropping up and remain worrisome. The latest youth tobacco survey tracked an emergence of youth use of nicotine pouches such as Zyn, though at low levels, with about 2 percent of adolescents reporting use.
While the annual youth tobacco survey did not seek data on cannabis or vaping of other products, the Monitoring the Future survey in 2023 for the first time asked about Delta-8 THC — the potent psychoactive ingredient in cannabis. It found that about 11 percent of high school seniors said that they had used the products in the last year.
Dr. Sharon Levy, a pediatrician and chief of the division of addiction medicine at Boston Children’s Hospital, said that there was no need for new types of flavored vapes that advertised 15,000 puffs and contained as much as nicotine as 20 packs of cigarettes.
“It would be nice,” she said, “to actually get ahead of these things.”
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