Background: For most of these prior two decades, tobacco use disorder in American adolescents has decreased dramatically. However, in recent years, the fall of traditional cigarettes have been replaced by an alarming rise in e-cigarette use among youths in the United States. Various legislative efforts have been tried at the state level. Prior to Aug 2016, e-cigarette regulation varied significantly among the states and prevalence of e-cigarette use differed greatly geographically as well. Then in Aug 2016, e-cigarettes changed from being regulated by a variety of state regulators to being officially regulated by the FDA. The FDA enacted changes such as banning access to minors as well as restricting ability to advertise e-cigarettes as safer than other tobacco products.
This study uniquely analyzes the trends in e-cigarette popularity by states before and after the change in e-cigarette legislation in 2016.
Methods: Data from the Youth Risk Behavioral Surveillance System Data was analyzed for prevalence of e-cigarette use among U.S. high school students and geographic patterns over time with the focus on before and after 2016.
Results: In 2015, 24.1% of U.S. high school students surveyed identified as a current e-cigarette user. Prevalence varied from high of 31.2% in West Virginia to low of 13.4% in Washington D.C. Interestingly in 2017, only 13.2% of U.S. high school students in the survey identified as current e-cigarette user. There are also significant differences geographically as well with West Virginia being one of the largest decreases, with prevalence dropping from 31.2% to 14.3%.
Conclusions: Prevalence of vaping actually decreased among U.S. high school students from 2015-2017. E-cigarette use differed significantly among states with certain states having a dramatic change in youth vaping rates from 2015 to 2017. Interestingly, the popularity of vaping turned from downward trend to upward trend in 2017-2018 with further increases 2018-2019 (National Youth Tobacco Survey). Further investigation regarding regional changes can shed valuable insight regarding future legislative efforts to manage rise in e-cigarette use among adolescents.