A new federal survey has found that e-cigarette use among teenagers has surpassed the use of traditional cigarettes as smoking has continued to decline. Health advocates say the trend for e-cigarette use is dangerous because it is making smoking seem normal again. They also worry it could lead to an increase in tobacco smoking, though the new data do not show that.
The survey, released Tuesday by the National Institute on Drug Abuse, measured drug and alcohol use this year among middle and high school students across the country. More than 41,000 students from 377 public and private schools participated. It is one of several such national surveys, and the most up-to-date.
It was the first time this survey measured e-cigarette use, so there were no comparative data on the change over time. Other surveys have shown e-cigarette use among middle and high school students to be much lower, but increasing fast.
This June 12, 2013, file photo shows a person posing with an electronic cigarette, or e-cigarette. Electronic cigarettes have surpassed traditional smoking in popularity among teens, the government’s annual drug use survey finds. (AP archive)
“The numbers are stunning,” said Matthew L. Myers, president of the Campaign for Tobacco Free Kids, an advocacy group.
The survey found that 17 percent of 12th-graders reported using an e-cigarette in the last month, compared with 13.6 percent who reported having a traditional cigarette. Among 10th-graders, the reported use of e-cigarettes was 16 percent, compared with 7 percent for cigarettes. And among eighth-graders, reported e-cigarette use was 8.7 percent, compared with just 4 percent who said they had smoked a cigarette in the last month.
A 2013 youth tobacco survey by the federal Centers for Disease Control and Prevention released in November found that the share of U.S. high school students who use e-cigarettes rose to 4.5 percent in 2013 from 2.8 percent in 2012. The share of middle school students who use e-cigarettesremained flat at 1.1 percent over the same period.
The gap between the two sets of findings was substantial, and researchers struggled to explain it. Both are broad, reliable federal surveys that go back years, and their methodologies do not differ greatly. The drug abuse institute uses individual school grades, while the disease centers combine grades, which may account for some of the difference.
Some experts said that the new data suggested the rate may have increased substantially since 2013, though it will be impossible to know for sure until the CDC releases its 2014 data sometime next year.
E-cigarettes have split the public health world, with some experts arguing that they are the best hope in generations for the 18 percent of Americans who still smoke to quit. Others say that people are using them not to quit but to keep smoking, and that they could become a gateway for young people to take up real cigarettes.
But that does not seem to be happening, at least so far. Daily cigarette use among teenagers continued to decline in 2014, the survey found, dropping across all grades by nearly half over the past five years. Among high school seniors, for example, 6.7 percent reported smoking cigarettes daily in 2014, compared with 11 percent five years ago.
Most experts agree that e-cigarettes are far less harmful than traditional cigarettes. But they contain nicotine, an addictive substance that some experts contend is potentially harmful for brain development. Some experts also warn that nicotine use could establish patterns that leave young people more vulnerable to addiction to other substances.
The survey found significant declines in the use of other drugs. Among high school seniors, about 6 percent reported having taken a prescription drug, substantially down from the peak of 9.5 percent in 2004. Abuse of Vicodin, the opioid pain reliever, declined by nearly half among 12th-graders over five years.
In states with medical marijuana laws, 40 percent of high school seniors who reported using marijuana in the past year said they had consumed it in food, compared with 26 percent in states without such laws.
