Youth tobacco use declines, e-cigarettes used more frequently

While overall youth tobacco use is at its lowest since 2012, minors are using e-cigarettes more frequently than previous years, according to the 2022 Indiana Youth Tobacco survey released Tuesday. 

The survey takes place every two years, gathering responses from more than 2,900 high school students and 2,500 middle school students in 2022. 

The findings showed a clear preference for e-cigarettes among young people. One out of every ten high school students reported using tobacco products. Just below that — 9.2% of high schoolers surveyed — said they use e-cigarettes. 

For middle school students, the number was smaller, but still significant — 3.3% of middle school students use tobacco, with 2.9% of middle school students reporting that they used an e-cigarette. A majority of all respondents who use tobacco products said they used flavored products. 

“We are pleased to see that overall tobacco use is lower among Indiana youth, which is the same pattern being observed nationally,” State Health Commissioner Lindsay Weaver said in a press release. “But it is concerning that the majority of students who use tobacco reported using flavored tobacco, including menthol. We know that flavors increase the appeal of tobacco products to youth, promote youth initiation, and can contribute to lifelong tobacco use.”

The percentage of e-cigarette use is now half of what it was in 2018. That year, 18.5% of high school students and 5.5% of middle school students reported they used e-cigarettes. But the rates are much higher than in 2012 – 3.8% and 1.2%

Since 2018, the minimum age to buy tobacco products has increased from 18 to 21. The proposal was signed into law in December 2019. 

The law hasn’t had much luck with stopping access to e-cigarettes. From 2019 to 2022, the FDA has warned or cited 491 Indiana stores for selling vape products for minors. 

In North Carolina, a 2015 study found that online e-cigarette companies did not comply with the state’s age verification law — out of 98 e-cigarette purchase attempts by minors, only five of them failed due to age verification. 

As Indiana schools grappled with the issue of student tobacco use, some implemented harsh restrictions like limiting bathroom passes or stationing teachers by restrooms to keep watch. Most recently, schools in southern Indiana have implemented vape detectors that send a message to school leaders when it detects chemicals released by e-cigarettes.

But while the overall use of e-cigarettes declined in 2022, the frequency of use increased. Almost half of high school students who have used e-cigarettes said they use the products 20 or more times in the past 30 days. 

Parts of the survey that measure attitudes involving tobacco use found 20% of youth who have never used tobacco are susceptible to future experimentation with the drug. 

“Indiana has been vigilant about addressing youth tobacco use on many fronts, from schools and parents to local and state public health organizations,” Miranda Spitznagle, director of Tobacco Prevention and Cessation at the Indiana Department of Health, said in the press release. “We hope these entities can continue working together to ensure all Hoosier youth have access to free services to help them quit and to all the same protections from commercial tobacco to make sure they never start.”

The survey also found that the majority of users in both high school and middle school want to quit, with 74.6% and 55.9% of middle school and high school users respectively reporting that they made at least one attempt to quit tobacco products in the past year.

E-cigarettes have been proven to harm brain development in adolescents. They also pose health risks as e-cigarettes can contain heavy metals, cancer-causing chemicals and flavorings that are linked to lung diseases. At the same time, scientists have compared nicotine’s addictiveness to drugs like heroin or cocaine.