As Youth Vaping Declines, More Adults Are Using Vaping to Quit Smoking

The Centers for Disease Control and Prevention (CDC) recently released the much-anticipated results of the 2023 National Youth Tobacco Survey (NYTS). This annual assessment surveyed the use of various tobacco and vaping products among middle and high school students in the United States, including cigars, cigarettes, e-cigarettes, smokeless tobacco, and other novel tobacco products.

There is very good news—youth e-cigarette use has declined, and the youth use of traditional tobacco products is at a historic low. Additionally, data shows that the proportion of adults using e-cigarettes has increased, indicating that more adults are turning to less harmful tobacco (and non-tobacco) alternatives to meet their nicotine needs.

However, even with these welcome findings, public health agencies in the U.S. continue to exaggerate the false epidemic of youth tobacco and vaping product use. Continuing to sound alarm bells over declining youth use ignores the fact that millions of American adults are using e-cigarette products to quit smoking. In fact, according to the latest NYTS data, it is clear that adults are the primary users of e-cigarette products.

In 2023, only 7.7% of U.S. middle and high school students reported using e-cigarettes. The current use is defined as having used the product at least once in the past 30 days. This is an 18.1% decrease compared to 2022 and a staggering 61.5% decrease compared to the peak youth e-cigarette use rate of 20% in 2019.

Even more encouraging, since 2022, the proportion of daily e-cigarette users among youth has decreased by 8.6%, with only 1.9% of U.S. middle and high school students reporting daily e-cigarette use in 2023.

Traditional tobacco use remains at historic lows. In 2023, only 1.6% of students reported current cigar use, 1.6% reported currently smoking combustible cigarettes, and 1.2% reported current use of smokeless tobacco products. Since 2020, less than 5% of students have reported using these products annually. Contrary to the claims of harm reduction opponents, youth e-cigarette use has not normalized traditional tobacco use, as evidenced by these significant and sustained downward trends.

But clearly, American adults are using e-cigarettes. And they are using a lot of fruit-flavored and candy-flavored e-cigarettes, as evidenced not only by sales data but also by studies of adult consumers.

According to a CDC study sponsored by Bloomberg, published in June of this year, monthly sales of e-cigarettes grew by 46.6% from 2020 to 2022. In January 2020, an estimated 15.5 million e-cigarette units were sold monthly. By December 2022, that number had risen to 22.7 million units. During this period, youth e-cigarette use declined by 28.2%, from 13.1% in 2020 to 9.4% in 2022.

Youth e-cigarette use continues to decline, while the number of adults using e-cigarettes is increasing. In 2022, over 20 million American adults were using e-cigarettes, a 14.9% increase compared to 2021.

Nevertheless, the CDC and the Food and Drug Administration (FDA) continue to sound alarm bells over the so-called youth e-cigarette epidemic and continue to deny the effectiveness of flavored e-cigarettes as a tool for helping adults quit smoking.

In the accompanying press release for the June 2023 CDC report, this taxpayer-funded agency proposed various strategies to reduce youth "tobacco use in any form." These strategies include "implementing comprehensive restrictions on the sale of all flavored tobacco products, including e-cigarettes, menthol cigarettes, and flavored cigars, applicable to all jurisdictions." Given the age restrictions on purchases and the decline in youth usage numbers, there is clearly no need to ban flavors.

In response to the latest NYTS, the director of the FDA's Center for Tobacco Products expressed encouragement over the "significant decline in e-cigarette use" but stated that the agency cannot "rest on its laurels" and that "there is more work to be done to solidify this progress." The agency then doubled down, announcing another round of enforcement actions against e-cigarette retailers and stating that the FDA "will not sit idly by while bad actors put profits over the health of our nation's youth."

Nevertheless, it appears that it is the FDA, with its policies banning flavored e-cigarette devices and other novel harm reduction tobacco products, that is putting profits over health. The FDA has received over 26 million applications for so-called tobacco products, primarily e-cigarettes and vaping devices. The agency claims to have made decisions on over 99% of these 26 million applications. These decisions have primarily been rejections, as the agency has only authorized the sale of 23 e-cigarette products—all of which are only available in tobacco flavor.

Despite all these rejections, the proportion of adults using these products is increasing. In fact, from 2021 to 2022, the proportion of adults using e-cigarettes daily increased by 12.5%, and the proportion of adults using e-cigarettes occasionally increased by 20.6% during the same period.

Even if the CDC and FDA want to continue denying the data indicating that adults are using flavored e-cigarette devices, numerous studies show that adults prefer fruit and dessert flavors. In 2020, researchers at Penn State University found that adults who exclusively use e-cigarettes are more likely to use sweet-flavored vapor products. A recent study published in the Harm Reduction Journal, covering nearly 70,000 adult e-cigarette users in the U.S., found that the majority (82.8%) reported using fruit-flavored products when they started using e-cigarettes. The study also found that fruit, dessert, or pastry flavors and sweet flavors were considered "most helpful for quitting smoking." In other words, sweet-flavored e-cigarettes are not a malicious scheme to addict children.

U.S. public health agencies should have long recognized the astonishing potential of flavored e-cigarette products in reducing smoking rates. The data does not lie—youth e-cigarette use continues to decline; adult e-cigarette use is increasing. This decline in youth usage rates is even occurring amidst federal regulatory agencies attempting to stifle a growing harm reduction industry that American adults are using to successfully quit smoking.