The 2020 Monitoring the Future survey results released today provide fresh evidence that youth e-cigarette use remains at epidemic levels in the United States and that young people continue to have easy access to the flavored products that have fueled this youth nicotine addiction crisis. These results further demonstrate that as long as any flavored e-cigarettes are left on the market, kids will get their hands on them and we will not end this crisis. Action to eliminate flavored e-cigarettes and other flavored tobacco products that lure kids, including menthol cigarettes, is more critical than ever given the growing evidence about the impact of smoking and vaping on COVID-19.
 
According to the 2020 survey results, 21.8% of 10th and 12th graders reported vaping nicotine in the past month (considered current use), which is essentially unchanged from 22.5% in 2019. While youth e-cigarette use did not increase this year, this survey shows that we have yet to reverse the alarming increase that saw youth use more than double from 2017 to 2019, reaching what the U.S. Surgeon General called a public health epidemic.
 
In another troubling finding, today’s survey indicates that declines in cigarette smoking among 12th graders have stalled since 2018, with rates of 7.6% in 2018 and 7.5% in 2020. This finding raises questions about the impact of skyrocketing e-cigarette use on youth smoking and warrants close attention and strong action to prevent youth use of all tobacco products. 
 
The survey, which was abbreviated this year because of COVID-19, was conducted in February and March, starting shortly after the Trump Administration implemented its new flavored e-cigarette policy on February 7, 2020. Under that policy, the FDA prohibited the sale of cartridge-based e-cigarette products (like Juul) in flavors other than tobacco or menthol, but it allowed the continued sale of thousands of other flavored e-cigarettes. Even before the FDA’s policy, Juul had stopped selling flavors other than tobacco and menthol in the face of intense public and legal pressure.
 
Despite these restrictions, today’s survey results show that youth continue to report easy access to flavored e-cigarettes, with 80% of 10th and 12th graders who vape reporting that they could easily get a vaping flavor other than tobacco or menthol. Fruit, mint and menthol were the most frequently used flavors among youth who vaped.
 
Despite a decline in use, Juul remained the most popular e-cigarette brand among youth vapers at 41.1%. Juul’s decline was offset by increases in use of other brands, especially Puff Bar, a cheap, disposable e-cigarettes sold in an array of kid-friendly flavors like banana ice and pink lemonade. Youth use of R.J. Reynolds’ Vuse brand also increased significantly.
 
The Monitoring the Future results follow those of the 2020 National Youth Tobacco Survey (NYTS), which found that 3.6 million U.S. kids, including 19.6% of high school students, used e-cigarettes in 2020. Nearly 40% of these high school e-cigarette users reported frequent or daily use, a strong sign of addiction. The 2020 NYTS also found that 83% of youth e-cigarette users used flavored products and that kids have shifted dramatically to menthol and disposable e-cigarettes left on the market by the FDA’s current policy. 
 
Together, these surveys show that the youth e-cigarette epidemic is far from over and that we will not solve it without eliminating all flavored products. To protect the health of America’s kids, the incoming Biden Administration should make it a priority to clear the market of all flavored e-cigarettes. The FDA has the authority to act immediately by strengthening the policy it implemented earlier this year. The FDA is also reviewing applications from makers of e-cigarettes and certain other tobacco products to keep their products on the market. The FDA should not authorize the sale of any flavored or high-nicotine products that put young people at risk. Until the FDA acts, states and cities should continue their growing efforts to end the sale of flavored tobacco products.
 
The Monitoring the Future survey is conducted by the University of Michigan’s Institute for Social Research and is funded by the National Institute on Drug Abuse (NIDA). The 2020 survey results were released by NIDA and in a study published in the journal JAMA Pediatrics.

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