New National Survey Shows that Youth Nicotine Product Use Has Dropped to an All-Time Low

Opponents of tobacco harm reduction (i.e., vaping) have argued for years that the dramatic declines in youth smoking we have observed in recent years have been offset by equally dramatic increases in youth vaping, such that the total use of nicotine products among youth has remained stable. A new analysis using more recent data from the National Youth Tobacco Survey has found that in contradiction with this common claim, the truth shows something quite different.

According to the article: 

"Past-30-day use of any nicotine product decreased from 24.5% (95% confidence interval = 22.5%–26.6%) to 19.6% (16.8%–22.4%) between 2014 and 2017, increased sharply, reaching 31.4% (29.0%–33.7%) in 2019 (driven by an increase in e-cigarette use), then fell to the lowest level at 12.5% (10.9%–14.1%) by 2023." 

"The proportion who reported symptoms of nicotine dependence was substantially lower, but followed a similar pattern of changes over time. For example, the proportion reporting strong cravings decreased from 7.8% (6.6%–9.0%) to 5.5% (4.3%–6.7%) between 2014 and 2017, increased to 7.9% (6.8%–9.0%) between 2017 and 2018 and remained stable up to 2020, then fell to the lowest level at 2.5% (1.9%–3.1%) by 2023." 

The paper concludes that: "The sharp rise in the prevalence of nicotine product use (in particular, e-cigarettes) among US high-school students in the late 2010s was short-lived and was not accompanied by a sustained increase in the overall population burden of nicotine dependence. By 2023, both nicotine product use and nicotine dependence had reached historic lows."

The Rest of the Story

This research dispels the myth that reductions in youth smoking have been completely offset by an increase in youth vaping. It is not the case that the total amount of nicotine product use among youth has remained steady. It has in fact declined and reached its lowest point to date in 2023, driven by dramatic declines in youth smoking over the past decade and by more recent declines in youth vaping.

It is important to point out that even if youth smoking had been completely replaced by youth vaping, it still would have been a positive public health achievement, as the long-term effects of cigarette smoking dwarf those of e-cigarette use and because lifetime use of cigarettes is very common while most youth do not appear to be retaining their vaping habits into middle adulthood. 

In light of these new findings, any health group that continues to pooh-pooh the dramatic decline in youth smoking and the unprecedented public health gains of this public health miracle is either ignoring the data, obsessed with demonizing electronic cigarettes, or heavily smoking a non-nicotine-containing product.