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More American teens are using e-cigarettes in 2018 than ever before.

The 2018 Monitoring the Future survey shows 37 percent of 12th graders reported “any vaping” in the past year, compared to just 27 percent in 2017. The survey looked at a representative sample of eighth, 10th and 12th graders in schools across the country.

Reported use of vaping nicotine specifically in the month prior to the survey nearly doubled among high school seniors from just 11 percent in 2017 to 20 percent in 2018. More than one in 10 eight graders say they vaped nicotine in the past year. 

Dr. Jacques-Pierre Fontaine, thoracic surgical oncologist, Moffitt Cancer Center.

“There are more than 10 million people using e-cigarettes and the majority are young people,” said Dr. Jacques Fontaine, one of Moffitt’s thoracic surgeons. “We worked hard to get the percentage of young smokers down over 30 years, but now we are seeing middle and high schoolers using e-cigarettes.”

The survey team lead says the one-year increases translate into approximately 1.3 million additional teens who began vaping in 2018.

Because e-cigarettes are still a fairly new product, the long-term effects of vaping are not fully known. However, Dr. Fontaine says there is the same amount of nicotine—the addictive component in traditional cigarettes—in an e-cigarette pod as there is in a pack of cigarettes.

Teens’ brains are also still developing, so Dr. Fontaine says they are more sensitive to addictive chemicals. He says companies target teens using flavors like mango and creme, and that most advertising campaigns are directed to younger crowds on social media. The survey also showed about half of teens say the devices are “fairly easy” or “very easy” to get.

The evidence to date indicates that e-cigarettes are far less dangerous than traditional, combustible cigarettes, without the carbon monoxide, tars and most of the carcinogens of those cigarettes.  Therefore, adults who have been unable to quit smoking through other cessation methods might succeed by completely switching to e-cigarettes. 

“We have to keep the big picture in mind,” said Dr. Thomas Brandon, chair of Moffitt’s Department of Health Outcomes and Behavior and director of its Tobacco Research and Intervention Program. “The wider perspective is that smoking of traditional cigarettes is at an all-time low among youth, quite likely in part because of vaping.”  The survey shows that less than four percent of high school seniors smoke daily, compared to over 20 percent two decades ago, and over 12 percent just prior to the introduction of e-cigarettes.

Dr. Brandon agrees that it is important to monitor e-cigarette use by youth, but cautions against premature panic.  “We will need to craft policies that discourage vaping by youth without pushing them—or adults—back to traditional cigarettes, which are the real killers.”