US Pharm. 2024;49(8):14.
The CDC has found that electronic cigarettes (e-cigarettes) are the most-used tobacco product among U.S. adolescents aged 12 to 17 years. Approximately 7.7% of middle-schoolers and high-schoolers (~2.1 million) reported current use of e-cigarettes in 2023, with 25.2% using these electronic nicotine delivery systems (ENDS) daily, 34.7% using ENDS on >20 of the previous 30 days, and 89.4% using flavored varieties. Middle-school and high-school students (49.0% and 36.8%, respectively) who used e-cigarettes also used other tobacco products. Among youth who had ever used e-cigarettes, 46.7% reported continued use and 67.4% had attempted to quit in the past year.
PATH Study: The Population Assessment of Tobacco and Health (PATH) study is a collaborative effort of the FDA and the National Institutes of Health to longitudinally assess tobacco use, behaviors, determinants, and related impacts in the U.S. Data have been collected annually or biennially from civilian and noninstitutionalized persons aged >12 years since 2013–2014 (wave 1). Published findings from waves 1 through 5 (2013–2019) show a 9.1% increase in overall ever-use of ENDS among youth. The greatest increases over this period were in female adolescents (10.5% vs. 7.8% in males), high-schoolers (13.2% vs. 2.8% in middle-schoolers), and non-Hispanic white youths (11.7% vs. 4.5%, 7.7%, and 6.7% in non-Hispanic black, Hispanic, and other races).
Social Media: Accumulating evidence suggests that e-cigarette use among U.S. youth is linked to social media use. ENDS advertisements on social media platforms have been found to lead to decreased risk perception and increased susceptibility to use of these products. In an analysis (published in Addictive Behaviors, 2021) of data from PATH study waves 2 to 4 (2014–2018), Zheng and colleagues determined that higher risk perception among adolescents during wave 3 yielded a lower likelihood of e-cigarette use during wave 4 (odds ratio [OR] = 0.57, P <.001). High social media use during wave 2 was also directly associated with the likelihood of e-cigarette use during wave 4 (OR = 1.11, P <.001).
U.S. Advisory: In 2023, the U.S. Surgeon General released an advisory on social media and youth mental health. The advisory emphasizes growing concerns regarding the negative impacts of social media on the well-being of U.S. youth (e.g., disrupted sleep duration and quality, decreased physical activity, body dissatisfaction, low self-esteem). Although social media affects individual adolescents differently, those exposed for >3 hours per day are more likely to experience mental health issues such as depression, anxiety, and substance use. The advisory provides recommendations for continued public health campaigns, policies, and evidence-based interventions to reduce the use of all tobacco products among U.S. youth and identifies knowledge gaps requiring additional research (e.g., content, frequency, and intensity of social media causing the most harm).
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