Monitoring the Future: Soaring Use of Vaping Devices Mars Otherwise Encouraging Data

The latest national prevalence data on youth substance use shows much different patterns of use from adult use, with adolescents accounting for little of the longstanding opioid epidemic and emerging stimulant crisis. The issue of most concern in the data released on Monday, however, is skyrocketing growth in the past year in vaping among teens—and no longer just vaping of nicotine.

The 2018 Monitoring the Future Survey's principal investigator said that a near doubling of past-month prevalence of nicotine vaping among 12th-graders from 2017 to 2018 constitutes the largest percentage increase for any substance seen in the 40-plus year history of the annual survey. Richard A. Miech, PhD, of the Institute for Social Research at the University of Michigan, added during a morning teleconference that the ease of use, concealability and attractive flavorings of vaping products also are contributing to substantial increases in vaping of other substances, such as marijuana.

“Anything that can be vaped, it doesn't matter. It goes up,” Miech said of the current trend in the numbers.

Added Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), “This is a new technology that may in the future be used to administer other types of drugs.”

The allure of these electronic delivery systems for young people has recently led federal regulators to impose restrictions on the marketing and sale of electronic cigarettes.

Opioid use declining

The news about vaping threatens to overshadow some significant signs of ongoing progress in the 2018 numbers, which this year were based on surveys of more than 44,000 students in grades 8, 10 and 12 in 392 public and private schools.

Past-month use of opioids other than heroin declined from 1.6% in 2017 to 1.1% in 2018 among 12th-graders, with past-year use dropping from 4.2% to 3.4% in that group. Volkow said these findings are especially noteworthy because the next oldest age group, young adults, is highly prominent in experiencing the harms of the opioid crisis.

“There may be something providing resilience for teenagers that appears to be lost when they transition to young adulthood,” Volkow said. She has pledged that much of NIDA's new research in prevention will be focusing on factors in the transitional period between the teen years and adulthood.

Alcohol use is also on the decline for high school seniors (30.2% engaged in past-month use in 2018, compared with 33.2% in 2017, while past-year use dropped from 55.7% to 55.3%). Binge drinking among 12th-graders dropped from 16.6% in 2017 to 13.8% in 2018, with binge drinking defined as having five or more drinks in a row sometime during the past two weeks. That figure had stood at 31.5% at its peak in 1998.

“The progress has been impressive,” Lloyd D. Johnston, PhD, research professor at the University of Michigan and the researcher most associated historically with Monitoring the Future, said regarding the alcohol use data.

While youth use rates for most major categories of licit and illicit substances continue to decline, marijuana use rates are generally holding steady. Past-month use of marijuana increased from 5.5% to 5.6% among 8th-graders in 2018, rose from 15.7% to 16.7% among 10th-graders, and dropped from 22.9% to 22.2% among 12th-graders.

Young people's perception of risk associated with marijuana continues to be a source of major concern. According to the survey, only 26.7% of 12th-graders believe regular marijuana use carries a great risk of harm.

Hope for future?

Volkow and Johnston said it is important to note that the declines in use of most categories of illicit drugs among youths are taking place at a time when opioid and stimulant use among adults has surged to epidemic levels. Johnston expressed hope that the cohort of low-use individuals now at the high school level will bring down the young-adult user numbers for opioids when these young people reach that age group.

Conversely, though, this is the very source of concern about e-cigarettes and other forms of vaping, as leaders this trend could threaten the historic level of progress that the nation has made in curbing youth smoking.