Leaders of Youth Survey Express Worry Over Vaping`s Reach and Implications

Vaping among young people continues to be the discouraging outlier in national drug use survey results that otherwise show continued declines in youth use. Vaping of marijuana clearly takes the focus in this year's Monitoring the Future (MTF) survey results, released today by the National Institute on Drug Abuse (NIDA).

After a 2018 survey that documented a record-setting MTF year-over-year increase in the form of a near-doubling of past-month vaping of nicotine by 12th-graders, the jump in past-month marijuana vaping among 12th-graders from 2018 to 2019 nearly set another all-time record for a one-year increase. Fourteen percent of high school seniors in the latest survey reported past-month vaping of marijuana.

In a teleconference held today to discuss the 2019 MTF highlights, NIDA Director Nora Volkow, MD, and survey principal investigator Richard Mietch, PhD, cited several issues of concern around the steep rise in vaping among young people, including:

• The high concentration of active drug that vaping device technology delivers to the user, which substantially increases the risk of addiction;

• The theory that the availability of marijuana through vaping could be leading to more regular use of the drug overall, as evidenced by increases in daily use of marijuana by 8th- and 10th-graders in the latest survey; and

• The relative ease with which users of vaping devices can discreetly evade measures that have been put in place in schools to prevent substance use in the school setting. “There is a whole new uncharted territory here,” said Mietch, who works out of the University of Michigan's Institute for Social Research.

The 2019 survey found that while rates of past-year marijuana use held steady from 2018 levels, daily use increased significantly over the past year. The proportion of daily use among 10th-graders now stands at 4.8%. This leads Mietch to theorize that the availability of vaping technology is leading young marijuana smokers to supplement their smoking with vaping and therefore to use marijuana more regularly.

If this is indeed what is happening, it represents a reverse of the pattern seen with nicotine, where there has been evidence that vaping of nicotine is leading to tobacco use among many young people who had never smoked before, Volkow said.

Volkow opened the teleconference by stating that the emergence of vaping among youths demonstrates “a clear shift in the pattern of drug taking among adolescents” over the past two years.

The survey results also shed light on the various reasons that teens cite for why they vape, from being attracted to flavors to social factors. Of note, the percentage of high school seniors who said they vaped because they were “hooked” more than doubled in the past year, from 3.6% to 8.1%.

Other findings encouraging

The 2019 results on vaping stand in contrast to an overall pattern of decreases in young people's use of substances. In a number of cases, some statistics on prevalence of use stand at record lows in the history of MTF.

For example, misuse of the prescription opioids OxyContin and Vicodin is at the lowest level since these drugs were first included in the nationally representative survey in 2002. Past-year misuse rates of OxyContin and Vicodin among high school seniors in 2019 were 1.7% and 1.1%, respectively, while those rates had stood at 4% and 9.6% in 2002.

Over the past five years, past-year misuse of the prescription stimulant Adderall has declined significantly among 10th- and 12th-graders. However, Adderall misuse among 8th-graders increased from 1.3% to 2.5% over the same period, the researchers reported.

Alcohol use, including overall past-year use and past-year binge drinking, exhibited continued declines in the latest MTF survey, with youth alcohol use now at some of its lowest levels in the survey's 45-year history.