JUUL and flavors: Looking at teen e-cigarette use

E-cigarette use continues to be popular among middle and high school children, according to a new study published in JAMA. Flavored e-cigarettes are popular among them as well.

Researchers used a cross-sectional survey that was conducted among 19,018 students in grades 6 to 12 who were participating in the 2019 National Youth Tobacco Survey. They looked at the self-reported current (past 30-day) e-cigarette use as well as determining frequent use (≥20 days in the past 30 days) and the usual e-cigarette brands. The use of flavored e-cigarettes and flavor types among current e-cigarette users who did not use other tobacco products.

The sample included 10,097 high school students, who had an average age of 16.1 years, and 8837 middle school students, who had an average age of 12.7 years. The overall response rate was 66.3%. In the sample, roughly 27.5% (95% confidence interval [CI], 25.3%-29.7%) of the high school students and 10.5% (95% CI, 9.4%-11.8%) of middle school students stated that they were current e-cigarette use. In this subset, an estimated 34.2% (95% CI, 31.2%-37.3%) of high school students and 18.0% (95% CI, 15.2%-21.2%) of middle school students stated that they were frequent users plus 63.5% (95% CI, 59.3%-67.8%) and 65.4% (95% CI, 60.6%-69.9%) of middle school students said that they exclusively used e-cigarettes.

Unsurprisingly, JUUL was reported as the usual e-cigarette brand for the past 30 days in current users by roughly 59.1% (95% CI, 54.8%-63.2%) of high school students and 54.1% (95% CI, 49.1%-59.0%) of middle school students. No usual e-cigarette brand was stated by 13.8% (95% CI, 12.0%-15.9%) of high school students and 16.8% (95% CI, 13.6%-20.7%) of middle school students. Flavored e-cigarettes were used by a majority of users, with an estimate 72.2% (95% CI, 69.1%-75.1%) of high school students and 59.2% (95% CI, 54.8%-63.4%) of middle school students. The flavors most reported included candy, fruits, and menthol or mint.

The researchers concluded that self-reported e-cigarette use remains high among both high school and middle school students. Additionally, frequent use and use of flavored products also remains high.