A clear increase in nicotine addiction among American youth

Are American youth more addicted to nicotine?

Prominent American tobacco expert Stanton Glantz conducted a study analyzing national cross-sectional surveys on tobacco and specifically e-cigarettes among youth from 2014 to 2021. This study was supplemented by a confirmatory analysis using the Youth Behavioral Risk Factor Surveillance System from 2015 to 2019. Surveys were conducted with national probability samples of US students in grades 6-12. A total of 151 573 respondents were included in the analysis (51.1% male and 48.9% female with a mean age of 14.5 years).

The prevalence of e-cigarette use peaked in 2019 and then declined. Between 2014 and 2021, the age of e-cigarette initiation decreased, and intensity of use and addiction increased. Also, in 2017, e-cigarettes became the first most used product (77.0%). The age of onset of use did not change for cigarettes or other tobacco products, and changes in intensity of use were minimal. In 2019, more e-cigarette users used their first tobacco product within 5 minutes of waking up than e-cigarette users. Median e-cigarette use also increased from 3 to 5 d/month between 2014 and 2018 to 6 to 9 d/month between 2019 and 2020.

The changes detected in this study may reflect the higher levels of nicotine and addiction of modern e-cigarettes that use nicotine salts to facilitate nicotine inhalation. The increasing intensity of use of modern e-cigarettes highlights the clinical need to treat youth addiction to these new high nicotine products.

Nicotine Addiction and Intensity of e-Cigarette Use by Adolescents in the US, 2014 to 2021. S. S. Glantz & coll. JAMA Network Open. 2022;5(11):e2240671. doi:10.1001/jamanetworkopen.2022.40671