Teen Vaping Prevalence and Perception

University of Washington
Master of Health Administration Program
Team Skokomish: Leah Allman, Abisayo Ariwoola, Brittanie Bliss, Kelsey Brewer, Ben Ho, Stephen Landry

Editor’s note: Raising the age to purchase tobacco and nicotine products is one of WCAAP’s main priorities for the 2019 legislative session. You can help by responding to action alerts we send out during the session, writing a letter to the editor, or testifying on bills in Olympia! If you have a special interest in this issue, let us know. Also, be sure to register for our February 15th Advocacy Day!

Through the University of Washington MHA policy professor, Jeff Sconyers, WCAAP has an annual partnership with student groups who undertake policy projects with the Chapter. This year students examined vaping prevalence and perceptions amongst adolescents to improve our ability to educate legislators.  Past MHA projects have included adolescent confidentiality and Medicaid access to care.

E-cigarettes and vaping devices are harmful, with safety issues and associated risks. Despite many of these products containing multiple toxic chemicals (e.g., formaldehyde and acrylonitrile) and mislabeled amounts of nicotine on packaging, many adolescents still do not believe them to be harmful.

Dr. Nancy A. Rigotti, Massachusetts General Hospital and Harvard Medical School, states that “Adolescents may be especially susceptible to develop nicotine addiction after e-cigarette exposure because their brains are still developing and are particularly sensitive to nicotine.” Evidence shows that the adolescent brain is extremely sensitive to the effects of nicotine because the brain does not stop growing until around the age 25. Studies have shown that nicotine can interfere with memory and attention processing. Researchers also note that teens may be more likely to use e-cigarettes before other combustible tobacco products due to a perception that they are not harmful or addictive.

According to the 2016 Washington State Health Youth Survey (HYS), when it comes to perception of harm, 80% of 10th grade students believe there is a “great risk of harm from smoking one or more packs of cigarettes per day” yet only 30% believe there is a “great risk of harm from using e-cigarettes almost daily.” This illustrates that not only do many students not understand the safety and associated risks of e-cigarettes, they also are not associating e-cigarettes with cigarettes.

The HYS reports that 55% of daily teen smokers are only vaping.  In an interview conducted in Olympia, a high school student reported “I would say that 80% of my friends from high school use nicotine and 10% of that is cigarettes, the rest is vaping.” This demonstrates vaping is a huge influencer of daily teen smoking.

Past 30-day cigarette smoking prevalence amongst 12th graders has decreased from 23% in 2002 to 11% in 2016.  Sixth- to 10th-graders had similar decreasing trends in cigarette smoking. In contrast, past 30-day e-cigarette/vape use was just as prevalent amongst 12th graders (at 23%) in 2014 as cigarette use was back in 2002. While these figures hopefully suggest there is a decline (or at least leveling off) of e-cigarette use, comparing cigarette to e-cigarette prevalence trends shows that a lot of the efforts to decrease cigarette/tobacco use since 2002 are being negated and replaced by the new technologies of e-cigarettes and vapes.

Vaping and Tobacco Resources

WCAAP member Dr. Crystal Shen created a Vaping Resource Toolkit that is available on Dropbox: https://www.dropbox.com/sh/05oogr6pw8j1b6l/AAA-8Y5vBPusXVwbEhNeIwiYa?dl=0

Download: Vaping Resources Dec 2018

AAP Julius B. Richmond Center of Excellence – Fact Sheets

Download: ENDS Handout Clinicians

U.S. Surgeon General – Know the Risks: E-cigarettes and Young People

Download: SGR E-cig Health Care Provider Card