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Researchers at the University of California, San Diego found a surge in teen tobacco users as more than 1 million United States youth aged 14 to 17 years old in 2017 became new daily tobacco users within two years.

In the study, which appeared in the May 30, 2022, online edition of Pediatrics, researchers found that by 2019 more than three-quarters of youth were vaping e-cigarettes on a daily basis. One e-cigarette device, called JUUL, has gained popularity since its launch in 2015. 

UCSD researchers report that JUUL Labs “ disrupted the e-cigarette market when they introduced the first high nicotine e-cigarette, a sleek product with candy and fruit flavorings”. The U.S. surgeon general announced an epidemic of youth vaping when the nation saw a 40 percent surge in e-cigarette sales in 2017 driven by JUUL products. 

Using data from the nationally representative Population Assessment of Tobacco and Health (PATH) longitudinal study, undertaken by the National Institute on Drug Abuse and the FDA Center for Tobacco Products under contract with Westat, researchers assessed two cohorts of youth and young adults ages 14 to 34 years: one with baseline survey data in 2014 before the surge of JUUL products, and the other in 2017 as the surge in JUUL sales was occurring.

The researchers compared how many participants used tobacco for the first time and how many became daily tobacco users over a two-year period among five age groups.

There was a drop in the number of individuals who tried cigarette smoking, or who have become daily cigarette smokers between the two cohorts. However, researchers found that overall daily tobacco usage increased led by a rise in daily e-cigarette vaping, particularly among those aged 14 to 17.

Researchers found a 3.6-fold higher rate of progression among the 2017 cohort compared to the 2014 cohort. Two-thirds of all new daily tobacco users were aged 14 to 17 years.

“Our analysis translates to 2,284 new underaged daily tobacco users each day between 2017 and 2019. This rate of youth tobacco initiation has not been seen since the early 1990s, prior to the implementation of tobacco control measures,” said co-author John P. Pierce, Ph.D., Distinguished Professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science, and UC San Diego Moores Cancer Center.

“Given the recent evidence of the potential health consequences of vaping flavored e-cigarettes, this sharp rise among youth requires urgent public health attention and action.”

According to the Campaign for Tobacco-Free Kids, “electronic cigarettes” covers a wide variety of products now on the market, from those that look like cigarettes or pens to somewhat larger products like “personal vaporizers” and “tank systems”. Instead of burning tobacco, e-cigarettes most often use a battery-powered coil to turn a liquid solution into an aerosol that is inhaled by the user. 

According to JUUL Labs, all JUULpods contain flavorings and 0.7mL e-liquid with 5% or 3% nicotine by weight; JUUL Labs claims that the 5% pods contain the equivalent amount of nicotine as a pack of cigarettes.

The company produced flavored JUULpods available in eight flabors until November 2019 that include Mango, Fruit, Cucumber, Creme, Mint, Menthol, Virginia Tobacco, and Classic Tobacco.

The Centers for Disease Control and Prevention found there was an estimated 1.7 million high school and an estimated 2.8 percent of middle school students reported e-cigarette use. More than 8 in 10 of those youth use flavored e-cigarettes.

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