Vaping among America's teenagers continues to climb, while the use of other substances - such as alcohol and opioids - has declined in recent years, according to a new report.
"We are encouraged to see continued declines in a variety of measures of underage alcohol use", says George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism.
There is a new trend among teens, namely, vaping. More teens also vaped marijuana, with 7.5% of high school seniors saying they used vape pens for weed in the last month, compared to 4.9% past year.
They found that the use of traditional cigarettes is still at a record low, with 3.6 percent of high school seniors smoking daily, compared with 22.4 percent two decades ago.
The survey also asked about vaping of liquids that contained "just flavoring", to track students who may have consumed nicotine without realizing it.
"When we see rates of around 6 percent of high school seniors smoking marijuana on a daily or near-daily basis, that's an bad lot of kids whose memory may be impaired and their brains aren't working at full steam at the exact time when they need to be", Compton said. This year, 44,482 students from 392 public and private schools took part.
Most e-cigarettes contain nicotine. Even more worrisome, a growing body of research suggests that teens who vape are more likely to try regular cigarettes.
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The use of any kind of nicotine-containing product - including traditional cigarettes, cigars and smokeless tobacco - by 12th-graders grew from 23.7 percent in 2017 to 28.9 percent in 2018.
"Intriguingly, when they go off to college or go to work, you see the highest rates of opioid use among 18 to 24 years of age". Nicotine exposure during this time can cause addiction and harm the brain during development. When both categories of vaping were combined, the researchers found that 25 percent of high-school seniors, 20.3 percent of sophomores and 9.7 percent of eighth-graders used e-cigarettes in 2018. Surveys indicate many kids move back and forth between vaping and smoking. One out of every four 12th graders think they are only vaping flavoring, and are unaware of the nicotine in most e-cigarettes. Many claim they're just vaping e-liquid flavors.
Compton said marijuana use rates likely have remained steady due to societal acceptance of pot, as reflected in the state-level movement to legalize recreational use. "We know the dangers from smoked, combustible tobacco", Compton said. "They have less perception of risk from use of marijuana".
"We always want to see declines, but I think with the normalization and legalization and the big money behind marijuana products, steady is OK", Muench said. Further, some researchers are concerned that vaping will serve as a "gateway drug" to cigarettes and other drugs.
Flavoring was the most commonly reported substance among eighth-graders at 15.1%, followed by nicotine at 10.9% and then marijuana at 4.4%.
Fewer students are using opioids, also - a direct contrast to the rest of the population. About 17 percent of high school seniors reported being drunk during the past month, down from 26 percent five years ago. Regulators will need to pay close attention to the fast-changing market and be ready to modify their policies if necessary, they said.