FDA Commissioner Says Signs Point to Continued Growth in Youth Use of E-Cigarettes

SILVER SPRING, Md. — New data from the 2018 National Youth Tobacco Survey indicates that electronic cigarette use by underage users continues.

Initial results from the joint survey by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) were released in the fall. Those findings led the FDA to ramp up its regulatory actions as part of its Youth Tobacco Prevention Plan.

Pointing to the continued rise of youth e-cigarette use, FDA Commissioner Scott Gottlieb said the agency is "advancing those actions, and committing to some new steps. The epidemic use of e-cigarettes among children is one of the biggest public health challenges currently facing the FDA."

According to the survey data released on Feb. 11, approximately 4.9 million middle and high school students were current users (used in the past 30 days) of some type of tobacco product in 2018, up from 3.6 million in 2017.

Drilling deeper, more than 3.6 million middle and high school students were current (past 30 day) e-cigarette users in 2018, an increase of more than 1.5 million students in one year.

The rising popularity of certain types of e-cigarettes, including Juul, may be a contributing factor behind the increase, according to the FDA. Youth are also flavored products more than last year and using multiple products, it added.

"Among current tobacco users, about two in five (1.68 million) high school students and one in three (270,000) middle school students used two or more tobacco products in 2018," Gottlieb said. "The most commonly used tobacco product combination was e-cigarettes and conventional cigarettes among both middle and high school students."

Data from the recent National Institutes of Health's Monitoring the Future study found comparable trends, he added.

In addition, research recently published in JAMA Network Open showed that, compared with non-users, youth who use e-cigarettes are more likely to transition to conventional cigarettes.

"The bottom line is that kids using e-cigarettes aren't kids who 'would have smoked cigarettes.' Quite the opposite," the commissioner said, adding underage users do not associate the stigma surrounding cigarettes with e-cigarettes.

"Based on a growing body of evidence, I fear the youth trends will continue in 2019, forcing us to make some tough decisions about the regulatory status of e-cigarettes," Gottlieb said. "The signs that we’re seeing are not encouraging. They point to continued growth in youth use of these products."

To read Gottlieb's full statement on the newly released numbers, click here.