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Survey: Youth tobacco use flattens in 2017

6/8/2018
As new and novel tobacco products that appeal to youth continue to hit the market, research shows that tobacco use rates among middle and high school students essentially flattened in 2017 after an encouraging decline from 2015 to 2016, according to the National Youth Tobacco Survey results, released Thursday by the Centers for Disease Control and Prevention.

Among high school students, there were minor declines in cigarette use (7.6 percent; down 4 percentage points versus 2016) offset by slight increases in e-cigarette (11.7 percent; up 4 percentage points versus 2016) use. Cigar usage among high school students was unchanged (7.7 percent) and is now nearly equal to cigarette use.

While these numbers are much lower than they were five years ago, the lack of continued progress in 2016 is frustrating and worrying, stated Robin Koval, CEO and president of Truth Initiative, a national public health organization, noting that the rates may be stagnating due to the proliferation of new and novel tobacco products that appeal to youth.

According to the 2017 NYTS data, 3.6 million middle and high school students currently use tobacco products. Among those users, nearly half (46.8 percent) of high school and (41.8 percent) of middle school students report use of two or more tobacco products. E-cigarette use among high school students remained flat this year with 2.1 million students (11.7 percent of high school students and 3.3 percent of middle school students) reporting past 30-day use.

Commenting on the survey results, FDA commissioner Scott Gottlieb said, “While fewer youth are using cigarettes and other combustible tobacco products, we must do more to address the disturbingly high number of youth who are using e-cigarettes and vaping products. We must not lose sight of the fact that for the past several years, e-cigarettes have been the most commonly used tobacco product among both middle and high school students and a total of 2.1 million youth used e-cigarettes in 2017.”

Continued Gottlieb, “These figures are particularly concerning because youth exposure to nicotine — whether it comes from a cigarette or an e-cigarette — affects the developing brain and may rewire it to be more susceptible to nicotine addiction in the future. And while there was no change in e-cigarette use from 2016 to 2017 among high school-aged teens, it's too soon to tell whether this represents a leveling off, following a steep decline from 2015 to 2016. But this bears watching.”

As previously reported, the FDA is ramping up efforts to address youth use of e-cigarettes.

In April, as a new part of its comprehensive plan on nicotine and tobacco regulation, the FDA announced the Youth Tobacco Prevention Plan. The plan began with a nationwide blitz of brick-and-mortar and online retailers that led to warning letters to businesses that sold JUUL brand products to minors. The agency also issued numerous warning letters — many in partnership with the Federal Trade Commission — to manufacturers, distributors and retailers for selling e-liquids used in e-cigarettes with labeling and/or advertising that cause them to resemble kid-friendly food products. These e-liquid products resemble juice boxes, candy or cookies, and some of them included cartoon-like imagery.

The agency is also taking a closer look at certain design features and product marketing practices and has required JUUL Labs Inc. and the manufacturers/importers of several other similar products to provide information to further examine marketing practices and the youth use and appeal of these types of products.

The FDA is also conducting focus groups with teens across the country about e-cigarettes and, later this year, will be launching a full-scale campaign focused on youth use of e-cigarettes.

“Additionally, we’re exploring clear and meaningful measures to make tobacco products less toxic, appealing and addictive — with an intense focus on deterring youth use and exposure. This could include measures on flavors/designs that appeal to youth, child-resistant packaging and product labeling to prevent accidental child exposure to liquid nicotine. We also plan to explore additional restrictions on the sale and promotion of electronic nicotine delivery systems to further reduce youth exposure and access to these products,” Gottlieb added.

Said Koval, “Today's report only emphasizes the need to bring more of these proven policies to all Americans. While the public education efforts from truth, the CDC and the FDA have all been proven effective, they cannot fully do their job when countervailing influences offset that effectiveness. We can't take our foot off the gas when it comes to fighting against this epidemic that kills 540,000 Americans every year and an industry that continues to spend more than $9 billion to market their deadly products.”
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