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FDA Warns Against Alarming E-cigarette Use Among Middle, High School Students

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The U.S. Food and Drug Administration has raised concerns against increasing e-cigarettes use among U.S. middle and high school students. Youth e-cigarette use remains a serious public health concern amid the ongoing COVID-19 pandemic.

The study by the FDA and the U.S. Centers for Disease Control and Prevention, published in the Morbidity and Mortality Weekly Report, says more than 2 million U.S. middle and high school students were found to be using e-cigarettes in 2021. Almost 85 percent of them used flavored e-cigarettes, which is more than 8 in 10 students.

The regulators warned that youth use of tobacco products, in any form, including electronic nicotine delivery systems or ENDS like e-cigarettes, is unsafe as they contain nicotine, which is highly addictive and can harm the developing adolescent brain. The use can also increase risk for future addiction to other drugs.

The report, based on data from the 2021 National Youth Tobacco Survey or NYTS, assessed current e-cigarette use, frequency of use, and use by device type, flavors and usual brand.

In the surveyed students, an estimated 11.3 percent or 1.72 million of high school students and an estimated 2.8 percent or 320,000 of middle school students reported current e-cigarette use. During the survey at the pandemic time, many students were in remote learning environments that might have affected their access to tobacco products.

Among the youth who currently used e-cigarettes, 43.6 percent of high school students and 17.2 percent of middle school students reported using e-cigarettes on 20 or more of the past 30 days. More than 1 in 4 high school students and about 1 in 12 middle school students used them daily.

The most commonly used e-cigarette device type was disposables with 53.7 percent using it, followed by prefilled or refillable pods or cartridges, and tanks or mod systems.

84.7 percent used flavored e-cigarettes including 85.8 percent of high school and 79.2 percent of middle school users. Overall, the most commonly used flavor types were fruit, candy, desserts, or other sweets, mint, and menthol.

Among high school students who currently used e-cigarettes, 26.1 percent reported their usual brand was Puff Bar, followed by Vuse, SMOK, JUUL and Suorin. Among middle school students the highly used brand was Puff Bar followed by JUUL. A good number of users reported not knowing the e-cigarette brand they usually used.

Mitch Zeller, director of the FDA's Center for Tobacco Products, said, "These data highlight the fact that flavored e-cigarettes are still extremely popular with kids. And we are equally disturbed by the quarter of high school students who use e-cigarettes and say they vape every single day. The FDA continues to take action against those who sell or target e-cigarettes and e-liquids to kids, as seen just this year by the denial of more than one million premarket applications for flavored electronic nicotine delivery system products.."

As part of the efforts to protect youth from the dangers of all tobacco products, including e-cigarettes, the FDA said it has taken action on over 96 percent of the applications to date.

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