E-cigarette use among high school teens rose nearly 1286% between 2011 and 2018. Test your knowledge of this alarming trend with this quick quiz.
The increase in use of electronic cigarettes (e-cigarettes) in the United States has been particularly dramatic among youth, with many brands specifically targeting young adults.
Companies, like JUUL, blu, and NJOY use highly influential, youth-friendly marketing channels like social media to promote their e-cigarettes as a healthier alternative to traditional combustible cigarettes (cigarettes), as tastier than cigarettes with exotic flavors, and as a device that allows youth the freedom to smoke any time, anywhere.1 How can a tween, teen, or 20-something looking for inclusion, status, or the next cool thing resist? Given that vaping among high school students in grades 9-12 increased approximately 1286% between 2011 and 2018,2 it appears they are willing to give vaping a try.
If you follow the news, you should be able to identify which of the above 10 statements on e-cigarette use among adolescents are fact or just plain fiction.
Question 1. Fact or fiction? E-cigarettes contain harmless water vapor that is safe for adolescent users to inhale.
Answer: Fiction. E-cigarettes create an aerosol that users inhale after the battery heats up a liquid that contains nicotine, flavorings, and other additives that are not deemed safe for adolescent users. Nicotine exposure in particular can cause addiction and have developmental effects on the adolescent brain.1
Question 2. Fact or fiction? One of the most common reasons that youth and young adults report for using e-cigarettes is as an aid to quit smoking cigarettes.
Answer: Fiction. Youth and young adults most commonly cited curiosity, flavoring/taste, and low perceived harm as reasons for using e-cigarettes. The use of e-cigarettes as an aid to quit smoking cigarettes was not reported as a primary reason.1
Question 3. Fact or fiction? In 2018, e-cigarettes were the most commonly used tobacco product among high school and middle school students in the US.
Answer: Fact. In 2018, e-cigarettes were the most commonly used tobacco product among high school students (20.8%) and middle school students (4.9%) in the US, followed by cigarettes and then cigars.2
Question 4. Fact or fiction? Between 2017 and 2018, use of e-cigarettes increased approximately 70% among high school students in the US.
Question 5. Fact or fiction? In the US, the percentage of young adults aged 18-24 years who smoke e-cigarettes is lower vs the percentage of adult e-cigarette users aged ≥25 years.
Answer: Fiction. According to the National Adult Tobacco Survey, between 2013 and 2014 the percentage of young adults aged 18-24 years who smoked e-cigarettes (6.10%) was approximately 283% higher vs adults aged ≥25 years who smoked e-cigarettes (1.59%).1
Question 6. Fact or fiction? In 2018, e-cigarette use was most common among Hispanic middle school students followed by white and then black middle school students.
Answer: Fact. In 2018, 6.6% of Hispanic middle school students used e-cigarettes followed by 4.9% of white middle school students and 3% of black middle school students.2
Question 7. Fact or fiction? In 2018, e-cigarette use was more common among Hispanic high school students vs white high school students in the US.
Answer: Fiction. E-cigarette use in the US was more common among white high school students (26.8%) vs Hispanic high school students (14.8%) in 2018.2
Question 8. Fact or fiction? Teenagers who try e-cigarettes first are about twice as likely to start smoking cigarettes vs teenagers who have never tried e-cigarettes.
Answer: Fiction. In a recent study of 6123 youths aged 12 to 15 years, teenagers who tried e-cigarettes first were 4 times more likely to go on to at least try cigarettes vs teenagers who never tried e-cigarettes.3
Question 9. Fact or fiction? Low-risk teenagers who would otherwise never engage in risky behaviors are >5 times more likely to start smoking cigarettes as a result of e-cigarette use vs teenagers who never tried e-cigarettes.
Answer: Fact. In the same study of 12-to-15-year-olds, low-risk teenagers who smoked e-cigarettes were 8.5 times more likely to go on to smoke cigarettes vs teenagers who never smoked e-cigarettes.3
Question 10. Fact or fiction? A recent national online survey among young adults found that nearly 50% of past 30-days users of the popular JUUL e-cigarette knew that it always contains nicotine.
Answer: Fiction. A recent national online survey of 1012 young adults aged 15-24 years found that just slightly more than one-third (37%) of past 30-day users of JUUL e-cigarettes knew that the product always contains nicotine; 25% of participants who recognized, but had not used the product knew that JUUL always contains nicotine.4
1. US Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2016.
2. Gentzke AS, Creamer M, Cullen KA, et al. Vital Signs: Tobacco Product Use Among Middle and High School Students - United States, 2011–2018. Morb Mortal Wkly Rep. 2019;68:157–164. DOI: http://dx.doi.org/10.15585/mmwr.mm6806e1.
3. Berry KM, Fetterman JL, Benjamin EJ, et al. Association of electronic cigarette use with subsequent initiation of tobacco cigarettes in US youths. JAMA Netw Open. 2019;2:e187794.
4. Willett JG, Bennett M, Hair EC, et al. Recognition, use and perceptions of JUUL among youth and young adults. Tob Control. 2019;28:115-116.