Mon, March 13, 2017, noon:
Using data from Monitoring the Future, an annual, nationally representative survey of U.S. students in the 8th, 10th, and 12th grades, we looked at the substances they reported last using with a vaporizer, such as an e-cigarette. We found that, among all students who had ever used a vaporizer, about 65% reported that their last use was "just flavoring."' In all three grades, the percentage using just flavoring was above 57% for males, females, African-Americans, Hispanics, whites, and students both with and without a parent with a college degree. Nicotine use came in a distant second, at about 20% and students in 10th and 12th grades and 13% among 8th graders.
Accounting for students who reported last using nicotine in a vaporizer increases national estimates of tobacco/nicotine prevalence in the past 30 days by 24-38% above and beyond cigarette smoking. While this is a substantial increase, it is far less than estimates assuming all vaporizer users inhale nicotine.
These results challenge the common assumption that all vaporizer users inhale nicotine. They (a) call into question the designation of vaporizers and e-cigarettes as ENDS (Electronic Nicotine Delivery Systems), (b) suggest that the recent rise in adolescent vaporizer use does not necessarily indicate a nicotine epidemic, and (c) indicate that vaporizer users can be candidates for primary prevention programs. Finally, the results suggest the importance of developing different rationales for the regulation of vaporizer devices as compared to the regulation of substances marketed for vaporizer use.