Cigarette Smoking Falls Below Vaping and Marijuana Use Among Teenagers

Cigarette smoking has dropped so sharply among U.S. teenagers that vaping and marijuana use are more common, according to a national survey of adolescent drug use released Thursday.

The report, sponsored by the federal government’s National Institute on Drug Abuse and administered by the University of Michigan, found that 22.9 percent of high school seniors said they had used marijuana within the previous 30 days and 16.6 percent had used a vaping device. Only 9.7 percent had smoked cigarettes.

The survey of 43,703 eighth-, 10th- and 12th-graders in public and private schools nationwide raised concerns about the popularity of vaping devices, available in countless styles to appeal to different social groups. But it was otherwise optimistic. It found that teenagers’ consumption of most substances — including alcohol, tobacco, prescription opioids and stimulants — had either fallen or held steady at last year’s levels, the lowest rates in 20 years.

By contrast, rates of marijuana use have remained largely consistent, with occasional small shifts, in recent years. (Studies show, however, that marijuana rates have risen among young adults in the past decade.)

“We’re impressed by the improvement in substance use by all teenagers,” said Dr. Wilson Compton, deputy director of the institute.

Still, Compton continued, “we don’t yet know about the health problems in vaping.”

Vaping devices, which typically vaporize substances into an inhalant, are perceived by some experts as a healthier alternative to traditional cigarettes because they do not include carcinogens that come with burning tobacco. But Compton said, “The concern is that it may represent a new route for exposure to nicotine and marijuana.”

The devices are typically sold with nicotine. But when 12th-graders were asked what they believed was in the mist they had vaped most recently, 51.8 percent said “just flavoring.” When asked about use in the past month, 1 in 20 12th-graders said they had used marijuana in vaping devices and 1 in 10 said nicotine.

Cassie Poncelow, a school counselor at Poudre High School in Fort Collins, Colorado, has noticed an upsurge in vaping across all social groups.

“We’re seeing a ton of it,” she said. The devices are readily accessible and easy to conceal, she added.

“Kids are taking hits on their vape pens in the hallways and nobody notices,” Poncelow said, noting that some devices resemble flash drives, which students plug into laptops.

But educators and public health officials praised the drop in tobacco use. Compton noted that in 1996, 10.4 percent of eighth-graders reported smoking cigarettes daily. By 2017, that figure fell to 0.6 percent. In 1997, daily smoking among 12th-graders peaked at 24.6 percent. By 2017, only 4.2 percent smoked cigarettes daily.

Thomas J. Glynn, a former director of cancer science at the American Cancer Society and an adjunct lecturer at Stanford University School of Medicine, hailed the continuing tobacco decline as “an astounding accomplishment in public health.”

“But,” he added, “it doesn’t mean we close the door and go home now.”

While noting that the data on vaping devices as a gateway to cigarettes is inconclusive, he added, “I think we have to have alarms out.”

Compton attributed the tobacco decline to many factors, including strong anti-smoking campaigns, higher cigarette prices and peer pressure. Students in all grade levels reported that they viewed cigarettes and alcohol as distasteful and a serious health risk.

Similar explanations have been given for dropping rates of alcohol use, especially binge drinking. Students have become more self-conscious about the possibility of their drunken images being posted on social media, experts say, which can tarnish reputations and college eligibility.

But marijuana? Not so much.

In the report, only 14.1 percent of 12th-graders said they saw a “great risk” from smoking marijuana occasionally. In 1991, 40.6 percent of seniors held that view. In 2017, nearly 24 percent of students in all three grades said they had used marijuana over the past year, a rate that has stayed relatively stable.

Allison Kilcoyne, who directs a health center at a high school in a Boston suburb, has seen firsthand the evidence of the survey’s marijuana findings. Convincing students of marijuana’s risk is tricky, said Kilcoyne, a family nurse practitioner, especially in a state that permits medical marijuana.

“They perceive there are no negative effects,” Kilcoyne said. “I talk about the impact on their developing brain and the risk of learning to smoke marijuana as a coping mechanism. We have other interventions, I say. But the problem is that for them, it works. They’re feeling immediate relief of whatever symptoms they have. They’re medicating themselves.”

Yet while marijuana use among high school seniors has not declined, it has also not increased in recent years. Given that fewer students hold marijuana in disregard, researchers are perplexed but relieved that use of marijuana has not kept pace with attitudes toward it.

“Drug use tends to go hand in hand with perceptions of risk and approval,” said Ty S. Schepis, an associate professor of psychology at Texas State University who studies adolescent and young adult drug use.

But approving of marijuana may not necessarily translate in such a manner, he said. “I’ve had friends who like to go sky diving. I would never go sky diving. There are certain activities that we may quietly condone or tacitly approve, even though the majority still may not want to engage in it.”