What Substances Are Adolescents Vaping? Estimating Nicotine-Specific and Cannabis-Specific Vaping from US National Youth Surveys

Abstract

Background

Youth use of electronic cigarettes (“e-cigarettes”) is an ongoing concern. Vaping is usually assumed to be of nicotine, but survey responses may also include vaping of non-nicotine substances (particularly cannabis), which can impose different risks. The current study quantifies the proportions of nicotine-specific and cannabis-specific vaping among adolescents.

Methods

Data from the Monitoring the Future (MTF) 2021 survey were analyzed with respect to the substance vaped: nicotine, cannabis, or flavoring only. Past-30-day (P30D) nicotine-specific vaping (exclusively, or also having vaped other substances) and cannabis-specific vaping were calculated. Results were also broken down by grade level, cigarette smoking history (current, former, or never), and frequency of e-cigarette use (<20 vs. 20+ days in P30D).

Results

Among 4706 P30D e-cigarette users, 84.2% vaped nicotine; the remaining 15.8% reported not vaping any nicotine in P30D. Cannabis vaping was reported by 48.4% of P30D vapers. Vaping both nicotine and cannabis in P30D was more common in current and former smokers than in never-smokers, and in frequent vapers (of any substance). Conversely, never-smokers were more commonly vaping cannabis but not nicotine, compared to current and former smokers. Supplementary NYTS 2022 analyses were consistent with these findings.

Conclusions

A notable proportion of self-reported P30D vapers reported not vaping nicotine; nearly half vaped cannabis. Capturing the variety of substances used in vaping devices is imperative for accurate public health surveillance of both nicotine and cannabis vaping among US adolescents, considering their different respective harms and regulatory frameworks.

Keywords:

• Adolescents
• e-cigarettes
• cannabis
• nicotine
• tobacco
• vaping

Acknowledgments

The authors would like to thank Drs. Jennifer Pearson and Andrea Villanti for feedback on an initial draft of this manuscript.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Disclosure statement

Through Pinney Associates, Inc., all authors provide consulting services on tobacco harm reduction on an exclusive basis to JUUL Labs, Inc. (JLI). JLI had no involvement in this study nor in the decision to publish.

Additional information

Funding

There was no specific funding for this study. The authors’ efforts were supported by Pinney Associates, Inc.