The Centers for Disease Control and Prevention is blaming nicotine vaping devices like Juul for single-handedly driving a spike in tobacco use among teens, threatening to erase years of progress curbing youth use.
Over the course of a year, the number of high school students using tobacco products, which include e-cigarettes, increased by about 38 percent, the CDC found in its annual National Youth Tobacco Survey released Monday. That translates to about 27 percent of high school teens using tobacco products in 2018, the CDC said.
Of all the tobacco products the CDC surveys students about, including cigarettes and hookah, only e-cigarettes saw a meaningful increase in use. Among high school students, e-cigarette use surged nearly 78 percent. In 2018, nearly 21 percent of high school students vaped, up from close to 12 percent in 2017.
In 2018, 1.5 million more middle school and high school students vaped than in 2017, up to 3.6 million from 2.1 million, according to the survey.
While the survey did not specifically ask teens about Juul, Brian King, deputy director for research translation in the CDC's Office on Smoking and Health, said the increase in e-cigarette use coincides with the rise in sales of Juul's products.
Teens are also vaping more frequently than before. About 28 percent of teens who are vaping are doing it 20 or more times per month, a 39 percent increase from the 20 percent of teens who were defined as frequent users in 2017, the CDC said.
About 40 percent of high school students who said they used tobacco said they used two or more types of products, a 23 percent increase. About 15 percent of them vaped and smoked cigarettes, according to the survey.
The data confirms anecdotal reports that more and more teens have started to use e-cigarettes, particularly Juul. Public health officials, including the CDC, the Food and Drug Administration and the surgeon general, have warned that the trend could reverse two decades of driving down teen smoking rates.
"The skyrocketing growth of young people's e-cigarette use over the past year threatens to erase progress made in reducing youth tobacco use," CDC Director Robert Redfield said in a statement. "It's putting a new generation at risk for nicotine addiction."
Among other tobacco products, including cigarettes and cigars, the CDC did not find any significant change. That means e-cigarettes were the sole driver of the increase in overall tobacco use, the agency said. E-cigarettes surpassed cigarettes to become the most commonly used form of tobacco among middle school and high school students in 2014.
Cigarette smoking among high school students ticked up to 8.1 percent from 7.6 percent. It's not a statistically significant rise, but it still has some concerned.
"These survey results are deeply troubling," Matthew Myers, president of the Campaign for Tobacco-Free Kids, said in a statement. "They add to mounting concerns that the rise in youth use of e-cigarettes, especially Juul, is vastly expanding the number of kids addicted to nicotine, could be leading kids to and not away from cigarettes, and directly threatens the decades-long progress our nation has made in reducing youth smoking and other tobacco use."
Surgeon General Jerome Adams has declared youth e-cigarette use an epidemic. The FDA is trying to limit illegal sales to minors. The agency is drafting new rules that would limit flavored nicotine pods to age-restricted stores like vape shops. The agency plans to publish the proposed regulation within the next month, Commissioner Scott Gottlieb told CNBC last week.
Gottlieb said Monday that the FDA is also exploring possible civil and criminal enforcement tools "to target potentially violative sales and marketing practices by manufacturers as well as retailers."
"These trends require forceful and sometimes unprecedented action among regulators, public health officials, manufacturers, retailers and others to address this troubling problem," Gottlieb said in a statement.
Juul spokeswoman Victoria Davis said the company is "committed to fighting underage use of vaping products, including Juul products."