Marijuana Use in E-Cigarettes Has Increased Among Youth, Study Finds

Cigarette and marijuana use has climbed among teenagers over the last few years. A new study published in JAMA finds that marijuana in e-cigarette usage among middle schoolers and high schoolers follows this same trend.

Researchers found that an uptick in use in various racial and ethnic groups occurred from 2017 to 2020 and showed that Hispanic youth were the most frequent users. The results from the study will open doors to focused intervention to prevent continued use among the sixth to twelfth graders.

Testing and What It Revealed

Students in grades 6 to 12 attending public and private schools provided data for this study. The students answered questions given on the National Youth Tobacco Surveys (NYTS) in 2017, 2018, and 2020. No survey was administered in 2019. Providing answers was voluntary, and parental consent was required. The numbers of participants varied.

“The study found that a significant number (up to 1 in 5) of US middle and high school students have used marijuana in e-cigarettes, and this number is going up across all ethnic and racial groups over the last few years,” tells Armeen Poor, MD, clinical assistant professor of medicine at New York Medical College, and attending physician in the Division of Pulmonary & Critical Care at Metropolitan Hospital in New York City.

“The results of this study show that some youth are disproportionately impacted: Hispanic youth had the highest prevalence of use and experienced the greatest increase, followed by non-Hispanic Black youth,” notes study author Christina Vaughan Watson, DrPH, Health Scientist, Research Team Epidemiology Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention.

“This suggests a need for evidence-based strategies to prevent and reduce use among all youth,” she states.

In 2017, 11.1% of students reported using marijuana in an e-cigarette at any time; that number increased to 19.5% in 2020. Usage among Hispanic youths increased to 25.6%. The next highest group was non-Hispanic Black youths with 19.4%, then non-Hispanic White youths with 18.2%.

It is important to note that these results were self-reported by the students.

“We recognize that because we are asking about an illegal activity, some respondents could be less forthcoming about answering some of the questions,” Dr. Watson acknowledges.

Dr. Poor highlights another concern. “One key limitation is that this is all survey based, and only asked the question if they have ever used these products. We don’t know if this means a child used it once and decided never again to use it, or is a habitual user, which would make a big difference in terms of harm.”

What These Results Mean

Although the study does have its weaknesses, the strength of the findings can serve a beneficial purpose.

“These results are important because if marijuana can have these negative impacts on our children, and more of them are using it, then we really need to focus our efforts on understanding why and how we can help them,” Dr. Poor explains.

The findings provided insight into ways to give focused help.

“This suggests a potential need for targeted or tailored interventions (e.g., health education or messaging) and highlights the importance of equitable implementation of interventions,” remarks Dr. Watson.

The results also have a weighty impact on the trajectory of future drug usage among teens.

“It draws attention to a troubling trend that cannot be ignored, which is that more and more of our youth are using marijuana via e-cigarettes, which may also reflect the ease of obtaining it. This could have implications on their academic performance, relationships, and overall development, and may even open the door for other substances of abuse at a young age,” Dr. Poor highlights.

Dr. Poor continues. “Ultimately this can help with targeted interventions to reduce the use of marijuana via e-cigarettes and reverse this trend.”

Why Intervention is Necessary

“Youth use of tobacco – in any form – is unsafe. Nicotine can harm the developing brain, which continues to develop until about age 25. Additionally, marijuana use during adolescence is associated with decline in memory, attention, and learning,” states Dr. Watson.

Getting to them before they start gives the greatest chance of preventive success.

“The younger people are when they first try a substance, the greater the likelihood that they will abuse that substance at some point,” notes The Health Policy Institute.

The potential for early experimentation with drugs, along with availability of substances, makes it critical to take action.

“States are increasingly legalizing adult marijuana sales, which could impact ease of access, social acceptance, and marijuana use among youth. Monitoring the prevalence of modes of marijuana, tobacco and other substance use at national and state levels could inform policies, prevention education, communication, and cessation tools,” Dr. Watson concludes.