TUESDAY, Nov. 8, 2022 (HealthDay News) — There is increasing intensity of use of electronic cigarettes among U.S. teens, according to a study published online Nov. 7 in JAMA Network Open.

Stanton Glantz, Ph.D. (retired), from San Francisco, and colleagues from the Massachusetts General Hospital for Children, measured the intensity of use of e-cigarettes, cigarettes, and other tobacco products among U.S. adolescents and their dependence level over time. The analysis included 151,573 students in grades 6 to 12 participating in the National Youth Tobacco Surveys (2014 to 2021).

The researchers found that prevalence of e-cigarette use peaked in 2019 and then declined. The age at initiation of e-cigarette use decreased between 2014 and 2021, while intensity of use and addiction increased. E-cigarettes became the most common first product used (77 percent) in 2017. There was no change in age at initiation of use for cigarettes or other tobacco products, and changes in intensity of use by age were minimal. More e-cigarette users in 2019 were using their first tobacco product within five minutes of waking versus cigarettes and all other products combined. There was an increase in median e-cigarette use from three to five days/month in 2014 to 2018 to six to nine days/month in 2019 to 2020 and 10 to 19 days/month in 2021.

“These findings suggest that clinicians need to be ready to address youth addiction to these new highly addictive nicotine products during many clinical encounters, and stronger regulation is needed, including comprehensive bans on the sale of flavored tobacco products,” the authors write.

One author served as a paid expert witness against the tobacco industry outside the submitted work.

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