The prevalence of daily nicotine vaping among youths who currently vape rose from 15% in 2020 to nearly 29% in 2024, according to a cross-sectional study published in JAMA Network Open.
Among 115,191 US youths in grades 8 through 12 from the Monitoring the Future survey (2020-2024), researchers found that while overall past-30-day nicotine vaping declined (risk ratio [RR], 0.88), the youth vaping population appeared to harden during this period. Of the 15,226 youths who currently vaped, daily vaping prevalence increased significantly (RR, 1.14) though this increase showed a decelerating trend with smaller gains in later years. Of the 3,512 daily vapers, unsuccessful quit attempts rose from 28% to 53% (RR, 1.08).
Researchers used log-binomial regression models adjusted for demographics, behavioral health factors, and substance use to analyze 3 nested outcomes: current vaping prevalence in all respondents, daily vaping in current vapers, and unsuccessful quit attempts in daily vapers.
The study revealed disparities in vaping trends across demographic groups. Past-30-day vaping declined more slowly in females (from 18% to 11%, a 36% reduction) compared with males (from 18% to 8%, a 54% reduction). Among non-Hispanic Black youths, past-30-day vaping remained relatively stable (from 10% to 8%, a 16% reduction), while non-Hispanic White youths showed larger declines (from 20% to 12%, a 40% reduction).
Youths using other substances showed different patterns. Among those without cannabis use, past-30-day vaping declined from 10% to 4% (a 61% reduction), while among cannabis users, vaping remained stable (from 58% to 57%, a 1% reduction). Similar patterns emerged for tobacco and alcohol co-use.
Daily vaping increased more rapidly in rural youths (from 16% to 42%, a 155% increase) compared with urban youths (from 16% to 18%, a 14% increase). For cannabis users who currently vaped, daily vaping rose from 20% to 30% (a 51% increase).
The majority of daily vapers also reported depressive symptoms (76%) and behavioral problems (51%), indicating significant mental health comorbidities among this population.
More than half of daily vapers reported unsuccessful quit attempts in 2024, up from 28% in 2020. This measure represents a cardinal symptom of nicotine dependence and may reflect loss of control over nicotine use.
The findings align with market shifts toward products with higher nicotine concentrations. Data from 2024 showed that 48% of youth vapers used products with very high or ultrahigh nicotine potency (5% or greater concentration).
Study limitations included reliance on self-reported measures, abbreviated data collection in 2020 due to COVID-19, and inability to assess overall quit attempts or successful cessation among former users.
"Although the prevalence of current nicotine vaping declined during 2020 to 2024, the youth vaping population may have hardened over this period, evidenced by increasing daily use, more unsuccessful quit attempts, and shifting demographic profiles," wrote lead study author Abbey R. Masonbrink, MD, MPH, of the Department of Pediatrics, Children's Hospital Los Angeles, and colleagues.
The study was supported by the National Institute on Drug Abuse, National Institutes of Health, and the National Cancer Institute and US Food and Drug Administration.
Full disclosures can be found in the study.
Source: JAMA Network Open