Abstract
Background: The prevalence of electronic cigarette (“e-cigarettes”) use among youth has raised alarm over recent years. Vaping is usually assumed to be of nicotine, but uncertainties in survey definitions may also include non-nicotine substances which can impose different risks (particularly marijuana). The current study quantifies the proportions of nicotine-specific and marijuana-specific vaping among adolescents.
Methods: Data from the Monitoring the Future (MTF) 2020 survey and National Youth Tobacco Survey (NYTS) 2021 were analyzed with respect to the substance vaped: nicotine, marijuana, or (in MTF) flavoring only. Past-30-day nicotine-specific vaping (exclusively, or also having vaped other substances) and marijuana-specific vaping were calculated. Results were also broken down by grade level, by cigarette smoking history (current, former, or never), and among frequent e-cigarette users (on 20+ days out of the past 30 days).
Results: Among past-30-day e-cigarette users, 14.6% (MTF) and 18.8% (NYTS) reported not vaping _any_ nicotine in the past 30 days. Marijuana use was reported by 45.7% (MTF) and 42.5% (NYTS) of past-30-day vapers. Both _nicotine_ vaping and marijuana vaping in the past 30 days were more common in current and former smokers than in never-smokers, and in frequent vapers (of any substance). Conversely, never-smokers were more commonly _exclusively_ vaping marijuana compared to current and former smokers.
Conclusions: A notable proportion of self-reported past-30-day e-cigarette users reported not vaping nicotine, and nearly half of self-reported past-30-day e-cigarette users vaped marijuana. Inclusion of more detailed data capturing the variety of substances used in vaping devices is imperative for accurate public health surveillance of both nicotine and marijuana vaping among US adolescents, considering their different respective harms and regulatory mechanisms.