The Maryland Department of Health recently published the state results for the 2021 Youth Risk Behavior Survey (YRBS). The YRBS is a biennial survey conducted in coordination with the Centers for Disease Control and Prevention and examines various youth behaviors from eating habits to substance use, including youth use of tobacco and vapor product news.

The results could not have come sooner as lawmakers in the Old Line State are considering a bill that would ban the sale of flavored tobacco and vapor products.

According to the YRBS, in 2021, 3.6% of high schoolers and 1.3% of middle school students reported current combustible cigarette use, defined as having used the product on at least one occasion in the 30 days prior to the survey. Among high school students, current combustible cigarette use is at its lowest level recorded, and rates have declined by 78.2% since 2011, when 12.5% of Maryland high schoolers were currently smoking. Among middle schoolers, rates have decreased by 66.7% from 3.9% of middle school students smoking in 2013.

Use of other traditional tobacco products has also decreased and is at record lows. Only 3.2% of high schoolers and 1.9% of middle schoolers reported current cigar use. Further, only 3% of high school and 1.4% of middle school students reported current smokeless tobacco use in 2021.

As youth traditional tobacco use continues to decline, attention has turned towards youth vapor product use. Youth vapor use in Maryland seems to have peaked in 2019 when 23% of high schoolers and 5.9% of middle schoolers were currently using e-cigarettes. Between 2019 and 2021, current vaping rates among high schoolers decreased by 36.1% to 14.7% of students, and among middle schoolers, vaping rates decreased by 11.9% to 5.2% of students.

The Maryland YRBS also offers data on reasons why youth are using e-cigarettes. While Maryland high schoolers and middle schoolers reported largely using flavored e-cigarettes, they did not overwhelmingly cite flavors as a reason for use.

Among high school students, in 2021, 10.9% reported “some other reason” as a reason for e-cigarette use, while 10% cited using them because a friend and/or family member had, and only 2.2% cited using e-cigarettes because they were available in flavors.

Among middle school students, in 2021, 3.9% cited “other” as a reason for using e-cigarettes, 3.3% had used them because a friend/family member had, and only 0.8% cited using e-cigarettes because of flavors.

Lawmakers must focus on the reasons why youth are using e-cigarettes. According to the National Youth Tobacco Survey, in 2021, among U.S. middle and high school students that were currently using e-cigarettes, nearly half (43.4%) cited using them because they were feeling anxious, stressed, and/or depressed. Only 13.2% cited using them because of flavors.

According to the 2021 Maryland YRBS, the percentage of Maryland high schoolers that had felt sad or hopeless every day for nearly two weeks in a row and had quit doing usual activities increased by 22.5% from 32% of Maryland high schoolers in 2019 to 39.2% in 2021. This is an alarmingly increasing trend that was also seen in the national YRBS.

Maryland lawmakers should welcome the dramatic declines in youth traditional tobacco use and the new declines in youth vapor product use. Rather than imposing restrictions on adult access to safer alternatives, policymakers should focus on the reasons why youths are using e-cigarettes, and it is not flavors in Maryland, or nationally.

Lindsey Stroud is a Visiting Fellow at the Independent Women’s Forum, Director of the Taxpayers Protection Alliance’s Consumer Center, and a board member with the American Vapor Manufacturers Association.