The Centers for Disease Control and Prevention (CDC) published the long-awaited 2021 results of the National Youth Risk Behavior Survey (YRBS). This biennial survey, which is the “largest public health surveillance system in the United States,” monitors various behaviors and attitudes among U.S. high school students, from dietary and physical activity to substance use and mental health.
The YRBS is typically conducted in the spring, but due to the COVID-19 pandemic, students took the survey in the Fall of 2021. The CDC notes that the 2021 “YRBS findings can be compared with data from previous YRBS cycles.”
There is good news for policymakers and public health organizations that have spent the past four years launching a war on flavored vapor and tobacco products: youth use of e-cigarettes has dramatically declined between 2019 and 2021. More importantly, youth use of traditional tobacco products is at record lows.
In 2021, among U.S. high school students, 36.2% reported having tried an e-cigarette in their lifetime. This was a 27.7% decrease from 2019’s 50.1% of students. Among students that were currently using e-cigarettes, defined as having used the product on at least one occasion in the 30 days prior, 18% were currently using e-cigarettes in 2021, a whopping 45% decrease from 2019’s 32.7%.
Daily use of e-cigarettes has not increased either. In 2021, 5% of U.S. high school students reported using vapor products daily, which was a 30.6% decrease from 2019, when 7.2% of students were daily e-cigarette users.
Even better, with the advent of safer nicotine products, youth use of much more harmful combustible products has been essentially eradicated.
In 2021, 17.8% of American high schoolers reported ever trying a combustible cigarette in their lifetime. This is an impressive 74.6% decrease from 1999 (the first year of the YRBS) when 70.1% of American high schoolers had tried a cigarette in their lifetime. Further, only 3.8% of U.S. high school students reported currently using a combustible cigarette, which is an 86.2% decline from 1999 when more than one-fourth (27.5%) of students were then-currently smoking.
Youth are also not using other tobacco products. In 2021, only 2.5% of high schoolers reported currently using smokeless tobacco and 3.1% were currently using cigars. Smokeless tobacco and cigar use decreased by 34.2% and 45.6%, respectively, between 2019 and 2021.
These results are welcoming, but there are some alarming increases in the data. The percentage of youth reporting persistent feelings of sadness or hopelessness increased by 15.3% from 36.7% of high schoolers in 2019 to 42.3% in 2021. In fact, 2021 is the highest rate on record of students reporting such feelings. Worse, 10.2% of students reported having attempted suicide in the 12 months prior to the survey, which was a 14.6% increase from 2019.
This is troubling as policymakers keep pushing for prohibitionist flavor bans while ignoring other national data that were already indicating an increase in youth mental health concerns. For example, the 2021 National Youth Tobacco Survey found that among U.S. middle and high school students who were currently using e-cigarettes, 43.4% reported using them because they were feeling anxious, depressed, and/or stressed. Only 13.2% reported using them because they were available in flavors.
Policymakers and public health must be conscious and appreciative of the dramatic declines in youth tobacco and vapor product use. They also must address a growing mental health crisis among American youth—and it’s not flavored tobacco and vapor products.
Lindsey Stroud is a Visiting Fellow at Independent Women’s Forum, Director of the Taxpayers Protection Alliance’s Consumer Center, and a board member with the American Vapor Manufacturers Association.