The results from the 2021 Alabama Youth Risk Behavior Survey (YRBS) have recently been published. The biennial survey is conducted by the Centers for Disease Control and Prevention in coordination with state health and education departments including the Alabama Department of Public Health. There’s great news for policymakers and tobacco opponents as youth use of traditional tobacco products is at record lows, while, overall, youth vaping has declined in recent years. But alarmingly, more Alabama high school students are reporting an increase in suicidal thoughts and attempts, which should cause alarm for policymakers and parents alike.
According to the YRBS, among Alabama high school students, in 2021, 18.9% reported having ever tried a combustible cigarette, while 5.7% reported current combustible cigarette use. Current use is defined as having used the product on at least one occasion in the 30 days prior to the survey. These are some of the lowest levels of cigarette use recorded among Alabama youth. In 1991 (the first year the YRBS was conducted among high school students in the Yellowhammer State), nearly three-fourths (74.2%) of high schoolers reported having ever tried a combustible cigarette and more than one-fourth (27.8%) reported current combustible cigarette use. Between 1991 and 2021, ever-use of combustible cigarettes declined by 74.5%, while current use declined by 79.5%.
Youth use of other traditional tobacco products is down as well. In 2021, 3.9% of Alabama high schoolers reported currently using cigars, and 4.1% reported using smokeless tobacco products. Between 2019 and 2021, current use of cigars decreased by 58.9% and current use of smokeless tobacco products declined by 53.9%.
Ever-use and current use of vapor products has declined among Alabama high schoolers. In 2021, only 36.4% reported having tried an e-cigarette, while less than one-fifth (17.5%) reported current use. Unfortunately, frequent (20 or more days) and daily use has increased with 9.9% citing frequent e-cigarette use and 8% reporting daily use.
Now, policymakers must be wary of reasons why youth are using e-cigarettes. The National Youth Tobacco Survey found that in 2021, among U.S. middle and high school students who reported currently using e-cigarettes, 43.4% reported using them because they were feeling anxious, depressed, and/or stressed. Only 13.2% reported using e-cigarettes because of flavors.
This is alarming given that Alabama youth have reported an increase in mental health issues. In 2021, more than one-fifth (21.6%) reported having seriously considered suicide in the 12 months prior to the survey. Further, 21.4% reported having made a plan “about how they would attempt suicide,” which was a 33.8% increase from 2019. Alarming, nearly one in ten (9.7%) Alabama high school students reported having made a suicide attempt in the 12 months prior, which was an alarmingly 155.3% increase from 2019’s 3.8%.
Given that youth e-cigarette use has not led to increases in youth traditional tobacco use, lawmakers must be careful with policies that may inhibit adults who smoke from making a switch to a safer alternative to combustible cigarettes. While an increase in frequent and daily use of vapor products is cause for concern, policymakers in the Yellowhammer State must be conscious of the true reasons why youth are vaping. The increase in suicidal thoughts and actions by Alabama high schoolers must be addressed, but draconian policies are unlikely to affect youth tobacco and vapor product use.
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.