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5 keys to reversing the youth e-cigarette epidemic

The youth e-cigarette epidemic remains a pervasive public health threat, with millions of young people at risk of long-term nicotine addiction.

The latest National Youth Tobacco Survey found that nearly one in five high school students (19.6%) use e-cigarettes, nearly 40% of them (38.9%) every day or almost daily. The coronavirus pandemic has exacerbated concerns about vaping, with research finding that young people who reported ever using e-cigarettes were up to five times more likely to test positive for COVID-19 compared to their non-vaping peers. Yet, e-cigarette sales have already rebounded to pre-pandemic levels due in part by a huge shift in the use of disposable e-cigarettes, which come in many sweet and fruity flavors, and menthol e-cigarettes – two product categories exempted from federal restrictions put in place in 2020.

Truth Initiative is taking a holistic approach to ending this crisis and believes that we need to continue that work, from preventing young people from starting e-cigarette use in the first place to helping the millions already addicted as they quit. Truth Initiative hosted a virtual discussion as part of its Impact Series – Unvaping America’s Youth –  with public health experts, former vapers, and tobacco prevention advocates to explore the work happening on multiple fronts to reverse the youth e-cigarette epidemic.

Here are some key takeaways about the action needed to end this crisis.

Reaching young people with prevention and quitting education

Despite the tobacco industry’s insistence to regulators that e-cigarettes are intended for and marketed to adult smokers, youth and young adults continue to vape at the highest rates.

Reaching young people with the facts they need to make informed decisions is critical. Many young people did not know the health risks of e-cigarettes when they started using them. In fact, according to a 2018 study published in Tobacco Control, sixty-three percent of JUUL users did not know that this product always contains nicotine.

The national truth education campaign is designed to reach young people wherever they are. It includes a proven-effective mass media campaign; This is Quitting, the first-of-its-kind text message quit vaping program to help young people quit; a national youth vaping prevention curriculum available to educators nationwide; and rigorous and field-leading research on the topic of e-cigarettes.

Advancing the science on quitting

While there is strong demand for quitting vaping among young people, limited research exists on how to help them quit.

New research that demonstrates the effectiveness of This is Quitting is beginning to fill an important gap. A randomized clinical trial found that young adults aged 18-24 who used This is Quitting had nearly 40% higher odds of quitting compared to a control group.

[To enroll in This is Quitting, teens and young adults text DITCHVAPE to 88709.]

The findings show that text messaging is a scalable and cost-efficient approach to promote vaping abstinence among young adult e-cigarette users. The results of the clinical trial also establish an effectiveness benchmark and build the evidence base for understanding how to help young people quit e-cigarettes.

“This is a free [and] confidential program based on text messaging, which we know is really the preferred way that young people choose to communicate. They can engage easily and discreetly without necessarily having to disclose to an adult that they're interested in quitting,” says Amanda Graham, Chief of Innovations at Truth Initiative. Since it launched in 2019, This is Quitting has helped over 350,000 teens and young adults on their journey to quit vaping.

Parents can text QUIT to (202) 899-7550 to receive text messages designed specifically for parents of vapers or register at to access a supportive online community and interactive website. 

Building momentum to quit by sharing real stories

At the start of 2021, Truth Initiative data showed 60% of 15- to 24-year-old current e-cigarette users surveyed want to quit vaping within the year. To support the many people who wanted to quit, truth launched Quit Together – a campaign that tapped TikTok influencers to broadcast their own experiences as they quit vaping, in real-time, to their huge followings across social media platforms. 

The campaign’s emphasis on providing information, tools and a support system was key for the campaign. According to a Truth Initiative survey, of those who want to quit, more than half (51.2%) agreed that texting would help them do so. Respondents also noted that having a support system on social media (43.6%), following along with a group of social influencers who were quitting (41.7%) and watching an influencer quit vaping themselves (40.8%) would be helpful.

Sam, a former vaper from South Carolina, says the recent truth campaign gave him the push he needed to successfully quit.

“With the help of truth and the accountability of This is Quitting, it really made the load 10 times easier in the sense of actually getting free of nicotine,” explains Sam.

Calling for comprehensive federal regulation

The shift in sales of disposables and menthol flavored e-cigarettes underscores the need for comprehensive regulation. According to the 2020 NYTS data, almost all young current e-cigarette users vape flavored e-cigarettes, which remain widely available after partial flavor restrictions in early 2020 exempted many products.

After finally facing a September 2020 deadline for e-cigarette manufacturers to submit premarket applications (known as PMTAs), FDA has begun reviewing the millions of product applications submitted. Immediate action is needed to ensure a thorough and transparent FDA review of all products – including products that are positioned with unauthorized quit claims, but have not applied as quit devices –  so that regulatory measures can help protect youth from a lifetime of nicotine addiction.

Aggressively monitoring of the tobacco industry’s targeting of young people

The tobacco industry continues to make claims that they are part of the “public health solution” to end smoking, while at the same time putting a new generation at risk of nicotine addiction and continuing to sell cigarettes.

Their tactics to reposition itself as innovative tech-savvy champion of quitting and youth tobacco prevention, often appropriating the language of public health to change its image, is another attempt to grow a market for nicotine among a generation of young people who were rejecting traditional nicotine delivery products like cigarettes.

The Truth Initiative Impact Series is a robust, recurring event that brings together key stakeholders and experts to engage in thought-provoking conversations about ways we can innovate and inspire action to achieve a culture where young people reject smoking, vaping, and nicotine. The goal of this thought leadership series is to convene diverse partners in tobacco control and other public health organizations, parents, teachers, and policy makers, who can benefit from Truth Initiative’s work.

In case you missed it, watch the Impact Series event: “Not Buying It: The Tobacco Industry's Rebrand”