Marijuana use in electronic cigarettes on the rise among U.S. teens

A study published today online in the Journal of the American Medical Association (JAMA) found marijuana use in electronic cigarettes has been increasing among U.S. middle and high school students from 2017 to 2018.

In the observational study, Hongying "Daisy" Dai, Ph.D., associate professor, University of Nebraska Medical Center College of Public Health used the National Youth Tobacco Survey to analyze responses from 38,000 students, grades 6-12. Dr. Dai, who has been studying e-cigarette use for five years, said e-cigarettes recently have increased very quickly among adolescents.

Among all students, the proportion who reported ever using marijuana in an e-cigarette increased from 11.1% in 2017 to 14.7% in 2018. The increases were seen among some demographic groups, including adolescents age 13 to 17 and Caucasian and Hispanic students.

These statistics are very concerning as marijuana use in adolescence could lead to adverse effects in brain development, mental health and academic performance. Our other concern is e-cigarette use has also been related to severe respiratory diseases.

Dr. Hongying "Daisy" Dai, a biostatistician and associate professor at the University of Nebraska Medical Center College of Public Health

As of Nov. 20, Dr. Dai noted there had been 2,290 vaping-related lung injury cases and 47 deaths. About 77% of the cases were in people with a history of vaping products containing THC, the mind-altering ingredient found in the cannabis plant.

In 2018, the number of students using marijuana in e-cigarettes included:

• 42.7% of students who ever used e-cigarettes;
• 53.5% of current e-cigarette users; and
• 71.6% of multiple tobacco product users.

Dr. Dai said the increase in marijuana use in e-cigarettes could be attributable to:

• the increase of "pod mod" e-cigarette products – small, easy-to-conceal devices that aerosolize liquid solutions containing nicotine, flavoring and other contents;
• access to marijuana through informal sources such as friends, family members and illicit dealers; and
• reduced perception among adolescents of the harms of marijuana use.

"Parents really need to raise their awareness about vaping. E-cigarette products look much like school supplies, so it's hard for parents to know if their child is using e-cigarettes," she said. "Even for me, it's hard to distinguish between school supplies and e-cigarette products."

She said a limitation of the study is that the information was self-reported. She added that studies about the short- and long-term health effects of using marijuana in e-cigarettes need to be done.

The study was supported by the National Cancer Institute and U.S. Food and Drug Administration Center for Tobacco Products.