New CDC Survey Results Show End to Decline in Youth E-Cigarette Use, Highlighting Urgent Need for Meaningful FDA Action

Statement of American Lung Association National President and CEO Harold P. Wimmer in response to the Centers for Disease Control and Prevention (CDC)'s Morbidity and Mortality Weekly Report "Tobacco Product Use Among Middle and High School Students—United States, 2011–2017," released today:

"For the fourth straight year, the National Youth Tobacco Survey (NYTS) found e-cigarettes remain the most commonly used tobacco product among youth. After the promising results last year of a decline in youth use of e-cigarettes, this progress has since halted from 2016 to 2017– an ominous warning that e-cigarette use requires urgent attention.

"The American Lung Association is concerned that the youth e-cigarette usage rates reported in NYTS may reflect a more conservative estimate given the upsurge in the use of one type of e-cigarette, JUUL. The use of JUUL is referred to as 'JUULing' – making it possible that self-reported youth usage of this product is underreported in the NYTS, especially in light of other studies showing that youth may be unaware that JUUL is an e-cigarette. In a recent study published in the journal Tobacco Control, 63 percent of youth were unaware that JUUL contains nicotine.

"Overall, CDC has found that youth using at least one tobacco product has decreased from 4.5 million users in 2011 to 3.6 million in 2017. However, 46.8 percent of high school students and 41.8 percent of middle school students who use tobacco products report using two or more tobacco products within the past 30 days. This is extremely concerning as tobacco is highly addictive, placing our nation's youth at risk of becoming the next generation hooked on tobacco. Nicotine has a negative impact on adolescent brain development in particular, and has been associated with lasting cognitive and behavioral impairments, including effects on working memory and attention. The need to protect our youth is urgent, and underscores the urgency for states to implement a comprehensive tobacco control agenda as outlined in the American Lung Association's "State of Tobacco Control" 2018 report.

"In addition, the Food and Drug Administration (FDA) must take urgent, meaningful action against JUUL and the other manufacturers of flavored e-cigarettes. This morning, FDA announced it was extending the deadline for the public to submit comments on whether flavored tobacco products should be removed from the marketplace. This delay demonstrates that FDA is continuing to fail to fully implement the Tobacco Control Act. In April, the American Lung Association and our partners sent a letter to FDA Commissioner Scott Gottlieb that outlined a series of actions FDA should take immediately, including ordering the removal of the JUUL flavors, including the highly popular 'mango' and 'cool cucumber' flavors, that were introduced onto the market without first seeking the required FDA authorization – a requirement of the Tobacco Control Act. For too long flavored tobacco and e-cigarettes have been marketed to kids with no real response from FDA, placing another generation at risk for a lifetime of addiction to tobacco products. The FDA must take meaningful action."

For media interested in speaking with an expert about tobacco, e-cigarettes and tobacco prevention, contact Allison MacMunn at the American Lung Association at [email protected] or 312-801-7628. Our "State Tobacco Control" 2018 report (Lung.org/sotc) grades the progress of the federal government and states in fighting youth tobacco use and promoting tobacco control overall as of January 1, 2018.