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Nebraska Tobacco Quitline offering free medication to help quit tobacco

Efforts to curb e-cigarette smoking among young people have struggled to keep pace with industry trends. In 2019, Juul ceased advertising in the U.S. and discontinued most of its flavors as part of the FDA’s ban on “teen-preferred flavors” from reusable e-cigarettes. The flavor ban didn’t apply to disposable vapes—the kind that more than half of teens use, according to the FDA’s 2023 National Youth Tobacco Survey. Juul has settled legal cases with 48 states and U.S. territories. ​​

Meanwhile, competitors have flooded the market, many of which are imported and not FDA approved. Between 2020 and 2022 alone, 46% of new reusable and disposable vape brands sold in the U.S., according to the CDC’s Morbidity and Mortality Weekly Report.

As of late 2023, around 2,000 vaping and e-cigarette brands are on the market, 90% of which are from Chinese factories. The FDA has yet to approve any disposable vape brands and is struggling to regulate the market, particularly as diplomatic relations with China remain tense. By contrast, Australia has an outright ban on all disposable vape imports starting January 2024.

The FDA can ban imports of illegal products and warn retailers who are selling unauthorized products, but that doesn’t stop minors from getting vapes online.

The internet, more specifically TikTok, is an echo chamber for vaping use among young people. A comprehensive analysis by Australian researchers found that a majority of TikToks featuring vaping (63%) depicted its use positively. In 2020, a third of TikTok’s users were 14 or younger.

Yet, teen vaping rates appeared to fall by about 40% in 2020, as many were going to school remotely, according to a 2021 CDC survey, which was conducted online for the first time.

Teen vaping rates may continue to decrease—with or without Juul’s recent attempt to sell vapes while “blocking” underage users using Bluetooth technology. TikTokers went viral ‌in late November 2023, vowing to quit vaping in response to reports of child labor abuses in the Democratic Republic of Congo’s mining of cobalt, used in disposable vapes. Disposable vapes also create huge amounts of e-waste: An estimated 150 million vapes containing cobalt and other materials like iron and copper end up in landfills yearly.

Vaping rates in middle school are on a slightly different trajectory

CDC data also shows that vaping among middle schoolers has climbed from 3.3% in 2022 to 4.6% in 2023. Bebi Davis, the vice principal of Kawānanakoa Middle School in Hawaii, told EducationWeek that younger students may not have been as exposed to anti-vaping messages during remote schooling.

Now that middle-schoolers have returned to in-person learning, school staff may struggle to notice changing tobacco technologies. Davis said that vapes that once were mistaken for pens and new oral tobacco pouches can look like candy.

Kurt Ribisl, a University of North Carolina researcher, spoke to NBC News about the middle school data, saying it may be too soon to be concerned. While smoking rates of middle and high schoolers usually rise and fall together, he said that the survey’s finding may be a short-term blip.

Data reporting by Wade Zhou. Story editing by Jeff Inglis. Copy editing by Kristen Wegrzyn.

This story originally appeared on Counseling Schools and was produced and distributed in partnership with Stacker Studio.

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