A recent study published in Addiction shows teens who begin vaping after high school quickly progress to frequent use, with significant implications for public health policies.
A new study has revealed that young adults in the United States who begin using e-cigarettes after graduating high school are likely to progress to frequent use much faster than their peers who start earlier. Published in the scientific journal Addiction, the research highlights an alarming trend among late-initiating vapers.
While teenagers typically take about three years to transition to frequent e-cigarette use after starting in high school, those who begin vaping post-graduation — at an average age of 20 — reach this stage in just about one year. The study defines ‘frequent use’ as using e-cigarettes on 20 or more of the past 30 days.
The researchers followed a cohort of over 2,000 students from 10 California high schools, starting from their 9th-grade year in 2013 until 2023. Participants were surveyed about their e-cigarette use every six months during high school and annually thereafter.
“We know from existing research that youth who begin vaping early in their mid-teens are at high risk for developing nicotine dependence and are more likely to continue using nicotine products later in life,” lead author Junhan Cho, of the USC Keck School of Medicine, said in a news release. “Our study identified another high-risk group of late initiators who progressed to frequent use much more quickly. Not surprisingly, this ‘late initiation/rapid progression’ group showed swift increases in the use of nicotine and other substances and exhibited higher rates of e-cigarette dependence in young adulthood compared with other groups in our study.”
The study identified four distinct patterns of e-cigarette initiation and progression among the young adults:
1. Young Adulthood/Rapid Progression: About 21% of participants did not start vaping until after high school graduation but became frequent users within approximately 1.2 years.
2. Early High School/Gradual Progression: Nearly 14% began vaping early in high school and gradually progressed to frequent use over three years.
3. Late High School/Gradual Progression: A smaller group (4.3%) started using e-cigarettes in the latter part of high school, progressing to frequent use within three years post-graduation.
4. Low Initiation Risk/No Progression: 60% had a low risk of starting e-cigarette use and those who did start did not progress to frequent use.
The study also found that late initiators reported the highest prevalence of starting with JUUL devices (34.2%), which might contribute to their rapid progression to frequent use.
“This suggests that the rapid progression to frequent use might be connected in some way to the widespread availability and use of JUUL among US youth in 2018-2019,” added Cho.
The findings emphasize the need for health policies that address not only adolescent vaping but also young adults post-high school. This comprehensive approach may be vital in preventing the swift development of nicotine dependency and other substance use among late-initiating vapers.