New data on substance use among young adults suggests that many former teen e-cigarette users are continuing the habit. Mental Health, Public Health, States, Children’s Health, Colorado, Substance Misuse, Vaping KFF Health News
G Kumar’s vaping addiction peaked in college at the University of Colorado, when flavored, disposable vapes were taking off.
“I’d go through, let’s say, 1,200 puffs in a week,” Kumar said.
Vaping became a crutch for them. Like losing a cellphone, losing a vape pen would set off a mad scramble.
“It needs to be right next to my head when I fall asleep at night, and then in the morning, I have to thrash through the sheets and pick it up and find it,” Kumar recalled.
They got sick often, including catching covid-19 — and vaping through all of it.
Kumar, now 24, eventually quit. But many of their generation can’t shake the habit.
“Everyone knows it’s not good for you and everyone wants to stop,” said Jacob Garza, a University of Colorado student who worked to raise awareness about substance use as part of the school’s health promotion program.
“But at this point, doing it all these years … it’s just second nature now,” he said.
Marketing by e-cigarette companies, touting the allure of fruity or candy-like flavors and names, led many teens to try vaping. As more high schoolers and younger kids experimented with e-cigarettes, physicians and researchers warned it could lead to widespread addiction, creating a “Generation Vape.”
Research has shown nicotine is highly rewarding to the brains of young people.
New data on substance use among adults ages 18-24 suggests that many former teen vapers remain e-cigarette users. National vaping rates for young adults increased from 7.6% in 2018 to 11% in 2021.
It’s not surprising that many of them start in high school for social reasons, for all sorts of reasons,” said Delaney Ruston, a primary care physician and documentary filmmaker. “And many of them now — we’re seeing this — have continued to college and beyond.”
Her latest film is “Screenagers Under the Influence: Addressing Vaping, Drugs & Alcohol in the Digital Age.”
In Colorado, the share of those 18 to 24 who regularly vaped rose by about 61% from 2020 to 2022 — to nearly a quarter of that age group.
“That’s an astounding increase in just two years,” Ruston said.
Trends in that state are worth noting because, before the pandemic, Colorado led the nation in youth vaping among high school students, surpassing 36 other states surveyed.
Nationally, vaping rates among high schoolers dropped from 28% in 2019 to 10% in 2023, according to the Annual National Youth Tobacco Survey. But for many young people who started vaping at the height of the trend, a habit was set.
At Children’s Hospital Colorado, pediatric pulmonologist Heather De Keyser displayed on her screen a clouded X-ray of the lung of a young adult damaged by vaping.
For years, doctors like her and public health experts wondered about the potentially harmful impact of vaping on pre-adult bodies and brains — especially the big risk of addiction.
“I think, unfortunately, those lessons that we were worried we were going to be learning, we’re learning,” said De Keyser, an associate professor of pediatrics in the Breathing Institute at Children’s Hospital Colorado.
“We’re seeing increases in those young adults. They weren’t able to stop.”
It’s no coincidence the vaping rates soared during the pandemic, according to several public health experts.
For the past couple of years, undergraduates have talked about the challenges of isolation and using more substances, said Alyssa Wright, who manages early intervention health promotion programs at CU-Boulder.
“Just being home, being bored, being a little bit anxious, not knowing what’s happening in the world,” Wright said. “We don’t have that social connection, and it feels like people are still even trying to catch up from that experience.”
Other factors driving addiction are the high nicotine levels in vaping devices, and “stealth culture,” said Chris Lord, CU-Boulder’s associate director of the Collegiate Recovery Center.
“The products they were using had five times more nicotine than previous vapes had,” he said. “So getting hooked on that was … almost impossible to avoid.”
By “stealth culture,” Lord means that vaping is exciting, something forbidden and secret. “As an adolescent, our brains are kind of wired that way, a lot of us,” Lord said.
All over the U.S., state and local governments have filed suits against Juul Labs, alleging the company misrepresented the health risks of its products.
The lawsuits argued that Juul became a top e-cigarette company by aggressively marketing directly to kids, who then spread the word themselves by posting to social media sites like YouTube, Instagram, and TikTok.
“What vaping has done, getting high schoolers, in some cases even middle schoolers, hooked on vaping, is now playing out,” said Colorado Attorney General Phil Weiser.
Juul agreed to pay hundreds of millions in settlements. The company did not respond to requests for comment on this article.
R.J. Reynolds, which makes another popular vape brand, Vuse, sent this statement: “We steer clear of youth enticing flavors, such as bubble gum and cotton candy, providing a stark juxtaposition to illicit disposable vapor products.”
Other big vape companies, like Esco Bar, Elf Bar, Breeze Smoke, and Puff Bar, didn’t respond to requests for comment.
“If we lived in an ideal world, adults would reach the age of 24 without ever having experimented with adult substances. In reality, young adults experiment,” said Greg Conley, director of legislative and external affairs with American Vapor Manufacturers. “This predates the advent of nicotine vaping.”
The FDA banned flavored vape cartridges in 2020 to crack down on marketing to minors, but the products are still easy to find.
Joe Miklosi, a consultant to the Rocky Mountain Smoke-Free Alliance, a trade group for vape shops, contends the shops are not driving vaping rates among young adults in Colorado. “We keep demographic data in our 125 stores. Our average age [of customers] is 42,” he said.
He has spoken with thousands of consumers who say vaping helped them quit smoking cigarettes, he said. Vape shops sell products to help adult smokers quit, Miklosi said.
Colorado statistics belie that claim, according to longtime tobacco researcher Stanton Glantz. The data is “completely inconsistent with the argument that most e-cigarette use is adult smokers trying to use them to quit,” said Glantz, the former director of the Center for Tobacco Control Research and Education at the University of California-San Francisco.
For recent college graduate G Kumar, now a rock climber, the impetus to quit vaping was more ecological than health-related. They said they were turned off by the amount of trash generated from used vape devices and the amount of money they were spending.
Kumar got help from cessation literature and quitting aids from the university’s health promotion program, including boxes of eucalyptus-flavored toothpicks, which tasted awful but provided a distraction and helped with oral cravings.
It took a while and a lot of willpower to overcome the intense psychological cravings.
“The fact that I could just gnaw on toothpicks for weeks on end was, I think, what kept me sane,” Kumar said.
This article is from a partnership that includes CPR News, NPR, and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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