Findings released this month from the most recent Monitoring the Future (MTF) survey of substance use behaviors and related attitudes among teens in the United States indicate that levels of nicotine and marijuana vaping did not increase from 2019 to early 2020, although they remain high.

The annual MTF survey is conducted by the University of Michigan’s Institute for Social Research, Ann Arbor, and is funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

In the four years since the survey began including questions on nicotine and marijuana vaping, use of these substances among teens have increased to markedly high levels From 2017 to 2019, the percentage of teenagers who said they vaped nicotine in the past 12 months roughly doubled for eighth graders from 7.5 percent to 16.5 percent, for 10th graders from 15.8 percent to 30.7 percent, and for 12th graders from 18.8 percent to 35.3 percent. In 2020, the rates held steady at a respective 16.6 percent, 30.7 percent and 34.5 percent. 

“The rapid rise of teen nicotine vaping in recent years has been unprecedented and deeply concerning since we know that nicotine is highly addictive and can be delivered at high doses by vaping devices, which may also contain other toxic chemicals that may be harmful when inhaled,” said NIDA Director Nora D. Volkow, M.D. “It is encouraging to see a leveling off of this trend though the rates still remain very high.”

Past-year vaping of marijuana also remained steady in 2020, with 8.1 percent of eighth graders, 19.1 percent of 10th graders, and 22.1 percent of 12th graders reporting past-year use, following a two-fold increase over the past two years. Additionally, daily marijuana vaping significantly decreased among 10th graders from 3 percent in 2019 to 1.7 percent in 2020.

Survey results also showed that reported use of JUUL vaping devices (also known as e-cigarettes), which contain nicotine and were previously the most popular brand among teens, significantly decreased from 2019 to 2020 among the older two grades. In 10th graders, past 12-month use of JUUL vaping devices decreased from 28.7 percent in 2019 to 20 percent in 2020 and in 12th graders, it decreased from 28.4 percent in 2019 to 22.7 percent in 2020.

The MTF survey is given annually to students in eighth, 10th and 12th grade who self-report their substance use behaviors over various prevalence periods: daily, past 30 days, past 12 months and lifetime. The survey also documents students’ perception of harm, disapproval of use and perceived availability of drugs. The survey results are released the same year the data are collected.

From February 11 through March 14, 2020, the MTF survey investigators collected 11,821 surveys in 112 schools before data collection stopped prematurely due to the COVID-19 pandemic. While the completed surveys from early 2020 represent about 25 percent of the sample size of a typical year’s data collection, the results were gathered from a broad geographic and representative sample, so the data were statistically weighted to provide national numbers. Estimates from MTF may differ from other government surveys due to differences in study population, questionnaire language and other factors. Study investigators are working with schools to deploy the survey in early 2021 to gather data that will reflect substance use during the COVID-19 pandemic and related periods of social distancing.

MTF researchers also conducted an in-depth analysis of a subset of the 2020 MTF data, combining 10th and 12th graders into a sample of 8,660 high schoolers, which was published this month in JAMA Pediatrics. The percentage of combined 10th and 12th graders who said they vaped nicotine in the past 30 days, past 12 months, or over the course of their lifetime were similar from 2019 to 2020, at 22 percent, 32 percent and 41 percent respectively. Similarly, in this group, daily, or near daily (20 or more occasions in the past 30 days), nicotine vaping declined from 9 percent to 7 percent from 2019 to 2020.

Overall, investigators concluded nicotine vaping for participants in these two grades remained steady despite decreases in use of previously popular brands like JUUL because teens moved to use of other vaping device brands, such as disposable, single use vaping devices. This and other data on trends in vaping brands used, perceived availability of vaping devices, and perceived risk of vaping from this subset of teens were published today in the same study.

Other highlights:

• The use of marijuana (in all forms, including smoking and vaping), the most commonly used illicit drug by adolescents, did not significantly change in any of the three grades for lifetime use, past 12-month use, past 30-day use and daily use from 2019–2020.

• Alcohol use has not significantly changed over the past five years. However, across all grades, alcohol use in the past 12 months has leveled off from its historical gradual decline.

• Past year non-medical use of amphetamines among eighth graders increased from 3.5 percent in 2017 to 5.3 percent in 2020. However, 10th and 12th graders reported recent lows in past year use at 4.3 percent for both grades and significant 5-year declines.

• Among eighth graders, past 12-month use of inhalants has increased from 3.8 percent in 2016 to 6.1 percent in 2020, a 64 percent proportional increase, unlike 12th graders, who reported an all-time low use of inhalants.

• Cigarette smoking in the last 30 days did not significantly change from 2019 to 2020. In all three grades, prevalence has dropped at least four-fold since the mid-1990s and is at or near historic lows.

• Past year use of over-the-counter cough medicine among eighth graders has gradually increased over the past five years, from 1.6 percent in 2015 to 4.6 percent in 2020, its highest rate since 2006.

• The percent of students reporting past year use of other drugs remains relatively low among 12th graders: 3.9 percent for LSD; 2.4 percent for synthetic cannabinoids; 2.9 percent for cocaine; 1.8 percent for MDMA (ecstasy); 1.4 percent for methamphetamine; and 0.3 percent for heroin.

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.drugabuse.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.