Vaping rates among teens appeared to decline in 2021 compared with 2019, according to the latest Youth Risk Behavior Survey — the first to reflect data collected during the COVID-19 pandemic.
The number of middle and high school teens surveyed who said they use e-cigarettes dropped to 14.8%, about half of the 30.6% who said they did in 2019. The number of teens who said they ever tried an e-cigarette dropped to 32.4%, compared with 48.3% in 2019.
The state Department of Health advises caution reading these survey results due to historically different conditions for public school students, who had in the previous 12 months attended school either fully or partially online.
Students’ lives were dramatically affected by the pandemic during this time, according to Lola Irvin, DOH administrator of Chronic Disease Prevention & Health Promotion, with great variations in home and learning environments.
Also, the survey is normally conducted in the spring, but due to COVID-19 was administered in the fall semester of 2021. Data from spring 2023 would be needed to determine trends.
Still, she said the report offers hints to what potentially happens when youth have limited access to tobacco products.
“In the past when we interviewed students and conducted surveys, the students indicated they were getting it from each other,” she said. “They didn’t have that social interaction. That actually verifies we need policies that would remove these products from access and availability.”
According to the survey, 58% of teens got e-cigarettes from a social source, while 7.6% got them from a retailer and 2% from the internet.
In Hawaii the purchase of e-cigarettes by those under the age of 21 is illegal.
DOH noted that in 2021 there was also an outbreak of e-cigarette- and vaping-associated lung injury cases, which was associated with a decline in e-vaping.
The survey also looked at other issues affecting teen health, including unintentional injuries and violence; tobacco, alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy; mental health and suicide; and physical activity.
Under the category of tobacco and substance abuse, there were several other areas of improvement.
The data shows that cigarette use among high school students declined, with about 3% (compared with 5%) and 2% of middle school students (compared with 4%) having smoked in the past 30 days.
Additionally, 12% of high school students, compared with 17.2% in 2019, and 2.8% of middle school students, compared with 7.2% in 2019, used cannabis in the past 30 days.
While youth tobacco and cannabis use appears to have declined, one year of data does not constitute a trend, Irvin said, and both remain public health concerns.
DOH this year continued its “Stronger Together” campaign, calling attention to strategies used by tobacco companies to target and addict youth — based on their age, income, culture or challenges they face.
The tobacco industry spends an estimated $26 million on marketing in Hawaii, DOH said, more than triple the amount the state spends on tobacco prevention and control programs.
DOH supported several bills in this year’s state Legislature as part of efforts to reduce youth vaping.
House Bill 551, which would have banned the sales of flavored tobacco products, including vaping products, as well as the mislabeling of e-liquids as nicotine-free in Hawaii, died in the state Senate in March.
Irvin said it was the ninth attempt to ban flavored tobacco products, including vaping products, which lure youth with candy flavors.
The bill was backed by the Keiki Caucus, numerous health groups and the state Department of Education but opposed by the Taxpayers Protection Alliance, Hawaii Smokers Alliance and Retail Merchants of Hawaii.
Senate Bill 1447, seeking to give counties the authority to regulate the sales of tobacco products, also died this session when it was not scheduled for a hearing in the House Committee on Finance.
Only Senate Bill 975, which seeks to tax e-cigarettes and e-liquids at the same level as other tobacco products, is still alive.
In addition to substance abuse, adolescent mental health in Hawaii remains a major concern, with 34.4% of middle school students and 34.8% of high school students responding that they had ever experienced depression in 2021.
The question students were asked is whether they felt sad or hopeless almost every day for two or more weeks in a row in the past 12 months.
Key findings from the survey reveal that a majority of students — 54% of middle school and 56% of high school students —in 2021 responded that they never or rarely got the kind of help they needed when feeling sad, hopeless, angry or anxious.
Younger teens experienced higher rates of cyberbullying, at 27.7% in 2021 compared with 22.7% in 2019.
Physical activity or exercise among teens appeared to get a boost in 2021, with 42.3% saying they engaged in regular physical activity, up from 33.3% in 2019. About 23% of teens, up from 17% in 2019, meet aerobic guidelines, or were active at least 60 minutes per day every day in the past week.
More than 11,000 Hawaii students participated in the 2021 surveys, which are filled out anonymously and voluntarily. One survey is administered to middle school students in grades 6-8, and a different one to high school students in grades 9-12.
This year’s survey included 17 new indicators such as grades in school, weight as described by the student, and how cannabis was consumed in the past 30 days.
The survey, which has tracked data trends since 1991, is a joint effort of DOH, the state Department of Education and the University of Hawaii Curriculum Research & Development Group in collaboration with the U.S. Centers for Disease Control and Prevention.
YOUTH RISK BEHAVIOR SURVEY 2021 RESULTS*
2021 2019
Tobacco use
>> Teens who ever tried e-cigarettes: 32.4% 48.3%
>> Teens who use e-cigarettes: 14.8% 30.6%
>> Young teens who ever tried e-cigarettes: 12.8% 30.6%
>> Young teens who use e-cigarettes: 6.7% 17.7%
>> Teens who got e-cigarettes from social source: 57.8% N/A
Regular cigarettes
>> Teens who ever tried a cigarette: 13.3% 17.8%
>> Teens who smoke cigarettes: 3.0% 5.3%
>> Teens who smoke menthol cigarettes: 15.8% N/A
Alcohol and drug use
>> Teens who use alcohol: 16.6% 20.4%
>> Teens who binge-drink 8.3% 10.9%
>> Teens who use cannabis 12.0% 17.2%
>> Young teens who use cannabis 2.8% 7.2%
Adolescent health
>> Teens with recent depression: 34.8% 34.7%
>> Young teens who are cyberbullied: 27.7% 22.7%
Health/physical activity
>> Teens who engage in regular physical activity: 42.3% 33.3%
>> Teens meeting aerobic guidelines: 23.1% 17.0%
* Teens are students in grades 9-12, young teens in grades 6-8
Source: 2021 Hawaii Youth Risk Behaviors
