June 7 (UPI) -- E-cigarettes were the most common way for U.S. young people to use tobacco for the fourth year in a row in 2017, a new survey from the Centers for Disease Control and Prevention shows.
"For the fourth straight year, the National Youth Tobacco Survey (NYTS) found e-cigarettes remain the most commonly used tobacco product among youth," American Lung Association National President and CEO Harold Wimmer said in a statement released Thursday in response to the new survey.
The CDC based its data on seven years of voluntary pencil-and-paper surveys self-administered by U.S. middle and high school students. The 2017 survey had a sample size of 17,872 and a response rate of 68.1 percent.
Though e-cigarette use, also known as vaping, was also the most common way for youth to consume tobacco last year, it had at least been declining overall, Wimmer pointed out, but the new CDC survey shows that progress has halted.
E-cigarette use may be underreported among young people in the CDC report because 63 percent of youth are unaware that JUUL, a popular electronic smoking device, contains nicotine, Wimmer said, citing a 2018 study in Tobacco Journal.
"The American Lung Association is concerned that the youth e-cigarette usage rates reported in NYTS may reflect a more conservative estimate given the upsurge in the use of one type of e-cigarette, JUUL," Wimmer said. "The use of JUUL is referred to as 'JUULing' - making it possible that self-reported youth usage of this product is underreported in the NYTS."
Wimmer said tobacco is "highly addictive," and nicotine has "a negative impact on adolescent brain development," prompting a need to take steps to protect young people outlined in the American Lung Association's 2018 State of Tobacco Control report. These steps include petitioning federal and state governments to urge the Food and Drug Administration to eliminate all flavors from tobacco products and continuing CDC social media campaigns against tobacco use.
Overall, tobacco use among middle and high school students decreased from 4.5 million users in 2011 to 3.6 million in 2017, according to the CDC report.