UCLA Study Reports Rapid Rise in E-Cigarette, Marijuana Use Among Young Adults

Smoking cigarettes may have been on the decline for a decade, but two trends have become popular with Californians between the ages of 18 and 25: electronic cigarettes and marijuana. Findings from the study led by the UCLA Center for Health Policy Research (CHPR) highlights the need for new policies to make these products less desirable to young adults.

The policy brief, “The Changing Landscape: Tobacco and Marijuana Use Among Young Adults in California,” shows vaping surged by 48% from 2017–2018 amongst young adults in California, and marijuana use increased by 19% during that time. Using data from the UCLA CHPR’s 2018 California Health Interview Survey, researchers also found 48% of e-cigarette users, 40% of marijuana users, and 28% of cigarette smokers were between the ages 18 to 20 — under the legal age limit of 21 to purchase these products in 2018.

“The findings of our study on underage use of cigarettes, e-cigarettes, and marijuana show that the enforcement of existing laws and policies could be further strengthened. Local jurisdictions could regulate suppliers by preventing unlicensed retailers and underage sales of cigarettes, e-cigarettes and marijuana,” explains Ying-Ying Meng, DrPH, lead author, and codirector of the Chronic Disease Program and a senior research scientist at UCLA CHPR.

Some individuals use e-cigarettes to stop smoking, however, the nicotine-delivery systems have become an entrance to nicotine use by young adults who favor flavored e-cigarettes. According to researchers, only 1 in 5 young adults (19%) in California reported using e-cigarettes as a method of smoking cessation. In the most recent study, researchers found of the 682,000 young adults who used an e-cigarette in 2018, 58% reported social reasons, enjoyment, and curiosity as reasons for vaping. 

Previous studies on the adverse effects of e-cigarettes have reported how use of these products contributes to lung disease. The use of e-cigarettes and concurrent traditional cigarettes also puts users at risk of increased exposure to carcinogens.

Another significant finding notes any use of cigarettes, e-cigarettes or marijuana is significantly higher for males than females, with male e-cigarette use nearly double female cigarette use. 

These findings indicate a need for the state, cities, and counties to establish smoking, vaping and marijuana-use policies to help curb the use of these products. To date, efforts have been made in some jurisdictions to explicitly include e-cigarettes and marijuana in smoke-free policies; more than 80 local California communities have passed restrictions on the sale of flavored tobacco products, and several California jurisdictions have placed a moratorium or prohibition on the sale and distribution of e-cigarettes. Gov. Gavin Newsom has also proposed a nicotine tax on e-cigarettes that would become effective in 2021. 

While policies have been implemented to help curb the increase, more are needed. Meng adds, “Although the state and local governments have made massive strides in a tobacco control policy, our research underscores the importance of considering laws that affect access to all three products together. Policies are needed to discourage young adults from switching from one product to another due to differences in price, access, and availability.”

Additional recommendations include:

• Adopt new and effective policies to curtail the surge of emerging products by enacting price policies, such as e-cigarette taxes and minimum floor prices.
• Banning all flavored nicotine products.
• Capping or limiting the number of retailers of these products by geographic areas.
• Include e-cigarettes and marijuana in smoke-free policies.
• Local jurisdictions could regulate suppliers by preventing unlicensed retailers and underage sales of cigarettes, e-cigarettes and marijuana. 

Healthcare workers and oral health professionals can work together to improve care for these patients by expanding screening questions to include vaping and marijuana use, instead of only focusing on cigarette smoking. They can also help increase awareness about the potential harms of using cigarettes, e-cigarettes and marijuana, and provide cessation assistance.