Use of E-Cigarettes for Nicotine, Marijuana, and Just Flavoring Among U.S. Youth

Published:December 15, 2019DOI:


      E-cigarette use is gaining popularity among youth, but knowledge on patterns of youth vaping different substances is limited. This study examines risk factors associated with past-30-day self-reported vaping of nicotine, marijuana, and just flavoring among youth and the patterns (single, dual, and poly) of substances youth reported in their e-cigarettes.


      The 2017 Monitoring the Future survey was analyzed. Weighted estimates of substances that youth vaped were calculated, and multivariable logistic regressions were performed to examine risk factors associated with youth vaping these substances. Analyses were conducted in 2019.


      Overall (n=14,560), 8.0% of participants reported currently vaping just flavoring, followed by 7.4% vaping nicotine and 3.6% vaping marijuana. Youth who were in 12th and 10th grade (versus 8th grade), male (versus female), current smokers (versus noncurrent smokers), and current marijuana users (versus noncurrent users) had increased risk of vaping nicotine, marijuana, and just flavoring. Black non-Hispanics were less likely than white non-Hispanics to report currently vaping. Among students who reported e-cigarette use in the last 30 days (n=1,685), only 24.9% reported vaping just flavoring only, and a majority (75.1%) reported vaping nicotine, marijuana, or multiple substances. Higher (versus lower) grade or increasing cigarette smoking intensity was associated with a higher proportion of students reporting vaping nicotine only and a lower proportion of students reporting vaping just flavoring only.


      Youth e-cigarette use reveals a complex pattern, and youth reported vaping substances potentially addictive beyond just flavoring. Strategies and interventions to reduce youth e-cigarette use are needed.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Miech R
        • Johnston L
        • O'Malley PM
        • Bachman JG
        • Patrick ME
        Adolescent vaping and nicotine use in 2017–2018 — U.S. national estimates.
        N Engl J Med. 2019; 380: 192-193
        • HHS
        E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.
        HHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta2016
        • Miech R
        • Patrick ME
        • O'Malley PM
        • Johnston LD
        What are kids vaping? Results from a national survey of U.S. adolescents.
        Tob Control. 2017; 26: 386-391
        • Tam J
        • Warner KE
        Students’ cigarette smoking and the perceived nicotine content of their e-cigarettes.
        Am J Prev Med. 2018; 55: 376-383
        • Johnston LD
        • Miech RA
        • O'Malley PM
        • Bachman JG
        • Schulenberg JE
        • Patrick ME
        Monitoring the Future National survey results on drug use, 1975–2018: Overview, Key Findings on Adolescent Drug Use.
        Institute for Social Research, University of Michigan, Ann Arbor, MI2019
      1. Bachman J, Johnston L, O'Malley P, Schulenberg J. The Monitoring the Future project after thirty-seven years: design and procedures. Monitoring the Future Occasional Paper No. 76. Published 2011. Accessed on September 26, 2019.

      2. Food and Drug Administration. FDA launches new campaign: “the Real Cost” youth e-cigarette prevention Updated June 4, 2019. Accessed September 16, 2019.

      3. Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb. M.D., on advancing new policies aimed at preventing youth access to, and appeal of, flavored tobacco products, including e-cigarettes and Published 2019. Accessed September 16, 2019.

        • Farrelly MC
        • Duke JC
        • Nonnemaker J
        • et al.
        Association between the Real Cost media campaign and smoking initiation among youths — United States, 2014–2016.
        MMWR Morb Mortal Wkly Rep. 2017; 66: 47-50
        • Miech R
        • Johnston L
        • O'Malley PM
        Prevalence and attitudes regarding marijuana use among adolescents over the past decade.
        Pediatrics. 2017; 140e20170982
      4. Statement from CDC Director Robert R. Redfield, M.D., and Acting FDA Commissioner Ned Sharpless, M.D., on federal and state collaboration to investigate respiratory illnesses reported after use of e-cigarette products. Published 2019. Accessed September 16, 2019.

        • Willett JG
        • Bennett M
        • Hair EC
        • et al.
        Recognition, use and perceptions of JUUL among youth and young adults.
        Tob Control. 2019; 28: 115-116