Public health efforts to slow e-cigarette use in Minnesota teens appear to be working, but teens are still vaping at "very high rates," including a marked rise in teens vaping marijuana.

That's according to the Minnesota Department of Health's 2020 Minnesota Youth Tobacco Survey, which found one in five high school students use e-cigarettes and more than 70% of middle and high schoolers who vape report signs of nicotine dependence.  

Last year's survey suggests public health efforts have slowed the "rapid growth" of e-cigarette use that's happened in recent years, with the report noting e-cigarette use "held steady" in 2020 compared to 2017.

Related [Jan. 27]: Minnesota gets mixed grades on its tobacco report card

In 2017, 26.4% of high school students and 5.2% of middle school students surveyed reported using a tobacco product in the past 30 days. 

But in 2020, fewer students reported recently using tobacco, with 20.5% of high school students and 4.1% of middle school students saying they'd used tobacco in the past month. 

“This research suggests our public health efforts are working but also that there is a need for continued work,” MDH Commissioner Jan Malcolm said in a statement. “In particular, the data on youth vaping alarms us, as we see how this industry continues to use flavors, advertising, internet sales and other tactics to keep addicting youth to harmful nicotine.”

Meanwhile, the survey showed youth use of cigarettes and cigars has dropped to its lowest rates ever recorded in the survey, which has been conducted since 2000. Just over 3% of high school students report smoking cigarettes over the last 30 days and cigar use among high schoolers is just as low, MDH said. 

Nicotine dependence

In the 2020 survey, it was the first time MDH included a nicotine dependence scale for e-cigarettes. 

It found 70.4% of students who used e-cigarettes in the past month reported one or more signs of dependence on nicotine.

“These new data are consistent with conversations I’ve had with teens over the past three years in focus groups we conducted about youth vaping behavior and in our vaping prevention workshops,” Elyse Levine Less, executive director at the Tobacco-Free Alliance, said in a statement. “Teens do not intend to get addicted to nicotine and underestimate the risk."

Vaping marijuana

The number of e-cigarette users who have ever used an e-cigarette device to vape marijuana/THC has gone up from 2017 to 2020, the survey found. 

In 2017, 15.5% of middle school students and 33.4% of high school students who use e-cigs had ever used them to vape marijuana/THC. 

Last year's survey saw a "statistically significant" increase compared to 2017, with 71.7% of middle school students and 65.1% of high school students who use e-cigs saying they've used them to vape marijuana/THC. 

“The good news is that we know what it takes to make a positive change; we just need to act,” Malcolm said. “Minnesota needs a comprehensive approach to reverse the youth tobacco epidemic.”

MDH says preventing youth tobacco use requires a "sustainable and comprehensive approach," like counter-marketing efforts to raise awareness of the dangers of tobacco and e-cigs, as well as measures to reduce access to these products.

For youth looking to quit tobacco, the State of Minnesota has a program called My Life, My QuitTM, which is free and confidential. Teens can chat with a coach online at MyLifeMyQuit.com or text “Start” to 36072.