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Background
E-cigarettes, or vaping products, heat an e-liquid, usually containing nicotine and other additives, into an aerosol. Nicotine is highly addictive, can harm the adolescent brain, and can prime it for addiction to other drugs. In 2019, 27.5% of U.S. high school students currently used e-cigarettes, and 73.4% had seen them used on school grounds.
Youth vaping rose sharply in 2017–2019, along with "pod mods": devices with a prefilled or refillable pod cartridge and a modifiable system. Most use nicotine salts, which have a lower pH than the freebase nicotine in most other e-cigarettes and cigarettes, letting users inhale very high nicotine levels more easily and with less throat irritation. JUUL, the best-selling pod mod, had 75% of U.S. e-cigarette sales by the end of 2018, and 59.1% of high school e-cigarette users named it their usual brand.
What was done
To see what students were actually using at school, CDC, with the California Department of Public Health and Department of Education and North Carolina's Division of Public Health, asked high schools for products confiscated or found on school grounds in the 2018–19 school year: a convenience sample of 1,456 California schools (March 2019) and a state-representative sample of 25 North Carolina schools (May 2019). Sixteen (1%) California and nine (36%) North Carolina schools sent products, which were sorted by device type, cartridge type and brand.
What was found
About 1,000 products came in from the 25 schools.
| California | North Carolina | |
|---|---|---|
| Devices | 233 | 176 |
| E-liquid cartridges | 343 | 267 |
| Pod mods, share of devices | 64% | 74% |
| Pod cartridges, share of cartridges | 80% | 81% |
| Top brands | Suorin (29%), SMOK (15%), JUUL (14%) | JUUL (48%), SMOK (16%), Suorin (9%) |

Vaping products confiscated at public high schools. Figure from the CDC report.
Why the states differed
Brand popularity and price may explain some of it — and so may marijuana law. California allowed recreational and medical marijuana sales to adults 21 and older, making it more available for young people to get indirectly; North Carolina did not. Refillable pod mods such as Suorin and SMOK can hold non-nicotine liquids, including marijuana — and one-third of high school e-cigarette users report using marijuana in one.
Limits: response rates were low, so the findings may not represent all schools; not every school kept what it confiscated; staff may not have recognized easily hidden devices, some made to look like flash drives; and the contents of the products were not tested.
What schools can do
School efforts work best as part of a comprehensive, evidence-based approach:
- adopt tobacco-free policies that cover e-cigarettes, enforced with access to help and treatment rather than punishment;
- use evidence-based curricula not sponsored by tobacco companies;
- teach staff and parents about the changing products and the known risks of youth tobacco use, including e-cigarettes.
Sources
Based on Mays Shamout, Lauren Tanz, Carolyn Herzig and others, "Notes from the Field: Characteristics of E-cigarette, or Vaping, Products Confiscated in Public High Schools in California and North Carolina — March and May 2019," MMWR, Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licens: CC0 1.0 (offentligt eje) · Bearbejdet efter www.cdc.gov
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