Youth vaping has 'exploded' over time, as smoking rates decrease in North Dakota

GRAND FORKS — While youth smoking has decreased over the years, youth vaping has “exploded over time,” according to Neil Charvat, director of the North Dakota Department of Health & Human Services’ tobacco prevention and control program.

“The flavors can get people to try, but the nicotine is what keeps them coming back for more,” he said.

According to the North Dakota Department of Health & Human Services’ tobacco surveillance data, 21.2% of high school students, as of 2021, have used electronic nicotine delivery systems — also known by the abbreviation ENDS — such as vape pens and e-cigarettes. While this is lower than the 33.1% from 2019, COVID’s impact on schools could have affected the data, Charvat said. As for cigarettes, the current percentage of 5.9% is a considerable drop from the 12.6% of 2017, but still higher than the national average of 1.6%. The data was collected as a part of the North Dakota Youth Risk Behavior Survey, which is conducted each odd year.

Only 2.8% of high schoolers use cigars, and 4.3% use smokeless tobacco, according to the department’s data. In 2019, 32.7% of teen ENDS users seriously considered quitting, according to a North Dakota Youth Tobacco Survey.

Nationally, the CDC also reports lower cigarette use than products like ENDS. In 2022, while 2% of high school students said they smoked cigarettes (within the last 30 days of being asked), 14.1% said they’d used e-cigarettes. Since 2014, e-cigarettes have been identified as the most used tobacco product among youth. In general, as of 2022, 16.5% of high schoolers said they used some form of tobacco products.

Charvat said the kind of nicotine in vape products, such as Juuls, makes them much more addictive than cigarettes. While tobacco products can create a sick feeling in people using them for the first time, Juul uses nicotine salt, which allows for a person to process more nicotine.

Kailee Dvorak, a tobacco prevention coordinator for Grand Forks Public Health, says vape pens are more appealing to youth.

“The reason that they report using it is usually because of the flavors of those products and the type of nicotine in them is different than the traditional tobacco so that they don’t get that strong throat hit from it,” she said. “It’s very smooth. It’s easier for the teens to use them, and the flavors that they come in, they’re very smooth and enticing to youth to use them.”

Both the state health department and Grand Forks Public Health have taken steps to try and curb teen vaping and smoking.

One step is a number of programs available in the state to help users quit. NDQuits; This is Quitting; Vaping: Know the Truth; and My Life, My Quit are some of programs available to teens. Programs like My Life, My Quit are focused on texting instead of a more traditional hotline approach. According to Dvorak, this is a more comfortable way for teens to get help.

Also, Grand Forks Public Health has made strides to make Grand Forks a smoke-free environment, as well as making it more difficult for youth to access products like ENDS. In 2010, Grand Forks strengthened its Smoke-Free Workplace and Public Place Ordinance, and in 2015 the Grand Forks Park District passed a tobacco-free parks policy. In 2021, Grand Forks Public Health and Grand Forks city leadership increased the legal sales age from 18 to 21 for tobacco products.

The future is still uncertain, though. According to Charvat, tobacco companies have begun creating products similar to those regulated by the FDA to help people quit smoking — things like nicotine gum, patches and lozenges. These products, however, are meant to encourage addiction instead of quit it, Charvat said.

“They allow people to start and maintain those addictions without actually smoking or vaping. But, as much as people want to make it sound like those are to help people quit, there’s no step-down process with those. It’s just continued usage, so it just maintains that addiction. So that’s a concern we’re seeing right now,” he said.

Both Charvat and Dvorak have hope for the future. Charvat wants to make more people aware about the dangers of smoking and vaping, and how the consequences of using ENDS long-term are just starting to be understood.

“I would like for people to be aware of how addictive and potentially dangerous these products are, and for people to not assume that because they’re not actual combustible tobacco that they’re not dangerous, and that the addiction that these products cause is a real problem that could lead to further addictions of other products by youth and by anybody,” Charvat said. “There are resources out there to help people quit.”

Dvorak wants to see higher taxes on tobacco.

“One of the most effective tobacco control interventions is raising the price on products, such as vaping products,” she said.

As reported by the Grand Forks Herald , raising taxes on a state level isn't easy. The state last raised cigarette taxes to 44 cents a pack in 1993, and legislators have made three attempts to increase cigarette and tobacco taxes since 2013.

However, on Feb. 2, the North Dakota House passed House Bill 1412, which classifies electronic smoking devices as tobacco products in the state of North Dakota, following the FDA’s lead of doing the same and thus putting them under the same compliance checks as tobacco. This would require these products to be licensed the same as traditional tobacco products. The bill, which passed 58-35, was introduced by Reps. Alisa Mitskog, D-Wahpeton, and Jon Nelson, R-Rugby, and Sen. Brad Bekkedahl, R-Williston.

“We’re on the cusp of addicting another generation,” said Mitskog. “We can just keep denying this or we can act today, like we should be doing for our children in North Dakota if we truly cared.”