Many people nonetheless seem to believe that teenage nicotine vaping is rising. And this includes the administrators of US schools, as indicated by constant media reports of school systems all over the country installing vaping detectors.

In 2025 I testified in person at a state hearing on a proposed “registry bill”—effectively a vape flavor ban. I had five minutes to explain what CDC/FDA surveys actually show. I was followed by testimony after testimony from school officials claiming they were seeing a crisis.

Though I do not know why this huge gap between the evidence and schools’ perceptions exists, I have some ideas.

I had little chance of changing the lawmakers’ minds. When a high school principal shows up with two bulging bags of disposable vapes that have been confiscated in his school system, and parents testify about the impacts of the “crisis,” that weighs far more on the minds of politicians than accurate-but-dry evidence from official government surveys.

Though I do not know why this huge gap between the evidence and schools’ perceptions exists, I have some ideas.

What I do know is that the same CDC/FDA survey that was used in 2019 to claim a “teen vaping epidemic” now shows a 74-percent drop in teen vaping in the years since. (Granted, that figure is for “current use,” however occasional; frequent use, which may imply dependence, “only” dropped by 62 percent.) And I think it would be difficult to argue that teen lying on anonymous surveys has suddenly skyrocketed.

I can think of several factors that may explain why school officials’ perceptions currently—and very honestly and earnestly—are at odds with what I consider to be objective survey evidence.  In each case, I’ll attach a term for a well-known source of potential bias in scientific measurements.

First, teachers are now hyper-vigilant about vaping, thanks to years of loud media and political messaging on the subject. So they catch far more kids than they previously would. This is what’s known as sensitivity bias; the hyper-vigilance is self-reinforcing.

The fact that schools are now chock-full of vape detectors, again meaning they catch more kids than previously, is part of this sensitivity bias. Many US schools have detectors due to the Juul settlement, which sent nearly half a billion dollars to states.

And inevitably, schools that are chock-full of vape detectors will sometimes experience them going off without cause—a student using hairspray or perfume in a locker room, for instance—meaning a certain proportion of cases are what we call false positives.

The narrative of a vaping crisis in schools is driving truly harmful sin taxes and bans all over the US. The harm reduction community needs to confront it head-on.

Returning to sensitivity bias, this extends to the students themselves. They have been hammered with scare stories, so that today, more than in the past, many may think that vaping is super-scary and highly addictive. If they try a nicotine vape, they may rapidly fear they are becoming “addicted,” or at risk of horrific lung injury, and may even turn themselves in to a school nurse or a teacher for help.

Finally, people vape all kinds of things besides nicotine. There is no reason to think that school officials are experts at distinguishing between nicotine and THC, say, when the CDC itself fails to draw a clear distinction. Some school incidents recorded as “vaping” won’t involve nicotine at all. This conflation is known as lumping bias (or category bias).

If some or all of these hypotheses are substantially true, it would mean that in the past, far more students were vaping but fewer school officials were aware of it; whereas now, fewer students vape but those who do are far more likely to be caught, or to self-report.

I believe the gaping chasm between evidence and perception in US schools must be addressed. Just as the drug war has been justified as a series of child protection measures, the same is happening with nicotine today. The narrative of a vaping crisis in schools is driving truly harmful state-level sin taxes and bans all over the US right now. The community of tobacco control experts and consumers who support harm reduction needs to confront it head-on.

Top photograph (cropped) by SuSanA Secretariat via Wikimedia Commons/Creative Commons 2.0. Inset graphic by Charles Gardner.

The Influence Foundation, which operates Filter, has received unrestricted grants from Juul Labs, Inc. Filter‘s Editorial Independence Policy applies.

The post Teen Vaping Has Long Been Falling. Why Do Schools Think the Opposite? appeared first on Filter.

Yet misinformation persists. In the bad old days, when deadly cigarettes were the unrivaled source of nicotine, public health groups chose to demonize the drug for the desirable goal of discouraging smoking. Today, however, the public health campaign against nicotine harms adults seeking safer alternatives to smoking—and millions of neurodivergent people who now benefit, or could benefit, from nicotine’s cognitive effects.

Adults with forms of neurodiversity (e.g., ADHD) smoke at four-to-six times higher rates than the general “neurotypicals” population. The lead hypothesis is that they are self-medicating. Nicotine helps them. Many adults who smoke or use THR products do so for the positive effects on anxiety. Nicotine releases dopamine and serotonin, which can elevate mood and ease anxious feelings. One study found nicotine acts as an “antidepressant” for many.

Nicotine also enhances attention and working memory, offering potential benefits for conditions like attention-deficit/hyperactivity disorder (ADHD), schizophrenia and autism spectrum disorder (ASD). Public health professionals routinely prescribe stimulants to individuals with ADHD to manage symptoms—and individuals with ADHD are more likely to smoke. A study in Pharmacology Biochemistry and Behavior found that nicotine patches improved cognitive performance in several ADHD-related domains among non-smoking young adults.

Some estimates suggest up to 90 percent of individuals with schizophrenia smoke. Nicotine use appears to offer them measurable benefits.

People with schizophrenia are also significantly more likely to smoke. Some estimates suggest up to 90 percent of individuals with schizophrenia smoke, compared to 11 percent of United States adults in 2023.

Nicotine use appears to offer them measurable benefits. A 2017 Nature Medicine study concluded that nicotine may be a therapeutic strategy for treating schizophrenia. It helps restore activity in the prefrontal cortex. One author said the findings provided “compelling biological evidence that a specific genetic variant contributes to risk for schizophrenia, defines the mechanism responsible for the effect, and validates that nicotine improves that deficit.”

A 2024 study examining the “impact of smoking on clinical symptoms after antipsychotic treatment” assessed 145 male patients and found that those who smoked “showed greater improvement in negative symptoms” than those who did not smoke. No one would advise such patients to smoke, of course; safer nicotine use is a different matter.

Nicotine has also shown promise for individuals with ASD. The authors of a 2015 study in the Journal of Autism and Developmental Disorders, for instance, found that a transdermal nicotine patch reduced the need for emergency medications. They concluded that nicotine “may safely reduce aggression and irritability in people with ASD.”

Decades of deliberately demonizing nicotine for the purpose of discouraging smoking now make this a difficult pill to swallow.

Nicotine use also plays a role for people with substance use disorders (SUD), who are far more likely to smoke than the general population, often using cigarettes or THR products to complement—or replace—substances like opioids or alcohol. Nicotine can serve as a neurochemical bridge to help manage cravings and withdrawal symptoms.

Given the high prevalence of smoking among neurodivergent people and those with SUD—and emerging evidence of nicotine’s therapeutic effects—public health agencies and regulators should support innovation in THR products that deliver nicotine without the dangers of combustion.

However, decades of deliberately demonizing nicotine for the purpose of discouraging smoking now make this a difficult pill to swallow. It is difficult, too, to consider the possibility that a large proportion of the 2.3 percent of US teens who now vape nicotine frequently may have diagnosed or undiagnosed ADHD or other conditions. So difficult that no researcher has asked and tested this basic, obvious question.

Vapes and other THR products provide a gateway out of smoking while offering symptom relief for many neurodivergent adults. And they are easier to obtain than prescription drugs, particularly for people who have limited or no access to health care.

Numerous public health bodies have concluded that nicotine vapes are significantly less harmful than combustible tobacco. The US Food and Drug Administration has authorized some THR products—including vapes, heated tobacco and flavored nicotine pouches—after determining they are “appropriate for the protection of public health.”

Still, misinformation lingers, including among medical professionals who could help reduce smoking by encouraging neurodivergent patients, or those with SUD, to switch to safer alternatives.

It’s time for public health leaders and policymakers to rethink nicotine, embrace tobacco harm reduction and support vulnerable adults who rely on nicotine for therapeutic and cognitive benefits.

Photograph (cropped) by L.V. Olavi Rantala via Flickr/Creative Commons 2.0

The author was formerly employed by the Foundation for a Smoke-Free World (now Global Action to End Smoking), which previously provided grants to The Influence Foundation, the nonprofit behind Filter. Filter‘s Editorial Independence Policy applies.

The post The Overlooked Benefits of Nicotine for Mental and Cognitive Health appeared first on Filter.

Thankfully, by the turn of the millennium, high school smoking had dropped to about 20 percent. By 2011, high school smoking had dropped to 16 percent.

Then, over the past decade, US high school smoking dropped a further 90 percent. “Current use” of combustible tobacco cigarettes is now 1.9 percent. But for teens, “current use” means even one puff in the past month. “Frequent use” (20 or more days per month) is now 0.38 percent. Essentially nil.

We should all be dancing in the streets. Except we’re not. Because declines over the past decade coincide with the “e-cigarette era.”

Most smokers start in their teens. And teens basically don’t smoke now. Let that sink in. As this age group ages, the age of smoking will be over. Today’s teens will not die horribly from smoking-related cancer, heart and lung disease. We should all be dancing in the streets.

Except we’re not. Because declines over the past decade coincide with the “e-cigarette era.” Anyone glued to the media knows that US teen nicotine use from e-cigarettes has skyrocketed. So let’s take a closer look at that. I will use publicly available, easily obtainable data via the CDC National Youth Tobacco Survey (from 2001 to 2021) and NIH Monitoring the Future Survey (for the years prior to 2001). Spoiler: US teen nicotine vaping has gone up, down, up, and then way down.

Teen Vaping

US high school nicotine vaping began to creep up in 2012. By 2014, “current use” had reached 13.4 percent. It hit 16 percent by 2015.

Then, for some reason, high school nicotine vaping dropped back down to 11.3 percent in 2016 and stayed relatively low in 2017 (11.7 percent). Ironically, the only significantly relevant thing that happened just prior to that drop was Juul’s profoundly naïve 2015 launch campaign.

Teen vaping then began to rise again in 2018. “Current use” reached 20.8 percent and, in September 2018, the US FDA declared a “teen vaping epidemic.” High school nicotine vaping increased again in 2019, reaching 27.5 percent—something like the smoking rate had been in my teenage years. And that was the peak of the “epidemic.”

It is important to note that these numbers are for teen “current use.” Even during 2019, teen daily use of e-cigarettes was only 5.7 percent. 

It is strange that the FDA has not yet announced that the “epidemic” is over.

Thankfully, US high school nicotine vaping then dropped 60 percent. Down 29 percent by 2020 (pre-pandemic), and then another 42 percent during the pandemic. By 2021, it was 11.3 percent. That percentage is, coincidentally, exactly where we were in 2016. It is lower than where we were in 2014 (13.4 percent), four years before the FDA declared an “epidemic.”

So it is strange that the FDA has not yet announced that the “epidemic” is over. It is also strange that not one major US media outlet has emphasized this stunning 60 percent drop in just two years.

It’s also worth noting that there are 12 million adult vapers in the United States as of 2021 (out of 255 million adults). Adult current use means what intuition would suggest: “daily” or “some days” (basically, “regular use,” suggesting you own an e-cigarette and buy products).

Comparing that to teen “current use” is, of course, apples and oranges, because that’s “past 30-day ever-use.” US teen “current use” is now 2 million (out of 40 million middle and high school students). Teen frequent use (at least 20 days/month) may be closer in meaning to adult current use. These are the kids who may own an e-cigarette. That’s 0.8 million.

By either measure, the number of adults who own and buy these gizmos (the market) is far higher than the number of teens who use them. (Adults in the United States, of course, far outnumber children.) Still, you’d never know any of this from US media stories about e-cigarettes. And by the way, about 40 percent of adult current users have quit smoking completely (4.8 million). Another 30 percent may be “on the journey to quit” through dual use. And another 30 percent (at least) have quit smoking with e-cigarettes and then quit vaping.

To summarize: Teen nicotine use from deadly cigarettes is now near zero. And “current use” of e-cigarettes is 11.3 percent.  And most “current use” is infrequent experimentation. Daily use is 3.1 percent. 

Where Are We Now?

I am fully aware that everything you just read flies in the face of everything that the media has been telling you for several years now. I’m just not sure what to make of that. These are the facts. Fact-check me. The numbers are not difficult to extrapolate from NIH and CDC survey websites and CDC Morbidity and Mortality Weekly Reports (MMWR).

Teens should not vape or smoke. But because so few US teens now smoke and there is some dual use, total current US teen nicotine use from both sources is now 11.7 percent. Remember: Just 10 years ago, 16 percent of them were smoking and none vaped. And that 16 percent was much lower than previous decades.

The only thing that truly is way up is US adult moral panic over teen nicotine use.

There is no escaping this simple fact: Total teen nicotine use from cigarettes and e-cigarettes is lower today than any time in the past 50 years. So “what’s up with teen nicotine use?” The short answer is nothing. It’s way down. Like so many hot button issues in America today, there is a profound disconnect between public perception and reality. The only thing that truly is way up is US adult moral panic over teen nicotine use.

I believe this raises serious questions about the motivations of health “experts” who continue to insist that teen vaping is a gateway to smoking, that we’re in the midst of a teen vaping epidemic, and that a “whole new generation” is now “addicted to nicotine.” All of those claims bear an uncanny resemblance to 1930s Reefer Madness.

Photograph by Rawpixel/Public Domain

Both The Influence Foundation and INNCO, the organization led by the author, have received grants from the Foundation for a Smoke-Free World. The Influence Foundation has also received grants from Juul Labs, Inc. Filter‘s Editorial Independence Policy applies.

The post Why Aren’t We Celebrating the End of Teenage Smoking? appeared first on Filter.