Cannabidiol Vaping is Popular Among High School Students, Particularly Those With E-cigarette Use

Youth vaping via e-cigarettes and other devices is common in the US, and the use of one substance is often a risk factor for the use of others. This study used the nationally representative 2022 National Youth Tobacco Survey of middle and high school students (N=28,291) to examine the associations between e-cigarette use and cannabidiol (CBD) vaping.

• 7 percent of respondents had vaped CBD in their lifetime; 6% were unsure whether or not they had ever vaped CBD.
• CBD vaping was more common in older (high school versus middle school) and sexual minority students, and was similar across genders, races, and ethnicities.
• 21 percent of respondents with current e-cigarette use and only 1 percent of respondents who did not have e-cigarette use reported current CBD vaping.

Comments: Vaping is a relatively new mode of substance delivery that has become popular with adolescents within the last decade. While the initial attention to high levels of youth e-cigarette use in the late 2010s has passed, this article is a reminder that the introduction of youth-friendly vaping products forever changed the ways in which adolescents use substances, and that e-cigarette use may serve as a gateway to, or marker of, other substance use. Substantial evidence suggests that vaping can result in higher and quicker concentrations of drugs in the brain than smoking. While CBD is not psychoactive, cannabinoids play a major role in guiding brain development. The impact of high-intensity CBD use during adolescence on long-term brain development is unknown, but it is an area of significant concern.

Sharon Levy, MD, MPH

Reference: Dai HD, Subramanian R, Mahroke A, Wang M. Prevalence and factors associated with vaping cannabidiol among US adolescents. JAMA Netw Open. 2023;6(8):e2329167.