The percentage of 12th graders who said they’d vaped marijuana at least once in the past 30 days nearly doubled between 2018 and 2019, according to new data from the Monitoring the Future survey. The increase, from 7.5 percent to 14 percent, was the second-largest jump in the use of any drug ever found on the annual survey, which has asked eighth, 10th, and 12th graders in the United States about their drug use and opinions for the past 45 years. (The first-largest jump was last year’s leap in teen vaping.)

“We are seeing a pretty remarkable increase in the use of vaping products to ingest marijuana,” says Jack Stein, chief of staff at the National Institute on Drug Abuse, which funds the survey.

Vaping nicotine also remains popular among teenagers: 25 percent of 12th graders said they vaped nicotine in the past 30 days, and 11.7 percent said they vaped nicotine every day. Around 8 percent of 12th graders said that they vape because they are “hooked” this year, compared with only 3.6 percent in 2018.

Those increases are particularly concerning for researchers studying the potential health risks of vaping. First, there was the spike of frightening lung injuries associated with vaping illicit THC-containing products over the summer and fall. Then, a recent study of over 30,000 people found that people who use e-cigarettes are at an increased risk of developing a respiratory disease after only three years of using the products. The risk of disease is still lower with vaping than with traditional cigarettes. However, only a small percentage of teenagers smoke traditional cigarettes, and smoking rates continue to go down — so when teens pick up vaping, they’re often adding on harm that wasn’t there before.

It’s important to note that the Monitoring the Future survey data is collected between February and June each year, so teenagers were asked about their drug use before reports of vaping-related injuries and deaths began to circulate. “Next year, I imagine, we’ll see an increase in the perceived risk [of vaping],” says Richard Miech, co-investigator of the Monitoring the Future study and professor at the University of Michigan. Usually, among teenagers, as perceived risk of a substance goes up, the use of it goes down. “We’ll see if we see a decrease in vaping along with that next year,” he says.

The survey also found that daily use of marijuana went up from 2018 to 2019 for eighth and 10th graders. That’s likely related to the increase in vaping, says Miech. “It makes sense, especially for use in schools. If you can vape it, you can just have the Juul in your pocket. The obstacles that prevent some teens for using marijuana in school all the time are defeated, and the technology is enabling kids to use it more than they would otherwise,” he says. Just under 5 percent of 10th graders said that they use marijuana daily, compared with 3.4 percent in 2018, and 3 percent say that they specifically vape marijuana daily.

Overall, marijuana usage has remained fairly steady over the past few years, even though both daily use and marijuana vaping have increased. That could be due to one of two scenarios, Miech says: it could be that instead of smoking marijuana, teens are vaping marijuana. Or, he says, it could be that the teens who are smoking marijuana are also vaping it. “Because daily use is increasing, it’s maybe more consistent with the second. They’re not just substituting vaping for smoking,” he says.

It’s surprising that there’s been little change in marijuana usage over the past years, Miech says, because the data from Monitoring the Future shows that teenagers have found marijuana less and less risky over time. But that hasn’t led to an increase in use. That pattern might be related to the combination of two factors: the use of cigarettes among teenagers has plummeted over the years, and the fact that kids who have never smoked cigarettes are far less likely to use marijuana, Miech says.

“More and more of these kids have never smoked a cigarette, that’s growing substantially,” he says. “If it hadn’t been for that decline, marijuana use would probably be at the highest levels we’ve ever seen. But as smoking has gone down, it’s pulled down marijuana.”

Those patterns might change, though, if kids who vape nicotine start vaping marijuana — similar to the way that kids who smoke cigarettes are more likely to smoke pot. “I think it’s too soon to tell. Vaping hasn’t been around that long. But it seems like it might,” Miech says.

Other substance use

The Monitoring the Future survey also showed that teen use of other drugs, like prescription opioids and alcohol, continues to go down.

Misuse of Oxycontin and Vicodin among 12th graders is at its lowest levels since 2002, the survey found. “In general, the numbers have never actually been super high. But they have been declining, which is important,” Stein says. Use of Adderall also continues to decline among 10th and 12th graders, although more eighth graders report using Adderall — 2.5 percent said they used it in 2019, compared with 1.3 percent in 2014.

Alcohol use has also been declining over the past five years: only 52.1 percent of 12th graders reported using alcohol in the past year in 2019 compared to about 60 percent in 2014. Also, only 14.4 percent of seniors in the 2019 survey said that they binge drink: have five or more drinks in a row. That’s a five percentage point drop from 2014, when 19.4 percent of seniors said they did.

“It’s a consistent trend. Alcohol is really the most widely used drug,” Stein says. “It’s hard to say the reason, but we’re hoping the very aggressive prevention efforts are helping.”