By Alan Mozes
MONDAY, Sept. 17, 2018 (HealthDay News) -- E-cigarettes are fast becoming a clever way for American teens to use pot, with a new survey showing that nearly a third of high school e-cig users have vaped marijuana.
The survey involved nearly 20,700 middle and high school students from both public and private institutions. The goal was to gain fresh insight into vaping, which has been the most popular means for smoking among American youth since 2014.
One of every 11 students overall said he or she had ever used marijuana in an e-cigarette.
"That equates to more than 2 million youth who have ever used cannabis in an e-cigarette," noted lead investigator Katrina Trivers. She is a lead epidemiologist in the office on smoking and health with the U.S. National Center for Chronic Disease Prevention and Health Promotion at the U.S. Centers for Disease Control and Prevention.
Among those who said they have ever used an e-cigarette at all, 1 in 3 high schoolers and 1 in 4 middle schoolers said they had used pot by vaping it.
Trivers said the findings point to seemingly dramatic shifts underway in how and what teens smoke.
"Although we've seen considerable declines in the use of regular cigarettes among U.S. youth over the past several decades, the tobacco product landscape is evolving, and the use of other tobacco products has become increasingly popular," she said.
For example, Trivers noted that e-cigarette use shot up by 900 percent between 2011 and 2015 among American high schoolers, before declining somewhat in 2016 and holding steady in 2017.
"This high rate of cannabis use in e-cigarettes is a public health concern, because any form of tobacco product use is unsafe among youth, irrespective of whether it's smoked, smokeless or electronic," she stressed.
On that front, Trivers pointed out that National Academies of Science has stated that pot use among youth "can adversely affect learning and memory, and may impair later academic achievement and education."
More broadly, she noted that the U.S. Surgeon General "has concluded that the aerosol emitted from e-cigarettes is not harmless," based on its nicotine and chemical compound content.
Trivers explained that e-cigarettes heat liquid compounds to create a vapor that contains nicotine, flavorings and other additives, which users inhale.
By simply adding hash oils, waxes and other liquids that contain pot's active ingredient directly into the e-liquid section, teens can turn an e-cig into a pot-delivery device.
Trivers noted that the survey found that pot vaping was "significantly higher" among boys. It was also more common among high schoolers.
"Use was also higher among those who had used e-cigarettes more recently and more frequently," she added, as well as among students who said they use other tobacco products and/or live with someone who uses tobacco products.
Regardless, the researchers concluded that the survey showed pot use in e-cigs is as popular -- or perhaps more popular -- than believed.
The findings were published online Sept. 17 as a letter to the editor in the journal JAMA Pediatrics.
Going forward, Trivers said the focus should be on "ensuring that youth are aware of the risks of using all forms of tobacco products, including e-cigarettes," and on regulating e-cigarettes in the same manner as other tobacco products.
But Richard Miech, principal investigator of the "Monitoring the Future" project for the University of Michigan's Institute for Social Research, believes that e-cig use among adolescents will continue to rise in the coming year.
Still, on a positive note, he pointed to the warning issued last week by the U.S. Food and Drug Administration that threatened to take vaping devices off the market if manufacturers don't find ways to stem adolescent use.
"This is a forceful step that will hopefully reduce adolescents' access to these devices," Miech said.