By Kelly YoungEdited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Twice as many adolescents reported vaping nicotine in 2018 as in 2017, according to correspondence in the New England Journal of Medicine. The authors say it’s the largest absolute increase ever recorded in the 44-year history of the study, which surveys 8th through 12th graders about substance use.

From 2017 to 2018, the prevalence of nicotine vaping in the past 30 days increased from 11% to 21% among 12th graders. It increased from 8% to 16% among 10 graders and from 4% to 6% among eighth graders. The percentage of teens who vaped flavoring also rose, but not as steeply.The authors estimate that 1.3 million additional adolescents vaped nicotine in 2018.They conclude: “These results indicate that the policies in place as of the 2017–2018 school year were not sufficient to stop the spread of nicotine vaping among adolescents. The rapid entry of new vaping devices on the market, the latest example of which is the Juul, will require continual updates and modification of strategies to keep adolescents from vaping and its associated negative health effects.”