One in five U.S. youth who vaped also used CBD, UNMC-led study shows

They’ve also been tracking what youths are vaping. In 2019, researchers with the University of Nebraska Medical Center reported a significant increase in marijuana use in e-cigarettes by middle and high school students in the United States.

Now a new analysis by the UNMC-led team has traced a new trend: More than one in five youths who reported vaping within the past month in a national survey in 2022 also vaped cannabidiol, or CBD, according to a report they published last month in medical journal JAMA Network Open.

“It’s the first time for us to identify very high prevalence of adolescents reporting CBD use,” said Daisy Dai, professor of biostatistics and associate dean of research for UNMC’s College of Public Health.

Use of CBD, which does not cause a high, has been on the rise since the 2018 federal farm bill legalized the production of hemp, defining it as a cannabis plant with .3% or less of the high-inducing compound THC, or tetrahydrocannabinol. CBD now is widely available in forms ranging from gummies to tinctures, including in states like Nebraska where marijuana itself remains illegal.

The analysis looked at responses from 28,000 middle and high school students in 341 schools to the federal National Youth Tobacco Survey collected between January and May 2022.

Among the nearly 2,500 e-cigarette users, some 21% reported vaping CBD within the past month. Among the e-cigarette using youths, 6% reported that they did not know whether they had vaped CBD.

Hispanic youth were more likely than non-Hispanic ones to report using CBD. Youth who identified as LGBTQ+ also were more likely to use the compound than those who did not.

Dai, who led the study, said the researchers were surprised that so many youth who were vaping did not know whether they had vaped CBD. Regulation of labeling is limited.

“These kids are very, very young,” Dai said. “ … They have lots of peer influences. If their friend hands over a vaping device, they just use it.”

Shelby Bingham, director of the Metro Omaha Tobacco Action Coalition, agreed that the fact that some youth didn’t know whether they had vaped CBD was a particular concern.

None of the youth in the survey were old enough to buy the products themselves, she said. Congress raised the age at which people can buy both e-cigarettes and cigarettes to 21 in 2019. Someone buying the products for them could put other substances in them.

Law enforcement agencies last month executed search warrants at dispensaries across Nebraska over allegations that some products contain a percentage of THC “well over” the legal amount.

The researchers noted that CBD, nicotine, marijuana and other compounds can be used interchangeably in some devices, which can make it difficult to pinpoint the specific products responsible for any adverse health effects from vaping. That was the case with an outbreak of lung injury associated with e-cigarette use in 2019, which was linked to vitamin E acetate found in some THC-containing vaping products.

“The findings suggest that evidence-based educational campaigns, interventions and public policy changes are needed to reduce the harmful health outcomes possible with vaping CBD among developing youths,” the researchers wrote.

Dai and Bingham stressed that public health groups and tobacco education groups continue to work to educate youth, particularly the youngest ones, about potential concerns associated with vaping.

“Our team is not just reporting,” Dai said, “we are supporting the community to battle this.”