Hello, I am Mark Crosswhite, and I’m happy to be presenting data that were predominantly

sourced from the youth risk behavior survey and the National Youth tobacco survey regarding

the youth tobacco use of nicotine and CBD THC-containing electronic cigarettes, the main questions that

I’d like to address during this presentation how can these data sets be used to help us figure

out and plan for future trends, especially in light of past experiences, and in 2022, youth

consumption rates increased, so is the panic over youth and nicotine ending or evolving and

lastly, how might the use of cannabis use drag nicotine back into a harsh spotlight? The Center for

Disease Control and prevention is a federal agency whose mission is to protect America from

health safety and security threats, both foreign and in the US, for about the last 25 years, the CDC

has been conducting the National Youth tobacco survey to provide national long term

intermediate and short-term indicators key to the design implementation and evaluation of

comprehensive tobacco prevention and control programs additionally these data are used by

the US Department of Health and Human Services to compare progress towards the healthy

people 2030 goals since 1999, the National Youth Tobacco Survey questions have evolved to

address an ever-changing tobacco use landscape initially there were no questions regarding

electronic cigarette use, but has that format increased in popularity? Questions regarding electronic

cigarettes were added partly based on the NYS data in 2018 from the United States Department of

Health and Human Services surgeon general declared youth vaping an epidemic following

which is state and federal agencies acted quickly to mitigate that epidemic interestingly over the

In the last few years, the survey questions have continued to evolve, and now the CDC is including

questions on the national youth tobacco survey to collect data on the use of electronic

cigarettes containing CBD and THC. In this presentation, I will use those data sets to show trends

in tobacco-related electronic cigarette use leading up to the 2008 epidemic and compare some

of those trends to current data on THC and CBD-related use, the CDC and other organizations do

provide some ready-made data visualizations based on the YTS data set; however, they’re

generally for specific purposes chosen by the CDC and are not always applicable to address

larger questions, for example, in this visualization only high school students are included; we

know that the NYT data set also includes 6 through 9th graders, so this particular visualization is

missing an important part of the population on this slide, I showed the youth risk behavior

survey explorer for nicotine products, the data for a subgroup can be downloaded, and this is

helpful in exploring the data from this survey; however, what we find is federal agencies

generally seem to rely more heavily on the National Youth tobacco survey data than they do on

the youth risk behavior survey data when it comes to nicotine use. This may be partly because

the youth risk behavior survey includes many risky behaviors, including cocaine use, alcohol use

et cetera, I invented a video, a screen capture of a tool that I built to reliably and easily evaluate

the National Youth tobacco survey data. The idea here is to provide a tool that will allow

individuals to get a big-picture understanding of what’s happening in youth use across various

products and age demographics, gender demographics, sexual identity demographics, etc. I’ll

show the use of electronic cigarettes combustible cigarettes, marijuana, and electronic cigarettes

with CBD and THC using the National Youth tobacco survey data and the youth risk behavior

survey data in these two data sets, there’s the idea of current use is any youth who

has used a product even once in the last 30 days, and every use is going to an individual who has

ever used that product, what we see for current use amongst youth for combustible cigarettes is

a long-standing decline. What I’d like to contrast here is what muscle has been declining. We saw

electronic cigarette use amongst youth increasing up until the point of 2019 as the surgeon

general had declared you use an epidemic aver which factors including valley COVID and agreed

bill of public awareness on the issue has driven the youth use numbers down the same trends

are observed in the ever-use category, with combined cigarette use decreasing over the last

five or so years with electronic cigarette use growing and peaking in about 2019, and my point in

in this part of this presentation is to draw a comparison to marijuana use in this federal

report marijuana use was talented all time or at a near all-time low, a decades-long low, which is

fantastic current use of marijuana amongst youth is down to about 15%; however, we’re seeing

the same trend with marijuana as we saw with cigarettes and electronic devices with THC and CBD

are steadily increasing, and so the question here is, are we repeating the same story with

marijuana and electronic cigarettes with THC and CBD we experienced with combined

cigarettes and electronic nicotine delivery systems the next portion of this presentation shows

several major categories of nicotine products and their current use data from the National

Youth tobacco survey, what we see is 2021 to 2022 an increase in youth use in all of the

categories and combined cigarette use and smokeless electronic cigarette use and in

electronic cigarette use with THC and CBD is for the category of currencies. We see the same

trends in the category of ever used with combined cigarette smokeless electronic cigarette

and electronic cigarettes with THC CBD categories increasing from 2021 to 2022, so there is

the potential that the use of nicotine products is on the rise, coupling this fact with that electronic

cigarettes with THC and CBD will soon rival the use of electronic cigarettes with nicotine and

coupling this with the fact that oven school officials and even tobacco control groups have

demonstrated that those product categories are confusing, and if you think about a valley

which was an A vitamin E acetate problem with THC and CBD vapes, which was definitely

understood by the media and parents and many people to be an electronic nicotine delivery

problem, we can see that, generally, these two categories are very similar

to how they look, how they work, um, it’s very similar. There’s a lot of potential for people to

confuse the two products and the two product types, and given the fact that based upon

current use data, which we only have two years of for electronic cigarettes with THC and CBD, we

compare that with the current use of electronic cigarettes with nicotine, and this is post-COVID

Coast Valley, we’re seeing those trends increasing, and I feel like this has to draw electronic

cigarettes back into a spotlight that they will wind up sharing with electronic cigarettes with THC

and CBD, which is probably not going to be where the nicotine industry wants to have its

innovative potentially harm reduced products, so I think this is something that needs to be

noted, and people need to be thinking about this as they develop strategies to communicate

information on their electronic cigarette products and so lastly, in my conclusion slide

nothing says it better than a far-side cartoon, and of course, I added that tobacco control and the

most popular and in the THC CBD and next generation pins labels to the characters here, but I

I think this says a lot that we’ve got a narrative that with THC and CBD electronic

cigarettes and marijuana that we’ve already seen play out with combined cigarettes and

electronic nicotine delivery systems we’ve got youth use in nicotine products on the rise we’ve

got youth use in THC CBD products on the rise, and we have an almost equal amount of youth

use for THC CBD products as we have nicotine products, nicotine electronic delivery systems, and

so there’s a real potential here for these two product categories to be blended into the public

eye and not differentiated and for nicotine products to be drawn back into a negative spotlight

So that is the conclusion of this presentation. Thank you for your time and attention.