Vaping among kids is on a concerning rise across the US, but teens in rural areas of the country are the most likely to pick up the habit.
Researchers combed through state-by-state data from the Campaign for Tobacco-Free Kids, an advocacy group aimed at stopping youth smoking.
Based on a 2023 survey, the team found Wyoming had the highest rate of youth vaping, with nearly one in three teens using e-cigarettes in the last year, despite the state’s no-sale laws for residents under 21.
Meanwhile, California had the lowest rate of vaping – six percent – due to strict regulations from Governor Gavin Newsom, who recently outlawed the sale of flavored vapes to people of all ages.
The findings come as damning research mounts on the harms of e-cigarettes, particularly in young people, including irreversible lung damage and even cancer.
Wyoming topped the list for the most youth e-cigarette users, with West Virginia and Alaska following closely behind
A May analysis found that vaping increases the risk of asthma by 200 percent and previous studies have linked the products to lung cancer, respiratory conditions, lung disease and organ damage.
Overall, recent figures from JAMA suggest more than 2million kids under 18 vape regularly, along with 17million adults.
Researchers from online prescription marketplace Universal Drugstore, analyzed federal and state health data on air quality, youth obesity, sports participation, mental health, test scores, and youth e-cigarette use.
They then compiled these rates into one score to determine the ‘healthiest’ and ‘unhealthiest’ states for kids.
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Wyoming had the highest rate of youth vapers, with 30 percent of kids under 18 reporting they had used e-cigarettes in 2023.
The researches wrote: ‘While the state has a number of laws which aim to reduce vaping, including the prohibition of the sale or distribution of vapor products to persons under age 21 and the enforcement of e-cigarettes having child resistant packaging, vaping rates are still the highest in the country.’
In addition to these laws, e-cigarettes are prohibited from being used in child care facilities, and people purchasing tobacco products have to pay a 15 percent tax.
However, the state’s largely rural landscape and small population could be partly to blame for its high youth vaping rate. About 80 percent of Wyoming’s residents live in rural areas, as much of the land area is used for farming and national parks.
The large rural area may make it more difficult to enforce the state’s vaping laws. Rural areas also tend to have less access to clinics and resources about the health harms surrounding vaping.
Wyoming also has one of the smallest healthcare budgets in the US, accounting for just 0.1 percent of annual US healthcare spending.
The CDC has found the number of adults who light up cigarettes has fallen to an all-time low of 11 percent
West Virginia came in second place, with 28 percent of teens vaping last year.
The Mountain state has fewer restrictions than Wyoming and allows the sale of e-cigarettes to people under 21. It also doesn’t enforce smoke-free school zones.
West Virginia also ranked as the unhealthiest state overall to raise a child, with a score of just 0.75 out of 10.
And in 2022, the state had the highest adult smoking rate in the US at 25 percent.
Vaping is often pushed as a healthier alternative to smoking and used as a tool to get smokers to quit, which could have contributed to the state’s high vaping rate.
Alaska had the third-most youths trying e-cigarettes, at 26 percent.
Last year, Alaska Senate President Gary Stevens, a Republican, introduced Senate Bill 89, aimed at imposing the state’s first-ever tax on e-cigarette products.
A bill was also introduced in 2022 to raise the minimum age to purchase tobacco products and vapes from 19 to 21, but it was vetoed by Governor Mike Dunleavy.
Similar to Wyoming, the state’s vast rural areas might contribute to difficulty enforcing regulations surrounding youth vaping.
Louisiana and Montana tied to round out the top five, both with a quarter of teens using e-cigarettes.
A study linked vaping to health effects like asthma, pneumonia, and bronchitis. However, smoking has long been associated with severe health consequences like lung cancer and heart disease
As for adult vaping, a study in JAMA recently found Oklahoma topped the list
Meanwhile, California was the least popular state for youth vaping, as just six percent of teens had picked up the habit.
California has some of the strictest regulations in the US, including a ban on the sale of flavored tobacco products to residents of any age.
The minimum age to purchase e-cigarettes and other tobacco products has also been raised to 21.
Vaping products in the state also have to include health warnings per California state laws regarding the use of nicotine and other chemicals.
Following the Golden State, Washington had the second-lowest amount of youth vapers, at eight percent. In the Evergreen state, the legal age to purchase vapes is 21, and there is a ban on all flavored varieties.
s for vapes are also restricted in youth-centered areas like parks.
Indiana, Utah, and Oregon rounded out the bottom five, each boasting teen vaping rates under 10 percent.