Tobacco smoking is down but vaping is still a problem among Minnesota teens, according to an annual state-wide survey — and more are finding it harder to quit.

The 2020 Minnesota Youth Tobacco Survey, which polls 100 public schools at random, found that one in five high school students are using e-cigarettes.

The survey included, for the first time, questions on nicotine dependence in regards to vaping. Overall, 70 percent of students who had used e-cigarettes in the past 30 days reported one or more signs of dependence.

“Teens do not intend to get addicted to nicotine and underestimate the risk,” said Elyse Levine Less, executive director at the Tobacco-Free Alliance. “They are surprised how easy it is to lose control. I’ve heard kids say, ‘I wish I didn’t have to do this (vape)’ but can’t pinpoint when they lost their choice in the matter.”

The survey has been conducted by the Minnesota Department of Health since 2000 to provide information about the commercial tobacco use of young people and to design and evaluate prevention efforts.

Numbers for 2021 will be interesting, said Laura Oliven, MDH tobacco control manager, considering a number of factors that may influence the outcome.

Of the 100 public schools and classrooms surveyed, 34 participated in the study which resulted in 2,184 students or a 29 percent response rate. Past years have seen over 60 percent participate, but, due to COVID, the health department had less time in the field in 2020, having just distributed the survey about a month before students were sent home to do school virtually.

Oliven wonders how COVID affected use, but won’t know until the 2021 survey is complete.

“One can only imagine what those numbers are now, with the isolation, depression and disconnectedness, with the youth being home over the last year,” she said.

Another factor that may influence the outcome is the Tobacco 21 law passed by the state last May which made it illegal to sell tobacco products, including e-cigarettes, to customers under the age of 21. The law went into effect Aug. 1.

Some municipalities have tightened restrictions on the sale of flavored tobacco products, including menthol, which have long been criticized as a way tobacco companies attract young users.

In Ramsey County, six cities have passed regulations that restrict or prohibit the sale of flavored tobacco — Shoreview, Arden Hills, Roseville, Falcon Heights, Lauderdale and St. Paul.

A statewide ban on flavored products has been proposed at the Minnesota Legislature. The proposal, which is supported by some health care organizations, including Blue Cross and Blue Shield of Minnesota, thus far only has the support of Democrats in the House and Senate, and its prospects remained uncertain Tuesday.

Efforts like these seem to be making a difference, the survey suggests.

E-cigarette use held steady in 2020 compared to 2017. Overall tobacco use declined to 21 percent of high school and 4 percent of middle school students having used a tobacco product in the past 30 days, compared to 26 percent and 5 percent respectively in 2017.

The use of cigarettes and cigars has dropped to the lowest rates ever recorded by the survey. Just over 3 percent of high school students report smoking cigarettes over the last 30 days – a steep decline from 2017. Cigar use among high school students is now also just as low.

The survey also provided insight into youth who vape marijuana. Among students who use e-cigarettes, 65 percent of high school and 71 percent of middle school students had ever vaped marijuana, a statistically significantly increase from 2017.

Dave Orrick contributed to this story.

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