Full Breakdown
Anti-Vaping Campaigns and EVALI News Coverage Drive Sharp Decline in U.S. Teen Vaping
4/25/2026, 7:54:03 PM
Background: Youth Vaping Surge and EVALI Outbreak
U.S. adolescent vaping rose from 8.1 % in 2017 to 20 % in 2019. In 2019 an outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) caused over 2,800 hospitalizations and 68 deaths, mainly among youths. Media coverage of the outbreak reached roughly 20,000 stories between July 2019 and March 2020, raising public awareness of vaping risks.
Study Design and Researchers
The University of California, San Diego’s Herbert Wertheim School of Public Health examined two waves of the California Student Tobacco Survey. Senior author Shu-Hong Zhu, PhD, and first author Jijiang Wang, PhD, led the analysis of 117,000 students (grades 8, 10, 12) surveyed in 2017-18 and 143,000 students surveyed in 2019-20. Funding came from the California Department of Public Health; co-investigators included Anthony C. Gamst and Yue-Lin Zhuang.
Measured Behavioral Changes
Quit attempts among current vapers rose from 28.8 % to 53.2 % and intentions to quit increased from 56.9 % to 79.1 % between the two survey cycles. Susceptibility to future vaping among never-vapers fell from 30.3 % to 25.7 %. National youth vaping prevalence declined to 5.9 % by 2024.
Advertising Expenditure and News Coverage
Federal and state agencies, including the FDA, the Truth Initiative, and California’s Tobacco Control Program, ran coordinated anti-vaping ads with combined annual spending over $100 million. Statistical models showed that both ad exposure and independent EVALI awareness independently predicted higher odds of quit attempts and quitting intentions. EVALI awareness uniquely reduced susceptibility among never-vapers, indicating that crisis-driven news can influence behavior beyond paid campaigns.
Implications for Public Health
The combined effect of targeted advertising and extensive news coverage produced a rapid, population-level decline in adolescent vaping, a pattern rarely seen in tobacco-control efforts. The contrast with England, where youth vaping continues to rise, suggests that regulatory and media differences may shape outcomes.
Researchers’ Interpretation
Senior author Shu-Hong Zhu described the observed shift as exceptional and noted its rarity as a lesson for future public-health messaging. First author Jijiang Wang highlighted the profound implications of the changing media environment for quickly motivating widespread behavioral change. Both authors called for evaluation of the durability of these effects.
Remaining Gaps and Future Directions
Uncertainty remains about whether adolescents’ early belief that nicotine vaping caused EVALI persists and how it affects long-term behavior. The authors recommend longitudinal tracking of quit attempts and comparative studies across countries to identify the most effective elements of media-driven tobacco-control interventions.
