How a 2019 media blitz 'dramatically' shaped teen vaping habits

If it seems like fewer teens are vaping, there's new data that backs that up – and researchers say 2019 marked a turning point.

A University of California, San Diego study published on April 2 found that an increase in anti‑vaping ads and news coverage about vaping‑related lung injuries pushed many teens to quit, and discouraged others from ever starting. The shift, researchers say, offers a rare example of how public health messaging and media coverage can quickly change youth behavior.

“What we saw was a dramatic population‑level change,” said Dr. Shu‑Hong Zhu, a professor at UCSD and senior author of the study published in BMC Public Health. “Aggressive public health campaigns and frightening reports of severe lung injuries appear to have shaken adolescents out of complacency.”

A sharp rise, then a reversal

Youth vaping in the United States surged from 8.1% in 2017 to a peak of 20% in 2019, the study found, before entering what researchers described as a sustained decline. By 2024, youth vaping had fallen to 5.9%.

Researchers attributed the reversal to two powerful and overlapping forces in 2019: an unprecedented wave of anti‑vaping advertising from federal, state and nonprofit groups, and extensive news coverage of the outbreak known as EVALI, e‑cigarette or vaping use‑associated lung injury.

By February 2020, the Centers for Disease Control and Prevention reported 2,807 EVALI hospitalizations or deaths across all 50 states, including 68 deaths. The crisis dominated headlines for months, reinforcing warnings about the dangers of vaping, particularly among young people.

The media blitz behind the decline

According to the report, more than $100 million was spent on anti‑vaping advertising in 2019 alone.

More than half of that, about $60 million, came from the Food and Drug Administration’s “The Real Cost” campaign, which targeted teens on television and online platforms. Another $20 million funded a digital and social media campaign led by the California Department of Public Health, alongside efforts from groups such as the Truth Initiative and state tobacco control programs.

“A convergence of media forces – aggressive public‑health campaigns and frightening news reports about people being hospitalized with severe lung injuries – appears to have motivated many adolescents to quit,” Zhu said.

Teens quitting and fewer willing to start

The findings were based on California Student Tobacco Survey data from two periods: 2017–2018, which included nearly 118,000 student responses, and 2019–2020, which drew from roughly 143,500 student responses.

Among students who reported vaping, 53.2% attempted to quit between 2019 and 2020, nearly double the 28.8% recorded in the earlier survey. Nearly 80% said they intended to quit, compared with about 57% previously.

At the same time, interest among teens who had never vaped declined. About 25.7% of those students showed any “susceptibility” to trying vaping in the future, down from 30.3% two years earlier.

“Quit attempt rates on a population level almost never change this dramatically from one period to the next,” said Dr. Jijiang Wang, a coauthor of the study and postdoctoral scholar at UCSD’s Herbert Wertheim School of Public Health and Human Longevity Science. “When they do, it tells us something important about what is possible when the media environment shifts.”

A contrast abroad

Researchers noted that a similar reversal has not occurred everywhere. In England, for example, youth vaping rates have continued to climb. In response, the U.K. Parliament recently passed legislation aimed at tightening restrictions on both vaping and smoking.

For U.S. researchers, the contrast underscores a key takeaway: Sustained messaging, paired with credible health warnings, can make a measurable difference.