More than 1 in 10 middle and high school students in the United States used e-cigarettes within the last month, according to a University of Michigan study that found the rate in some schools is as high as 60%.
It also found that vaping is highest in schools with a higher percentage of white students and where more students smoke traditional cigarettes. Rates are also higher in the South and West.
The study, published recently in the Journal of Adolescent Health, is based on surveys of eighth-, 10th- and 12th-graders in 580 U.S. public and private schools in 2015 and 2016.
Most e-cigarette studies focus on individual use. But study author Sean Esteban McCabe said school-level use is more important because peers are a major influence for teens. McCabe is co-director of the university's Center for the Study of Drugs, Alcohol, Smoking and Health in Ann Arbor.
"Imagine how different a school environment would be to a teenager if none of their peers were vaping, compared to three out of every five of their peers," McCabe said in a university news release. "These would feel like two different worlds to a teenager."
And a greater number of peers with e-cigarettes means that teens have easier access to these products, said co-author Philip Veliz, research assistant professor of nursing.
"Greater availability of these products puts others at greater risk of using these products," Veliz said in the release.
Identifying the reasons behind high student use of e-cigarettes in a school can help officials make changes to reduce use, according to Veliz.
"The finding that current e-cigarette use was significantly higher at schools with a higher proportion of white students was a powerful reminder about the association race can have both at the individual and school level when it comes to substance use behaviors," McCabe said.
He said it's important to find the right time and context to talk with your teen about vaping.
"Parents and guardians can have nonjudgmental conversations about vaping by talking with their kids in middle and high school about what vaping is like in their schools," McCabe said. "Based on the prevalence of vaping, all students are exposed either directly or indirectly to vaping in school."
The U.S. National Institute on Drug Abuse has more about teens and e-cigarettes.