Youth Tobacco Use

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In 2017, 8.8% of high school students were cigarette users.

Summary graph for Youth Tobacco Use, Click to see detailed view of graph

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Introduction

Cigarette smoking is the leading preventable cause of disease, disability, and death in the United States. Smoking causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon and rectum, anus, as well as acute myeloid leukemia. Tobacco use is initiated and established primarily during adolescence: nearly 90 percent of adult cigarette smokers in the United States first tried cigarettes by age 18, and 98 percent first tried cigarettes by age 26. Each day in the United States, around 2,000 youth 18 years of age or younger smoke their first cigarette and another 300 become daily cigarette smokers.

Teen cigarette smoking rates reached a peak around 1996/1997 and have been declining since then. In addition, a substantial proportion of youth use other tobacco products, including cigars, smokeless tobacco, pipes, hookahs, and electronic cigarettes (e-cigarettes). Monitoring and preventing youth tobacco product use needs to incorporate other products, including new and emerging products.

There are many factors associated with youth tobacco use, including social influences and physical environment, and cognitive, affective, biological, and genetic factors. Because of nicotine dependence and social factors, initiation of smoking during adolescence is closely associated with persistent smoking in adulthood and with the many adverse health effects associated with chronic smoking. It is therefore critical to prevent smoking initiation as early as possible.

Understanding trends in the prevalence of tobacco product use among youth enables policy makers to more effectively target prevention resources. To decrease tobacco product use and susceptibility to use among youth, restrictions on advertising, promotion, and availability of tobacco products to youth should be combined with full implementation of evidence-based, population-based, comprehensive tobacco control policies such as product taxes and smoke-free air laws.

Special note on e-cigarettes: A new e-cigarettes measure on 2011-2018 trends was added to the report in September 2019 due to the availability of data from the Centers for Disease Control and Prevention’s (CDC) and U.S. Food and Drug Administration’s (FDA) National Youth Tobacco Survey (NYTS).  The NYTS provides data on an annual basis, rather than every other year as provided by the CDC’s Youth Risk Behavior Surveillance System (YRBSS). Because of the rapidly changing usage of e-cigarettes, annual monitoring is important; having multiple sources of estimates can be useful as well.

Measure

The percentage of high school students (grades 9–12) who reported use of cigarettes, cigars, or smokeless tobacco on at least 1 day during the 30 days before the survey.

Healthy People 2020 Target

  • Reduce to 21 percent the proportion of adolescents in grades 9–12 who used tobacco products in the past 30 days.
  • Reduce to 16 percent the proportion of adolescents in grades 9–12 who smoked cigarettes in the past 30 days.
  • Reduce to 6.9 percent the proportion of adolescents in grades 9–12 who used smokeless (chewing tobacco or snuff) tobacco in the past 30 days.
  • Reduce to 8 percent the proportion of adolescents in grades 9–12 who smoked cigars in the past 30 days.

Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.

Data Source

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System (YRBSS), 1999–2017.

Centers for Disease Control and Prevention, National Youth Tobacco Survey (NYTS), 2011–2018.

Trends and Most Recent EstimatesHelp with navigating the graphs and data tables

By Type of Tobacco Product

Percentage of high school students (grades 9-12) who used cigarettes, cigars, or smokeless tobacco in the past 30 days by type of tobacco product, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used cigarettes, cigars, or smokeless tobacco in the past 30 days by type of tobacco product, 1999-2017 Cigarettes, Cigars and Smokeless TobaccoClick to see the detailed trend graph for Cigarettes, Cigars and Smokeless Tobacco 14.0 12.2 - 15.9
CigarettesClick to see the detailed trend graph for Cigarettes 8.8 7.2 - 10.7
Smokeless tobaccoClick to see the detailed trend graph for Smokeless tobacco 5.5 4.4 - 6.7
CigarsClick to see the detailed trend graph for Cigars 8.0 7.2 - 8.9

Cigarettes, Cigars and Smokeless Tobacco

By Sex
Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 14.0 12.2 - 15.9
MaleClick to see the detailed trend graph for Male 17.3 15.3 - 19.4
FemaleClick to see the detailed trend graph for Female 10.7 8.9 - 12.7
By Race/Ethnicity
Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 14.0 12.2 - 15.9
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 16.8 14.3 - 19.7
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 10.2 8.5 - 12.3
HispanicClick to see the detailed trend graph for Hispanic 10.5 9.1 - 12.2

Cigarettes

By Sex
Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 8.8 7.2 - 10.7
MaleClick to see the detailed trend graph for Male 9.8 8.3 - 11.6
FemaleClick to see the detailed trend graph for Female 7.8 6.0 - 9.9
By Race/Ethnicity
Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 8.8 7.2 - 10.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 11.1 9.0 - 13.6
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 4.4 3.2 - 5.9
HispanicClick to see the detailed trend graph for Hispanic 7.1 5.8 - 8.6

Smokeless Tobacco

By Sex
Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 5.5 4.4 - 6.7
MaleClick to see the detailed trend graph for Male 9.0 7.3 - 11.0
FemaleClick to see the detailed trend graph for Female 1.9 1.4 - 2.6
By Race/Ethnicity
Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 5.5 4.4 - 6.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 6.8 5.3 - 8.7
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 3.6 2.5 - 5.1
HispanicClick to see the detailed trend graph for Hispanic 3.7 2.8 - 5.0

Cigars

By Sex
Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 8.0 7.2 - 8.9
MaleClick to see the detailed trend graph for Male 10.5 9.4 - 11.7
FemaleClick to see the detailed trend graph for Female 5.4 4.6 - 6.4
By Race/Ethnicity
Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 8.0 7.2 - 8.9
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 9.0 7.8 - 10.3
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 7.4 6.0 - 9.1
HispanicClick to see the detailed trend graph for Hispanic 6.4 5.3 - 7.5

E-cigarettes

By Sex
Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by sex, 2011-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by sex, 2011-2018 Both SexesClick to see the detailed trend graph for Both Sexes 20.8 18.8 - 22.8
MaleClick to see the detailed trend graph for Male 18.8 16.6 - 21.0
FemaleClick to see the detailed trend graph for Female 22.6 20.4 - 24.8
By Race/Ethnicity
Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by race/ethnicity, 2011-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by race/ethnicity, 2011-2018 All RacesClick to see the detailed trend graph for All Races 20.8 18.8 - 22.8
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 26.8 24.6 - 29.0
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 7.5 5.1 - 9.9
HispanicClick to see the detailed trend graph for Hispanic 14.8 12.8 - 16.8

Evidence-based Resources

Tobacco control resources are available that support collaboration, identify evidence-based approaches and list research-tested interventions on the Cancer Control P.L.A.N.E.T. web portal. To identify high-risk populations and prioritize cancer control efforts, state and county-level tobacco data can be found on State Cancer Profiles.

Additional Information on Youth Tobacco Use

For the public

For tobacco users

For health professionals

Scientific reports

Year Range

1999-2017

Recent Summary Trend Year Range

2013-2017

Summary Tables

Smoking

Recent Summary Trend

Falling

Desired Direction

Falling