Youth Tobacco Use

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In 2020, 15.9% of adolescents in grades 6-12 were current tobacco users.

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

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Background

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 (defined as ages 10-19): nearly 90 percent of adult cigarette smokers in the U.S. first tried cigarettes by age 18, and 98 percent first tried cigarettes by age 26. Each day in the U.S., around 1,600 youth aged 18 or younger smoke their first cigarette and another 200 become daily cigarette smokers.

E-cigarettes (also known as vapes or Electronic Nicotine Delivery Systems [ENDS]) are battery-powered devices that convert a liquid (“e-liquid”) into an aerosol. E-liquids typically contain nicotine, flavorings, vegetable glycerin, propylene glycol, and other chemicals. Besides nicotine, e-cigarette aerosol may contain heavy metals, volatile organic compounds, and fine and ultrafine particles that can be inhaled deeply into the lungs by both users and bystanders. Nicotine use among youth increases the risk of lifelong tobacco addiction and can also increase the risk for future addiction to other drugs. In August 2016, the FDA finalized a rule extending its regulatory authority to all tobacco products, including e-cigarettes, cigars, and hookah and pipe tobacco.

Teen cigarette smoking prevalence peaked around 1996/1997 but has been declining since.  However, a substantial portion of youth use other tobacco products, including e-cigarettes, cigars, smokeless tobacco, and hookah. Youth use of more than one tobacco product (dual use) is also common.  Since 2014, e-cigarettes have been the most commonly used tobacco product among youth. In 2020, more than 4.5 million U.S. youth, including 1 in 4 high school students and 1 in 20 middle school students, were current users of e-cigarettes.

There are many factors associated with youth tobacco use, including social, environmental, cognitive, and genetic influences. In addition, Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, published by the Centers for Disease Control and Prevention in 2012, concluded that tobacco advertising, promotion, and depictions of smoking in movies are causally related to youth tobacco use. Initiation of smoking during adolescence is linked to persistent smoking during adult life and the many adverse health effects caused by smoking.

Understanding trends in youth initiation of tobacco products – including cigarettes, e-cigarettes, cigars, and smokeless tobacco – enables policy makers to target prevention resources more effectively. Effective strategies to reduce youth initiation of tobacco use include effective federal regulation of tobacco products; significant increases in tobacco prices, including excise taxes; smokefree air laws; restrictions on tobacco advertising and promotion; restricting the availability of tobacco products to youth; mass-media public education campaigns; and full implementation of comprehensive state and community tobacco control programs. On December 20, 2019, the President signed legislation to amend the Federal Food, Drug, and Cosmetic Act, and raise the federal minimum age of sale of tobacco products from 18 to 21 years.

Measure

The percentage of middle and high school students (grades 6–12) who reported use of cigarettes, cigars, smokeless tobacco, or e-cigarettes on at least 1 day during the 30 days before the survey.

Healthy People 2030 Target

  • Reduce to 11.3 percent the proportion of adolescents in grades 6–12 who used tobacco products (cigarettes, e-cigarettes, cigars, smokeless tobacco, hookah, pipe tobacco, and/or bidis) in the past 30 days.
  • Reduce to 10.5 percent the proportion of adolescents in grades 6-12 who used e-cigarettes in the past 30 days.
  • Reduce to 3.4 percent the proportion of adolescents in grades 6–12 who smoked cigarettes in the past 30 days.
  • Reduce to 3 percent the proportion of adolescents in grades 6–12 who smoked cigars in the past 30 days.
  • Reduce to 2.3 percent the proportion of adolescents in grades 6–12 who used smokeless tobacco products (chewing tobacco or snuff) in the past 30 days.

Healthy People 2030 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 Youth Tobacco Survey (NYTS), 2011–2020.

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

By Type of Tobacco Product

Percentage of adolescents in grades 6 to 12 who were current tobacco product users by type of tobacco product, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current tobacco product users by type of tobacco product, 2011-2020 All TobaccoClick to see the detailed trend graph for All Tobacco 15.9 13.9 - 18.1
CigarettesClick to see the detailed trend graph for Cigarettes 3.3 2.6 - 4.2
E-CigarettesClick to see the detailed trend graph for E-Cigarettes 13.1 11.2 - 15.1
Smokeless TobaccoClick to see the detailed trend graph for Smokeless Tobacco 2.3 1.8 - 3.0
CigarsClick to see the detailed trend graph for Cigars 3.5 2.9 - 4.3

All Tobacco Products

By Sex
Percentage of adolescents in grades 6 to 12 who were current tobacco product users by sex, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current tobacco product users by sex, 2011-2020 Both SexesClick to see the detailed trend graph for Both Sexes 15.9 13.9 - 18.1
MaleClick to see the detailed trend graph for Male 16.3 14.1 - 18.8
FemaleClick to see the detailed trend graph for Female 15.6 13.5 - 17.9
By Race/Ethnicity
Percentage of adolescents in grades 6 to 12 who were current tobacco product users by race/ethnicity, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current tobacco product users by race/ethnicity, 2011-2020 All RacesClick to see the detailed trend graph for All Races 15.9 13.9 - 18.1
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 17.5 15.1 - 20.3
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 12.9 10.9 - 15.2
HispanicClick to see the detailed trend graph for Hispanic 16.7 14.0 - 19.8
By Current Grade Level
Percentage of adolescents in grades 6 to 12 who were current tobacco product users by grade level, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current tobacco product users by grade level, 2011-2020 Middle School (Grades 6-8)Click to see the detailed trend graph for Middle School (Grades 6-8) 6.4 5.2 - 7.8
High School (Grades 9-12)Click to see the detailed trend graph for High School (Grades 9-12) 23.3 20.8 - 26.0

Cigarettes

By Sex
Percentage of adolescents in grades 6 to 12 who were current cigarette users by sex, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current cigarette users by sex, 2011-2020 Both SexesClick to see the detailed trend graph for Both Sexes 3.3 2.6 - 4.2
MaleClick to see the detailed trend graph for Male 3.6 2.7 - 4.7
FemaleClick to see the detailed trend graph for Female 3.1 2.4 - 4.0
By Race/Ethnicity
Percentage of adolescents in grades 6 to 12 who were current cigarette users by race/ethnicity, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current cigarette users by race/ethnicity, 2011-2020 All RacesClick to see the detailed trend graph for All Races 3.3 2.6 - 4.2
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 3.7 2.8 - 4.8
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 2.5 1.7 - 3.7
HispanicClick to see the detailed trend graph for Hispanic 3.6 2.6 - 4.9
By Current Grade Level
Percentage of adolescents in grades 6 to 12 who were current cigarette users by grade level, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current cigarette users by grade level, 2011-2020 Middle School (Grades 6-8)Click to see the detailed trend graph for Middle School (Grades 6-8) 1.6 1.2 - 2.3
High School (Grades 9-12)Click to see the detailed trend graph for High School (Grades 9-12) 4.6 3.6 - 6.0

E-Cigarettes

By Sex
Percentage of adolescents in grades 6 to 12 who were current e-cigarette users by sex, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current e-cigarette users by sex, 2011-2020 Both SexesClick to see the detailed trend graph for Both Sexes 13.1 11.2 - 15.1
MaleClick to see the detailed trend graph for Male 13.4 11.5 - 15.6
FemaleClick to see the detailed trend graph for Female 12.8 10.8 - 15.0
By Race/Ethnicity
Percentage of adolescents in grades 6 to 12 who were current e-cigarette users by race/ethnicity, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current e-cigarette users by race/ethnicity, 2011-2020 All RacesClick to see the detailed trend graph for All Races 13.1 11.2 - 15.1
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 15.5 13.4 - 17.9
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 6.2 4.6 - 8.4
HispanicClick to see the detailed trend graph for Hispanic 13.7 11.1 - 16.8
By Current Grade Level
Percentage of adolescents in grades 6 to 12 who were current e-cigarette users by grade level, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current e-cigarette users by grade level, 2011-2020 Middle School (Grades 6-8)Click to see the detailed trend graph for Middle School (Grades 6-8) 4.7 3.6 - 6.0
High School (Grades 9-12)Click to see the detailed trend graph for High School (Grades 9-12) 19.6 17.2 - 22.2

Smokeless Tobacco

By Sex
Percentage of adolescents in grades 6 to 12 who were current smokeless tobacco users by sex, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current smokeless tobacco users by sex, 2011-2020 Both SexesClick to see the detailed trend graph for Both Sexes 2.3 1.8 - 3.0
MaleClick to see the detailed trend graph for Male 3.3 2.5 - 4.4
FemaleClick to see the detailed trend graph for Female 1.3 0.9 - 1.7
By Race/Ethnicity
Percentage of adolescents in grades 6 to 12 who were current smokeless tobacco users by race/ethnicity, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current smokeless tobacco users by race/ethnicity, 2011-2020 All RacesClick to see the detailed trend graph for All Races 2.3 1.8 - 3.0
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 3.0 2.3 - 4.0
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 1.2 0.6 - 2.3
HispanicClick to see the detailed trend graph for Hispanic 1.7 1.3 - 2.2
By Current Grade Level
Percentage of adolescents in grades 6 to 12 who were current smokeless tobacco users by grade level, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current smokeless tobacco users by grade level, 2011-2020 Middle School (Grades 6-8)Click to see the detailed trend graph for Middle School (Grades 6-8) 1.2 0.9 - 1.7
High School (Grades 9-12)Click to see the detailed trend graph for High School (Grades 9-12) 3.1 2.3 - 4.2

Cigars

By Sex
Percentage of adolescents in grades 6 to 12 who were current cigar users by sex, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current cigar users by sex, 2011-2020 Both SexesClick to see the detailed trend graph for Both Sexes 3.5 2.9 - 4.3
MaleClick to see the detailed trend graph for Male 3.7 3.0 - 4.5
FemaleClick to see the detailed trend graph for Female 3.4 2.7 - 4.4
By Race/Ethnicity
Percentage of adolescents in grades 6 to 12 who were current cigar users by race/ethnicity, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current cigar users by race/ethnicity, 2011-2020 All RacesClick to see the detailed trend graph for All Races 3.5 2.9 - 4.3
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 2.8 2.1 - 3.7
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 6.6 5.3 - 8.1
HispanicClick to see the detailed trend graph for Hispanic 4.0 2.9 - 5.4
By Current Grade Level
Percentage of adolescents in grades 6 to 12 who were current cigar users by grade level, 2011-2020
Overview Graph Detailed Trend Graphs Most Recent Estimates (2020)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who were current cigar users by grade level, 2011-2020 Middle School (Grades 6-8)Click to see the detailed trend graph for Middle School (Grades 6-8) 1.5 1.1 - 2.0
High School (Grades 9-12)Click to see the detailed trend graph for High School (Grades 9-12) 5.0 4.1 - 6.2

Evidence-based Resources

The Cancer Control P.L.A.N.E.T. web portal contains tobacco control resources that support collaboration, identify evidence-based approaches, and list evidence-based cancer control programs.

Additional Information on Youth Tobacco Use

Quitting Resources

Year Range

2011-2020

Recent Summary Trend Year Range

2016-2020

Summary Tables

Smoking

Recent Summary Trend

Non-Significant Change

Desired Direction

Falling