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 (voice box), mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon and rectum, as well as acute myeloid leukemia. Tobacco use is initiated and established primarily during adolescence (defined as ages 10-19): nearly 90 percent of adults in the U.S. who smoke daily first tried cigarettes by age 18, and 98 percent first tried cigarettes by age 26. Each day in the U.S., around 1,500 youth aged 17 or younger smoke their first cigarette.

Electronic cigarettes (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. In addition to 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 may also increase the risk for future addiction to other drugs.

Youth 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. According to data from the 2022 National Youth Tobacco Survey (NYTS), 16.2% of middle and high school students reported current use of a tobacco product. 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, and, in 2018, former U.S. Surgeon General Jerome Adams issued an advisory declaring youth e-cigarette use an epidemic.

According to data from the NYTS, in 2022, more than 2.5 million U.S. youth, including 14.1% of high school students  and 3.3% of middle school students, currently used e-cigarettes. Moreover, among high school students who reported current e-cigarette use, 42.3% reported using the products frequently (on 20 or more of the past 30 days) and 27.6% reported daily use. Flavors are an important aspect of appeal to youth e-cigarette users with 85% reporting having used flavored e-cigarettes (e.g., fruit, candy, menthol flavors).

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 and use of tobacco products – including cigarettes, e-cigarettes, cigars, and smokeless tobacco – helps policy makers determine how to allocate prevention resources. Effective strategies to reduce youth initiation of tobacco use include 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, legislation was enacted 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.

The percentage of middle and high school students who reported use of any tobacco product (cigarettes, e-cigarettes, cigars, smokeless tobacco—including chewing tobacco, snuff, dip—hookah, pipe tobacco, bidis, dissolvable tobacco, or snus) 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), 2019-2021.1, 2

1 Between 1999 and 2018, the NYTS was conducted using paper-and-pencil questionnaires. In 2019, the mode of administration changed to an electronic survey, making prior years’ estimates incomparable. This Report focuses on data from 2019 and later.

2 Because NYTS is administered in schools, to accommodate students learning under varying instructional models (in-person, distance/virtual, and hybrid), the 2021 NYTS was administered using a web URL. Approximately half of student respondents reported completing the survey at school or in the classroom, and half reported completing the survey at home or some other place. Prevalence estimates from 2021 should be interpreted with caution, as the proportion of students reporting any tobacco use differed greatly between those who completed the survey at school vs. at another location.

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 reported current tobacco product use by type of tobacco product, 2019-2020
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 reported current tobacco product use by type of tobacco product, 2019-2020 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 reported current tobacco product use by sex, 2019-2020
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 reported current tobacco product use by sex, 2019-2020 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 reported current tobacco product use by race/ethnicity, 2019-2020
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 reported current tobacco product use by race/ethnicity, 2019-2020 All Races/EthnicitiesClick to see the detailed trend graph for All Races/Ethnicities 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 reported current tobacco product use by grade level, 2019-2020
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 reported current tobacco product use by grade level, 2019-2020 Middle SchoolClick to see the detailed trend graph for Middle School 6.4 5.2 - 7.8
High SchoolClick to see the detailed trend graph for High School 23.3 20.8 - 26.0

Cigarettes

By Sex
Percentage of adolescents in grades 6 to 12 who reported current cigarette use by sex, 2019-2020
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 reported current cigarette use by sex, 2019-2020 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 reported current cigarette use by race/ethnicity, 2019-2020
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 reported current cigarette use by race/ethnicity, 2019-2020 All Races/EthnicitiesClick to see the detailed trend graph for All Races/Ethnicities 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 reported current cigarette use by grade level, 2019-2020
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 reported current cigarette use by grade level, 2019-2020 Middle SchoolClick to see the detailed trend graph for Middle School 1.6 1.2 - 2.3
High SchoolClick to see the detailed trend graph for High School 4.6 3.6 - 6.0

E-Cigarettes

By Sex
Percentage of adolescents in grades 6 to 12 who reported current e-cigarette use by sex, 2019-2020
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 reported current e-cigarette use by sex, 2019-2020 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 reported current e-cigarette use by race/ethnicity, 2019-2020
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 reported current e-cigarette use by race/ethnicity, 2019-2020 All Races/EthnicitiesClick to see the detailed trend graph for All Races/Ethnicities 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 reported current e-cigarette use by grade level, 2019-2020
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 reported current e-cigarette use by grade level, 2019-2020 Middle SchoolClick to see the detailed trend graph for Middle School 4.7 3.6 - 6.0
High SchoolClick to see the detailed trend graph for High School 19.6 17.2 - 22.2

Smokeless Tobacco

By Sex
Percentage of adolescents in grades 6 to 12 who reported current smokeless tobacco use by sex, 2019-2020
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 reported current smokeless tobacco use by sex, 2019-2020 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 reported current smokeless tobacco use by race/ethnicity, 2019-2020
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 reported current smokeless tobacco use by race/ethnicity, 2019-2020 All Races/EthnicitiesClick to see the detailed trend graph for All Races/Ethnicities 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 reported current smokeless tobacco use by grade level, 2019-2020
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 reported current smokeless tobacco use by grade level, 2019-2020 Middle SchoolClick to see the detailed trend graph for Middle School 1.2 0.9 - 1.7
High SchoolClick to see the detailed trend graph for High School 3.1 2.3 - 4.2

Cigars

By Sex
Percentage of adolescents in grades 6 to 12 who reported current cigar use by sex, 2019-2020
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 reported current cigar use by sex, 2019-2020 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 reported current cigar use by race/ethnicity, 2019-2020
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 reported current cigar use by race/ethnicity, 2019-2020 All Races/EthnicitiesClick to see the detailed trend graph for All Races/Ethnicities 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 reported current cigar use by grade level, 2019-2020
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 reported current cigar use by grade level, 2019-2020 Middle SchoolClick to see the detailed trend graph for Middle School 1.5 1.1 - 2.0
High SchoolClick to see the detailed trend graph for High School 5.0 4.1 - 6.2

Previous Trends, 2011-2018

Percentage of adolescents in grades 6 to 12 who reported current tobacco product use by type of tobacco product, 2011-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of adolescents in grades 6 to 12 who reported current tobacco product use by type of tobacco product, 2011-2018 All TobaccoClick to see the detailed trend graph for All Tobacco 18.3 16.9 - 19.9
CigarettesClick to see the detailed trend graph for Cigarettes 5.4 4.6 - 6.2
E-CigarettesClick to see the detailed trend graph for E-Cigarettes 13.8 12.4 - 15.3
Smokeless TobaccoClick to see the detailed trend graph for Smokeless Tobacco 4.1 3.5 - 4.9
CigarsClick to see the detailed trend graph for Cigars 5.0 4.4 - 5.7

Additional Information on Youth Tobacco Use

Quitting Resources

Year Range

2019-2020

Recent Summary Trend Year Range

2019-2020

Summary Tables

Smoking

Recent Summary Trend

Falling

Desired Direction

Falling