Latest study on youth nicotine use shows mix of positive and negative findings

Fewer high school students used tobacco products in 2023, but use among middle school youth increased significantly, according to a study released Nov. 2 by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration.

Based on findings from the 2023 National Youth Tobacco Survey, the study describes lifetime and current use of nine tobacco product types, flavored tobacco products and e-cigarette use behaviors among middle (grades 6-8) and high (grades 9-12) school students nationwide.

Overall, 2.8 million (10 percent) of middle and high school students reported currently using a tobacco product in 2023. Youth were more likely to report current e-cigarette use in 2023, at 7.7 percent, compared to cigarettes (1.6 percent), cigars (1.6 percent), nicotine pouches (1.5 percent), smokeless tobacco (1.2 percent), other oral nicotine products (1.2 percent), hookah (1.1 percent), heated tobacco products (1 percent) and pipe tobacco (0.5 percent).

Current use (within the last 30 days) of any tobacco product declined during 2022–23 (16.5 percent to 12.6 percent), primarily driven by a decline in e-cigarette use (14.1 percent to 10 percent). Declines also occurred for use of any combustible tobacco product, including cigars, among high school students.

Among middle school students, current use of at least one tobacco product jumped from 4.5 percent to 6.6 percent in 2022–23, and the use of multiple tobacco products increased from 1.5 percent to 2.5 percent. However, no other significant changes occurred during this time period for any individual tobacco product type, including e-cigarettes, among middle school students.

For the 10th year, e-cigarettes have been the most commonly used tobacco product among both middle and high school students, with almost 90 percent of young people using flavored e-cigarettes.

Experts noted that youth e-cigarette use remains a critical public health concern, with about half of students who ever tried e-cigarettes reportedly still using them — about a quarter reported using e-cigarettes daily. This indicates that many youth who try e-cigarettes remain e-cigarette users.

“The decline in e-cigarette use among high school students shows great progress, but our work is far from over,” said Deirdre Lawrence Kittner, director of CDC’s Office on Smoking and Health. “Findings from this report underscore the threat that commercial tobacco product use poses to the health of our nation’s youth. It is imperative that we prevent youth from starting to use tobacco and help those who use tobacco to quit.”

While disposable products were the most commonly used e-cigarette device type among youth, the most popular brands among students currently using e-cigarettes — Elf Bar (56.7 percent), Esco Bars (21.6 percent), Vuse (20.7 percent), JUUL (16.5 percent) and Mr. Fog (13.6 percent) — included a variety of both disposable and cartridge-based products.