Decline in High School E-Cigarette Use; Rise in Middle School Tobacco Consumption: CDC and FDA Study

CigarettesImage by Gerd Altmann

A new study by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration reveals significant shifts in tobacco and e-cigarette use among U.S. middle and high school students in 2022-2023.

The study found a notable decline in the current (past 30-day) use of any tobacco product among high school students, dropping from 16.5% to 12.6%. This decrease was primarily driven by a reduction in e-cigarette use, which fell from 14.1% to 10.0%. There were also decreases in the use of any combustible tobacco product, including cigars.

However, the news is less positive among middle school students. The 2022-2023 period saw significant increases in current use of at least one tobacco product, rising from 4.5% to 6.6%, and the use of multiple tobacco products, increasing from 1.5% to 2.5%.

Despite these changes, e-cigarettes remained the most commonly used tobacco product among both middle and high school students for the 10th consecutive year. The report highlights that approximately half of students who ever tried e-cigarettes reported currently using them, suggesting that many youth who try e-cigarettes continue to use them. Among students reporting current e-cigarette use, about one-quarter reported daily use, with nearly nine out of 10 favoring flavored e-cigarettes.

Deirdre Lawrence Kittner, Ph.D., M.P.H., director of CDC’s Office on Smoking and Health, commented on the findings, “The decline in e-cigarette use among high school students shows great progress, but our work is far from over. 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.”

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The study, based on the 2023 National Youth Tobacco Survey, explored ever use and current use of nine tobacco product types, flavored tobacco products, and e-cigarette use behaviors among U.S. middle (grades 6-8) and high (grades 9-12) school students.

Key findings include:

  • Among middle and high school students, 2.8 million (10%) reported current use of a tobacco product in 2023.
  • 2.13 million (7.7%) students reported current e-cigarette use in 2023.
  • E-cigarettes were followed by cigarettes (1.6%), cigars (1.6%), nicotine pouches (1.5%), smokeless tobacco (1.2%), other oral nicotine products (1.2%), hookah (1.1%), heated tobacco products (1.0%), and pipe tobacco (0.5%).
  • Disposable products were the most commonly used e-cigarette device type among youth.
  • Among students who currently used e-cigarettes, the most commonly reported brands were Elf Bar (56.7%), Esco Bars (21.6%), Vuse (20.7%), JUUL (16.5%) and Mr. Fog (13.6%).

The study underscores the ongoing public health concern posed by youth tobacco and e-cigarette use. As efforts continue to reduce high school e-cigarette consumption, it is evident that there’s an urgent need for strategies to address the rising trend of tobacco product usage among middle school students.

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