Atlanta–About 6.2 million U.S. middle and high school students were current (past 30-day) users of some type of tobacco product in 2019, according to new National Youth Tobacco Survey (NYTS) data released in today’s Morbidity and Mortality Weekly Report.
The survey found that about 1 in 3 high school students (4.7 million) and about 1 in 8 middle school students (1.5 million) are current tobacco users.
For the sixth year in a row, e-cigarettes were the most commonly used tobacco product among high school (27.5%) and middle school students (10.5%). Tobacco products used by middle and high school students were not limited to e-cigarettes, but also included cigars, cigarettes, smokeless tobacco, hookahs, and pipe tobacco.
Many of these students are also using more than one tobacco product. Among current tobacco product users, about 1 in 3 middle and high school students (2.1 million) used two or more tobacco products. Among youth, symptoms of nicotine dependence are increased in multiple tobacco product users compared with single tobacco product users.
- Among high schoolers, e-cigarettes were the most commonly used (27.5%) tobacco product, followed by cigars (7.6%), cigarettes (5.8%), smokeless tobacco (4.8%), hookahs (3.4%), and pipe tobacco (1.1%).
- Among middle schoolers, e-cigarettes (10.5%) were also the most commonly used tobacco product, followed by cigars (2.3%), cigarettes (2.3%), smokeless tobacco (1.8%), and hookahs (1.6%).
- Among middle and high school students overall, the most commonly used tobacco product combination among multiple tobacco product users was e-cigarettes and cigars (17.2%), followed by e-cigarettes and cigarettes (13.3%), and e-cigarettes and smokeless tobacco (9.8%).
- In 2019, among middle and high school students, more than half (57.8%) of current tobacco product users reported seriously thinking about quitting all tobacco products. In addition, 57.5% reported they had stopped using all tobacco products for one or more days because they were trying to quit. Increasing successful quit attempts could complement prevention efforts to reduce tobacco product use among youths.
Many factors influence youth tobacco product use
Multiple factors influence youth initiation and use of tobacco products. Today’s report assessed several of these factors, including tobacco product advertising and promotions, flavored tobacco products, curiosity, and misperceptions of harm.
- Tobacco product advertising and promotions: In 2019, nearly 9 in 10 middle and high school students (22.9 million) reported exposure to tobacco product advertisements or promotions from at least one source.
- Flavored tobacco products: Nearly 7 in 10 (4.3 million) middle and high school students who currently use tobacco reported use of flavored tobacco products in 2019.
- Curiosity: Among students who reported ever having tried e-cigarettes, the three most common reasons for use were “I was curious about them” (55.3%), “friend or family member used them” (30.8%), and “they are available in flavors, such as mint, candy, fruit, or chocolate” (22.4%). Among students who never used e-cigarettes, 39.1% were curious about using e-cigarettes and 37.0% were curious about smoking cigarettes.
- Misperceptions of harm: Among all students, perceiving no harm or little harm from intermittent tobacco product use (use on some days but not every day) was 28.2% for e-cigarettes, 16.4% for hookahs, 11.5% for smokeless tobacco products, and 9.5% for cigarettes.