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E-Cigarettes Still a Threat to Youth Despite Decline in Use, New Data Show


Despite e-cigarette use dropping 4.1% in the past year, it is still the most commonly used tobacco product among both middle and high school students.

Despite the decline in tobacco product use among US high school and middle school students, including e-cigarettes, tobacco remains a threat to the health of young people, according to a study released today by the CDC and the FDA.

The researchers, writing in the Morbidity and Mortality Weekly Report, reported that the percentage of high school students currently using any tobacco product declined from 16.5% to 12.6% over the past year. They noted that this decline was primarily driven by the drop in students using e-cigarettes from 14.1% to 10.0%, as well as fewer students using any combustible tobacco product.

Despite the decline, 2.13 million high school and middle school students still reported currently using e-cigarettes, marking the 10th year that e-cigarettes have been the most commonly used tobacco product among students. Of those who currently use, 25.2% reported using e-cigarettes daily, and 89.4% used flavored e-cigarettes. The researchers noted that most used disposable products, like Elf Bars (56.7%), Esco Bars (21.6%), Vuse (20.7%), JUUL (16.5%), and Mr. Fog (13.6%).

“Youth e-cigarette use remains a critical public health concern, as approximately half of students who ever tried e-cigarettes reported currently using them, indicating that many youth who try e-cigarettes remain e-cigarette users,” the authors wrote.

young people using e-cigarettes

Young people using e-cigarettes

Image credit: yta - stock.adobe.com

These findings were based on survey results from the 2023 National Youth Tobacco Survey, which described the use of 9 tobacco product types, including flavored tobacco products and e-cigarettes, among US middle school (grades 6-8) and high school (grades 9-12) students. Overall, of both middle and high school students, 2.8 million (10%) reported currently using tobacco products in 2023.

Other than e-cigarettes (7.7%), other tobacco products students reported using included 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%).

The researchers acknowledged their study’s limitations, one being that the data were obtained through self-report, which could result in social desirability and recall biases. Also, the findings may not be generalizable to young people who are homeschooled, dropped out of school, enrolled in alternative schools, or are in detention centers.

Despite these limitations, the authors noted that the survey's findings showed that tobacco use is still a threat to young people's health as they continue to use it due to flavors, marketing, and misperceptions of harm. They added that young people using tobacco products is unsafe as nicotine can harm their developing brains, lead to lifelong addiction, and result in subsequent disability, disease, and death. To prevent tobacco use among this group, the authors suggested price increases, comprehensive smoke-free policies that include e-cigarettes, counter-marketing campaigns, and health care interventions.

“The decline in e-cigarette use among high school students shows great progress, but our work is far from over,” Deirdre Lawrence Kittner, PhD, MPH, director of the CDC’s Office on Smoking and Health, said. “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.”


Birdsey J, Cornelius M, Jamal A, et al. Tobacco product use among US middle and high school students — National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep. 2023;72(44):1173-1182. doi:10.15585/mmwr.mm7244a1

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