In a significant shift in tobacco habits among young Americans, a recent report reveals a slight decrease in overall tobacco consumption, with a marked drop in e-cigarette use among high school students.
However, the study presents a worrying uptick in tobacco use among middle schoolers, raising alarms about the future health implications for the younger generation.
Middle School Tobacco Users Enticed by New Flavors
The prevalence of tobacco use among youths has decreased by about 1% since the previous year, according to the 2023 National Youth Tobacco Survey, which the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) jointly conducted. This decline is primarily attributable to a decline in e-cigarette use among high school students. This dip translates to about 580,000 fewer high school students engaging in e-cigarette use.
The new data, however, is not entirely promising. Middle school tobacco consumption has seen an increase from 4.5% to 6.6%, with the report showing a concerning rise in the use of multiple tobacco products, including cigarettes, cigars, e-cigarettes, and smokeless tobacco, up from 1.5% to 2.5%.
E-cigarettes remain the most commonly used tobacco product for the tenth consecutive year among both high school and middle school students. Out of the estimated 2.8 million youth who reported using tobacco in the past year, 2.1 million were e-cigarette users. This trend persists despite a quarter of these young e-cigarette consumers using the product daily and the overwhelming majority (89.4%) preferring flavored variants.
Deirdre Lawrence Kittner, the CDC's Office on Smoking and Health director, stated, "While the decline in e-cigarette use among high school students is encouraging, our efforts to eradicate tobacco use among youth are far from complete." She emphasized the importance of preventing the initiation of tobacco use in youths and assisting current users to quit.
For the first time, the survey also inquired about 'concept flavors,' like 'iced' or 'island bash,' providing insights into the nuanced preferences of the youth market, which may suggest that the use of flavored tobacco products is more widespread than previously understood.
Advocacy Groups Urge for Stricter Regulations on Flavored E-Cigarettes
Dr. Brian King, director of the FDA's Center for Tobacco Products, pointed to the report as evidence of "good progress," comparing the decrease from over 5 million e-cigarette-using youths in 2019 to just over 2 million. However, he cautioned against complacency and highlighted the need for persistent efforts to combat all forms of tobacco use among youth.
The FDA and CDC continue to focus on compliance and enforcement actions along the supply chain to address this issue. They are also collaborating closely with states and communities to equip them with the necessary information to counteract this health risk among kids.
The noticeable increase in middle school tobacco use, which may be a result of youth-targeted advertising, alluring flavors, and high nicotine levels in the products, only serves to further complicate the situation. Dr. King stresses that nicotine is highly addictive and can harm the developing adolescent brain, potentially leading to other drug addictions.
Yolonda Richardson, president and CEO of the Campaign for Tobacco-Free Kids, welcomed the survey results as "terrific news," but also called for intensified action, including the elimination of all flavored e-cigarettes from the market to further reduce youth tobacco use.
The National Youth Tobacco Survey, a web-based questionnaire targeting students from grades 6 through 12, was conducted between March 9 and June 16. The data is complete, but because it was self-reported and only included youth who were in school (not homeschooled, in jail, or had dropped out), the results may not be applicable to all situations.
The CDC warns that e-cigarettes and other tobacco products are unsafe for youth, potentially causing lasting harm. As tobacco use remains a leading preventable cause of disease and death in the United States, the new report serves as both a beacon of progress and a clarion call for sustained, concerted public health efforts.
