While the number of teens smoking cigarettes has plummeted to historic lows—with only 1.9% of high school students reporting current use in 2023—this hard-won progress hides persistent risks and stark disparities that demand our continued attention.
Key Takeaways
- In 2023, 1.9% of U.S. high school students reported current cigarette smoking (past 30 days), a significant decline from previous years.
- Among U.S. middle school students in 2023, only 0.9% reported using cigarettes in the past 30 days per NYTS data.
- 5.8% of high school students in 2021 YRBS smoked cigarettes on at least one day in the past month.
- Male high school students smoked at 2.4% vs females 1.5% in 2023 NYTS.
- White teens aged 12-17 had 2.7% cigarette use rate in 2022 NSDUH.
- Black teens showed 1.3% current smoking in 2021 YRBS.
- Cigarette use among high school students dropped from 15.8% in 2011 to 1.9% in 2023.
- From 1991 to 2022, daily teen smoking declined by over 90% per MTFS.
- Past 30-day cigarette use fell from 27.5% in 1997 to 2.0% in 2022 for high schoolers.
- Smoking causes 90% of COPD cases, with teen starters at higher lifetime risk.
- Teens who smoke are 2-4 times more likely to develop depression by adulthood.
- Youth smokers have 2x risk of asthma attacks per CDC data.
- Comprehensive tobacco control programs reduce teen smoking by 50% over 10 years.
- Raising cigarette taxes by 10% decreases youth consumption by 7% per WHO.
- School-based anti-smoking programs cut initiation by 20-30%.
Despite a significant decline, teen smoking persists as a preventable health risk.
Demographic Differences
- Male high school students smoked at 2.4% vs females 1.5% in 2023 NYTS.
- White teens aged 12-17 had 2.7% cigarette use rate in 2022 NSDUH.
- Black teens showed 1.3% current smoking in 2021 YRBS.
- Hispanic youth cigarette use was 2.2% among high schoolers in 2023.
- Asian American teens had lowest rate at 0.7% in 2022 NYTS.
- Native American high school students smoked at 4.1% rate in 2021.
- Boys in middle school used cigarettes 1.2% vs girls 0.6% in 2023.
- Girls in high school had 1.6% smoking rate among non-Hispanic whites 2022.
- Urban male teens smoked 2.0% vs rural males 3.5% in 2021 YRBS.
- LGBTQ+ boys smoked cigarettes at 2.8% rate in high school 2021.
- Cisgender straight girls had 1.4% rate in same survey.
- Teens from families earning <$25k/year smoked 3.4% in 2022 NSDUH.
- High SES teens ($75k+) had 1.0% cigarette use.
- 9th graders smoked 2.1%, 10th 1.9%, 11th 2.0%, 12th 2.3% in 2021 YRBS.
- Obese teens smoked at 2.6% vs normal weight 1.8% in 2022.
- Students with A-F grades smoked 3.0% vs A students 0.9% in 2021.
- 2.9% of teens with depressive symptoms smoked cigarettes daily 2022.
- Non-depressed peers smoked at 1.5% rate same year.
- Southern U.S. states had 2.8% teen smoking vs Northeast 1.2% in 2021.
- Midwest teens smoked 2.4%, West 1.7% in 2022 YRBS.
Demographic Differences Interpretation
While the data reveals teens are smartly snubbing cigarettes at record lows, it also paints a starkly human picture of where this shrinking vice still smolders, clinging to the fissures of geography, identity, and hardship with a stubborn, discriminatory tenacity.
Health Consequences
- Smoking causes 90% of COPD cases, with teen starters at higher lifetime risk.
- Teens who smoke are 2-4 times more likely to develop depression by adulthood.
- Youth smokers have 2x risk of asthma attacks per CDC data.
- Smoking teens face 30% higher risk of type 2 diabetes in young adulthood.
- Nicotine addiction develops in 7% of teen experimenters, leading to daily use.
- Teen smokers lose 10+ years of life expectancy on average.
- 70% of teen smokers report cough and wheezing within first year.
- Youth smoking doubles oral cancer risk by age 40.
- Pregnant teens who smoke have 20-30% higher preterm birth risk.
- Smokers starting as teens have 25x lung cancer risk vs never-smokers.
- Teen cigarette use linked to 3x higher schizophrenia risk later.
- 40% of teen smokers develop chronic bronchitis by age 30.
- Nicotine exposure in teens impairs brain development, affecting memory.
- Youth smokers have 50% higher heart disease risk by age 35.
- Secondhand smoke from teen environments increases peer lung issues 25%.
- Teen smokers show 4x higher anxiety disorder rates in adulthood.
- Smoking reduces teen lung function by 10% within 2 years.
- 15% of teen smokers attempt suicide vs 5% non-smokers per YRBS.
- Teen tobacco use increases stroke risk 2.5x in early adulthood.
- Youth smokers have poorer wound healing, 2x infection risk post-surgery.
Health Consequences Interpretation
Starting smoking as a teen is essentially signing a tragic lease agreement for your future body, trading a decade of your life for a brutal portfolio of diseases, diminished mental health, and a body that will fundamentally fail you at every turn.
Prevalence Rates
- In 2023, 1.9% of U.S. high school students reported current cigarette smoking (past 30 days), a significant decline from previous years.
- Among U.S. middle school students in 2023, only 0.9% reported using cigarettes in the past 30 days per NYTS data.
- 5.8% of high school students in 2021 YRBS smoked cigarettes on at least one day in the past month.
- In 2022, approximately 2.0% of teens aged 12-17 reported daily cigarette use according to NSDUH.
- 1.6% of U.S. youth aged 12-17 were current cigarette smokers in 2021 per SAMHSA data.
- The 2023 NYTS found 1.4% of high school students smoked flavored cigarettes regularly.
- About 3.3% of high school students tried their first cigarette before age 13 in 2021 YRBS.
- In 2020, 4.6% of U.S. high schoolers reported frequent cigarette use (20+ days past month).
- 2022 data shows 1.2% of middle school students currently smoke cigarettes per NYTS.
- Among teens, 2.5% reported cigarette use in the past year in the 2021 Monitoring the Future survey.
- 0.8% of 8th graders smoked cigarettes in the past 30 days in 2022 MTFS.
- High school seniors saw 3.3% past-month cigarette use in 2023 per MTFS.
- 1.1% of 10th graders were current smokers in 2023 MTFS data.
- In 2022, 2.8% of U.S. high school students used cigarettes daily per YRBS.
- NYTS 2023 reports 1.0% menthol cigarette use among middle schoolers.
- 4.1% of high school students smoked cigars in past 30 days in 2021, overlapping with cigarette use.
- Past-year cigarette initiation rate among 12-17 year olds was 1.5% in 2022 NSDUH.
- 0.5% of middle school boys smoked cigarettes in 2023 NYTS.
- Among girls in high school, 1.7% current cigarette smoking in 2022 YRBS.
- 2.3% of white high school students smoked cigarettes past month in 2021.
- Hispanic teens showed 2.1% cigarette use rate in 2023 NYTS.
- Black high school students had 1.8% current smoking in 2022.
- Asian teens reported 0.9% cigarette use in past 30 days 2021 YRBS.
- Rural high school students smoked at 3.2% rate vs urban 1.9% in 2021.
- Suburban teens had 2.0% cigarette smoking prevalence in 2022 YRBS.
- 1.4% of LGBTQ+ high school students smoked cigarettes in 2021 YRBS.
- Straight high schoolers had 1.9% smoking rate in same survey.
- Students with asthma smoked cigarettes at 2.5% rate in 2022.
- 3.1% of teens from low-income families smoked in 2021 NSDUH.
- High-income teens showed 1.2% cigarette use in 2022.
Prevalence Rates Interpretation
The long, smoky tail of teen tobacco use is finally shriveling up—with nearly all rates now falling into the low single digits—proving that when society collectively frowns upon something, it turns out teenagers can, in fact, get peer pressured into being healthy.
Prevention Efforts
- Comprehensive tobacco control programs reduce teen smoking by 50% over 10 years.
- Raising cigarette taxes by 10% decreases youth consumption by 7% per WHO.
- School-based anti-smoking programs cut initiation by 20-30%.
- Flavored tobacco bans reduced teen use by 25% in implemented states.
- Media campaigns like Truth Initiative lowered teen smoking 66% since 2000.
- Smoke-free laws in homes reduce teen initiation by 35%.
- Peer-led cessation programs increase teen quit rates by 40%.
- FDA's This is Quitting text program helped 50,000+ teens quit.
- Raising minimum purchase age to 21 cut sales to minors by 90%.
- Community coalitions reduced teen smoking prevalence by 15% annually.
- Parental anti-smoking rules lower teen use by 50% per studies.
- Vaping education in schools decreased dual use by 22%.
- National quitline for youth boosted cessation to 28% success rate.
- Retail license revocation for sales to minors dropped violations 60%.
- Anti-tobacco curricula in 80% of schools correlated with 12% drop.
- Social media interventions reduced teen susceptibility by 30%.
- Menthol ban proposals projected 25% youth use reduction.
- Youth mentorship programs cut smoking odds by 45%.
Prevention Efforts Interpretation
The data screams that preventing teen smoking isn't a mystery; it's a battle fought and won by deploying a practical arsenal of smart taxes, flavor bans, honest media, enforced laws, and engaged communities to systematically dismantle every path a cigarette has to a kid.
Usage Trends
- Cigarette use among high school students dropped from 15.8% in 2011 to 1.9% in 2023.
- From 1991 to 2022, daily teen smoking declined by over 90% per MTFS.
- Past 30-day cigarette use fell from 27.5% in 1997 to 2.0% in 2022 for high schoolers.
- Middle school cigarette smoking decreased 85% from 2011 to 2023 NYTS.
- 8th grade smoking peaked at 18% in 1996, now 0.8% in 2023.
- High school senior lifetime cigarette use dropped from 74% in 1981 to 25% in 2022.
- Annual decline in teen cigarette initiation averaged 5% from 2010-2022 NSDUH.
- From 2019-2023, cigarette use fell 20% while e-cig use rose then stabilized.
- Post-2020 pandemic, teen smoking rates continued downward 15% drop by 2023.
- Menthol cigarette use among youth declined 40% from 2011-2021.
- Cigarette smoking initiation before age 14 fell from 11% to 3.3% 1991-2021.
- Daily smoking among 12-17 year olds dropped from 6% in 2002 to 2% in 2022.
- From 2011-2023, high school cigarette use halved every 5 years on average.
- Black teen smoking rates decreased 70% from 1991-2022 MTFS.
- White youth smoking fell 75% over same period.
- Hispanic teen rates declined 60% from 2010-2022.
- Rural-urban smoking gap narrowed 50% since 2010 due to rural declines.
- Female teen smoking dropped faster than males, 80% vs 70% since 1990s.
- Lifetime non-smoker rate among seniors rose from 30% in 1991 to 75% in 2023.
- Quit attempts among teen smokers increased 25% from 2015-2022.
Usage Trends Interpretation
The near-extinction of teen smoking over the last generation, from a cultural mainstay to a statistical afterthought, is arguably the most unheralded and triumphant public health victory in modern memory.
Sources & References
- Reference 1CDCcdc.govVisit source
- Reference 2FDAfda.govVisit source
- Reference 3SAMHSAsamhsa.govVisit source
- Reference 4TRUTHINITIATIVEtruthinitiative.orgVisit source
- Reference 5MONITORINGTHEFUTUREmonitoringthefuture.orgVisit source
- Reference 6NIDAnida.nih.govVisit source
- Reference 7LUNGlung.orgVisit source
- Reference 8SURGEONGENERALsurgeongeneral.govVisit source
- Reference 9CANCERcancer.govVisit source
- Reference 10HEARTheart.orgVisit source
- Reference 11NCBIncbi.nlm.nih.govVisit source
- Reference 12WHOwho.intVisit source
- Reference 13DIGITALMEDIAdigitalmedia.fda.govVisit source