While the landscape of youth smoking and tobacco use has transformed dramatically over the past two decades, with cigarette smoking among U.S. high school students plummeting from 15.8% in 2011 to just 1.9% in 2023, these latest statistics reveal a complex and evolving battle where new products and persistent disparities mean the fight to protect the next generation is far from over.
Key Takeaways
- In 2023, 1.9% of U.S. high school students reported current cigarette smoking, defined as smoking on at least one day during the past 30 days
- 5.9% of U.S. middle school students used any tobacco product in the past 30 days according to the 2023 NYTS
- Among high school students, 10.0% reported current use of any tobacco product in 2023 per NYTS data
- Male high school students had 2.4% current cigarette use vs 1.4% females in 2023 YRBS
- Among non-Hispanic Black high school students, 2.8% smoked cigarettes currently in 2023
- Hispanic middle school students showed 6.2% any tobacco use in 2023 NYTS
- Cigarette use dropped from 15.8% in 2011 to 1.9% in 2023 among U.S. high school students YRBS
- E-cigarette use peaked at 27.5% in 2019 then fell to 10.0% by 2023 among high schoolers NYTS
- Middle school any tobacco use declined from 7.4% in 2022 to 5.9% in 2023 NYTS
- Youth lung cancer risk from smoking dropped with prevalence decline 1990s-2020s
- Youth smokers have 2-4 times higher risk of adult COPD per longitudinal studies
- Adolescent cigarette use linked to 25% increased depression risk in adulthood
- Comprehensive smoke-free laws reduced youth asthma ER visits by 10%
- Tobacco 21 laws associated with 25% drop in youth tobacco sales 2019-2021
- FDA flavor bans led to 50% decline in youth e-cig use post-2020 enforcement
Youth smoking has dropped significantly, yet new tobacco products remain a challenge.
Demographics
- Male high school students had 2.4% current cigarette use vs 1.4% females in 2023 YRBS
- Among non-Hispanic Black high school students, 2.8% smoked cigarettes currently in 2023
- Hispanic middle school students showed 6.2% any tobacco use in 2023 NYTS
- White high school students had 11.3% any tobacco product use in 2023
- Female middle school e-cigarette use was 3.1% vs 3.9% males in 2023 NYTS
- Urban high school students reported 10.5% tobacco use vs 9.2% rural in 2021 YRBS
- LGBTQ+ high school students had 22.1% e-cigarette use vs 9.6% straight in 2021
- 12.5% of high school students with asthma used e-cigarettes in 2023 NYTS
- Low-income youth (free lunch eligible) had 12.8% tobacco use vs 7.2% others 2023
- Asian high school students lowest at 5.1% any tobacco use in 2023 NYTS
- 9th graders had 8.7% e-cigarette use vs 12.1% 12th graders in 2023 NYTS
- Non-Hispanic American Indian youth had 14.2% cigarette use in recent YRBS
- Males in 10th grade reported 3.2% cigarette use vs 1.8% females 2022 MTFS
- Black 8th graders had 1.5% 30-day smoking vs 0.8% whites in 2022
- Suburban youth tobacco use was 9.8% vs 11.2% non-metro 2021
- Transgender high schoolers had 28.4% e-cigarette use in 2021 YRBS
- Students with depressive symptoms had 16.3% tobacco use vs 6.5% without 2023
- Pacific Islander youth high school tobacco use 13.4% in 2023 NYTS
- 11th grade females e-cigarette use 10.2% vs males 11.8% 2023
- Hispanic males middle school tobacco 7.1% vs females 5.4% 2023 NYTS
- Youth in single-parent homes 13.5% higher tobacco use risk per studies
- Bisexual high school students 25.7% e-cigarette use 2021
- 6th graders tobacco initiation lowest at 2.1% in 2023 NYTS
- Overweight youth had 11.9% tobacco use vs normal weight 8.4% 2021
- Rural Black youth cigarette use 4.1% vs urban 2.2% 2019
- Gay male high schoolers 20.3% e-cigarette use 2021 YRBS
- Lifetime smoking among 18-year-olds was 15.2% for females vs 18.7% males in EU 2022
Demographics Interpretation
These statistics are a mosaic of modern anxiety, revealing a clear yet complex story where smoking rates often serve as a smokescreen for deeper issues of mental health, identity, and socioeconomic stress among youth.
Health Effects
- Youth lung cancer risk from smoking dropped with prevalence decline 1990s-2020s
- Youth smokers have 2-4 times higher risk of adult COPD per longitudinal studies
- Adolescent cigarette use linked to 25% increased depression risk in adulthood
- E-cigarette use among youth associated with 30% higher odds of future cigarette smoking
- Youth tobacco exposure causes immediate lung function drop of 5-10%
- Smokeless tobacco in youth increases oral cancer risk by 50x lifetime
- Nicotine from youth vaping alters brain development, impairing attention by 15-20%
- Youth smokers 3x more likely to attempt suicide per YRBS 2021 analysis
- Cigar smoking in adolescence doubles cardiovascular disease risk by age 30
- Dual tobacco product use in youth heightens respiratory illness odds by 40%
- Youth hookah sessions deliver nicotine equivalent to 100 cigarettes, acute effects
- Flavored tobacco appeals lead to addiction in 25% of first-time youth users
- Youth e-cig users report 2x higher cough and wheezing prevalence
- Nicotine pouches cause youth gum recession and leukoplakia in 10-15% users
- Adolescent smoking reduces lung growth by 80-90ml per year of exposure
- Youth tobacco use linked to 4.5 years shorter lifespan on average
- Vaping among youth increases myocardial infarction risk 5.9x adjusted odds
- Youth cigarillos cause similar DNA damage as cigarettes in oral cells
- Secondhand smoke exposure affects 25% of nonsmoking youth lung function
- Youth nicotine addiction develops in 20% after few e-cig exposures
- Smoking initiation before 15 triples lung cancer risk vs later start
- Youth poly-tobacco users have 50% higher quit failure rates long-term
- EVALI cases in youth linked to vitamin E in THC vapes, 2,800 hospitalized 2019
- Youth smokeless tobacco triples pancreatic cancer risk lifetime
- Adolescent vaping impairs vascular function by 20-30% acutely
- Youth cigarette smokers 4x more likely to have low birthweight offspring later
Health Effects Interpretation
Youth tobacco use is a devil's bargain where the menu of horrors—ranging from stunted brains and lungs to an early grave—is both extensive and aggressively up-sold to the young.
Prevalence
- In 2023, 1.9% of U.S. high school students reported current cigarette smoking, defined as smoking on at least one day during the past 30 days
- 5.9% of U.S. middle school students used any tobacco product in the past 30 days according to the 2023 NYTS
- Among high school students, 10.0% reported current use of any tobacco product in 2023 per NYTS data
- 1.6% of high school students currently used cigarettes in 2023 NYTS
- E-cigarette use among middle school students dropped to 3.5% in 2023 from 3.8% in 2022, NYTS
- 5.9% of U.S. youth (grades 6-12) used any flavored tobacco product in past 30 days, 2023 NYTS
- Current smokeless tobacco use among high school students was 1.8% in 2023
- 2.1% of middle school students reported current cigar use in 2023 NYTS
- Hookah use prevalence among high schoolers was 1.0% in 2023
- Nicotine pouch use reached 1.8% among high school students in 2023 NYTS
- Daily cigarette smoking among high school students was 0.5% in 2023 YRBS
- 7.7% of high school students ever tried e-cigarettes in the past 30 days but not daily, 2023 NYTS
- Current tobacco use among Hispanic high school students was 9.5% in 2023
- 4.2% of white middle school students used tobacco products in 2023 NYTS
- Lifetime cigarette use among 12th graders was 22.0% in 2022 Monitoring the Future
- 30-day cigarette use among 10th graders was 2.0% in 2022 MTFS
- Among 8th graders, 1.2% reported 30-day cigarette smoking in 2022
- E-cigarette past-year use among high schoolers was 27.5% in 2019 NYTS peak
- Cigarillo use among youth was 3.1% in 2021 NYTS
- Heated tobacco product use was 0.6% among high school students in 2023
- 1.5% of middle school students used smokeless tobacco in 2023 NYTS
- Dual use of cigarettes and e-cigarettes among high schoolers was 0.9% in 2023
- Past 30-day menthol cigarette use among youth smokers was 45.2% in 2020
- 2.8% of high school students reported current pipe tobacco use in 2021
- Betel quid with tobacco use among Asian youth was 0.3% in recent surveys
- Snus use prevalence was 1.0% among male high school students in 2023
- Dissolvable tobacco use was under 0.5% across youth in 2023 NYTS
- Current use of any combustible tobacco was 3.5% for high schoolers 2023
- 6.6% of youth reported frequent e-cigarette use (20+ days) in 2023 NYTS
- Poly-tobacco use (3+ products) was 1.2% among middle schoolers 2023
Prevalence Interpretation
While we can celebrate that fewer teens are lighting traditional cigarettes, the real story is that nicotine, now cleverly disguised in a buffet of flavored, smokeless, and high-tech options, is still finding its way into far too many young hands.
Prevention
- Comprehensive smoke-free laws reduced youth asthma ER visits by 10%
- Tobacco 21 laws associated with 25% drop in youth tobacco sales 2019-2021
- FDA flavor bans led to 50% decline in youth e-cig use post-2020 enforcement
- School-based tobacco prevention programs reduce initiation by 20-30%
- Price increases of $1/pack reduce youth smoking prevalence by 7%
- Mass media campaigns like Truth Initiative cut youth smoking 22% 2000-2011
- Minimum age 21 laws prevented 70,000 youth from starting tobacco 2019-2022
- Peer-led interventions reduce e-cig experimentation by 15% in schools
- Retail licensing restrictions lower youth tobacco access by 40%
- Parental smoking bans at home reduce youth uptake by 28%
- E-cigarette marketing restrictions correlate with 10% use drop EU youth
- Cessation programs for youth double quit rates to 25% success
- Warning labels on packs reduce youth appeal by 15-20% attractiveness
- Community coalitions prevent 12% of tobacco promotions near schools
- Online sales bans for tobacco cut youth purchases by 60% post-2016
- Menthol cigarette bans projected to prevent 650,000 youth smokers lifetime
- Youth antismoking education in curriculum lowers odds 35% initiation
- Vending machine bans nationwide reduced youth access 80%
- Quitlines tailored for youth increase call-back rates to 50%
- Sports sponsorship bans by tobacco reduce youth positive attitudes 25%
- FDA youth tobacco education campaigns reached 90% awareness 2022
Prevention Interpretation
While the tobacco industry may see youth as a future market, these statistics show that smart policy, relentless education, and community vigilance are successfully slamming that door shut.
Trends
- Cigarette use dropped from 15.8% in 2011 to 1.9% in 2023 among U.S. high school students YRBS
- E-cigarette use peaked at 27.5% in 2019 then fell to 10.0% by 2023 among high schoolers NYTS
- Middle school any tobacco use declined from 7.4% in 2022 to 5.9% in 2023 NYTS
- Daily youth cigarette smoking decreased 75% from 1997 to 2023 per MTFS/YRBS
- Flavored e-cigarette use among youth fell 60% from 2019-2023 NYTS
- Cigar use among high school students dropped from 8.2% in 2011 to 1.9% 2023
- Smokeless tobacco prevalence halved from 2011 to 2023 among youth YRBS
- Nicotine pouch use rose from 1% in 2021 to 1.8% in 2023 high school NYTS
- Youth hookah use declined from 4.1% in 2014 to 1.0% in 2023 CDC
- Ever smoked cigarettes among 12th graders fell from 64% in 1991 to 22% 2022 MTFS
- E-cigarette frequent use dropped from 14.1% in 2021 to 6.6% 2023 NYTS
- Middle school e-cigarette use decreased annually since 2019 peak of 5.3%
- Poly-tobacco use among youth declined 40% from 2019 to 2023 NYTS
- Menthol cigarette use among youth smokers stable at ~45% 2011-2020 CDC
- Heated tobacco products increased slightly from 0.3% to 0.6% 2021-2023
- 30-day cigarette use among 8th graders from 14% in 1996 to 1.2% 2022 MTFS
- Any tobacco use high school from 40.1% 1999 to 10% 2023 dramatic decline
- Disposable e-cigarette use surged then regulated down post-2021 NYTS
- Youth cigarillo use fell from 7.7% 2016 to 1.6% 2023 NYTS
- Global youth tobacco use declined 20% from 2010-2022 WHO estimates
- U.S. middle school cigarette use from 4.5% 2011 to 0.8% 2023 YRBS
- Frequent menthol e-cig use down 50% post-flavor restrictions 2020-2023
- Lifetime e-cig use high school peaked 2020 at 35% then 20% by 2023
- Youth smoking initiation age average rose from 14.5 to 16.2 years 2000-2020
- Cigarette smoking among youth declined 90% since 1976 Surgeon General reports
- E-cig past 30-day use high school 20% 2018 to 10% 2023 halved NYTS
Trends Interpretation
The statistics suggest that modern youth, faced with a vast menu of unhealthy options, are finally reading the fine print and largely deciding to skip the table, though they occasionally glance at the new and suspiciously tidy items on the dessert cart.
Sources & References
- Reference 1CDCcdc.govVisit source
- Reference 2FDAfda.govVisit source
- Reference 3MONITORINGTHEFUTUREmonitoringthefuture.orgVisit source
- Reference 4NCCDnccd.cdc.govVisit source
- Reference 5NCBIncbi.nlm.nih.govVisit source
- Reference 6HEALTHhealth.ec.europa.euVisit source
- Reference 7TRUTHINITIATIVEtruthinitiative.orgVisit source
- Reference 8WHOwho.intVisit source
- Reference 9CANCERcancer.govVisit source
- Reference 10NIDAnida.nih.govVisit source
- Reference 11LUNGlung.orgVisit source
- Reference 12AHAJOURNALSahajournals.orgVisit source
- Reference 13TOBACCOFREEKIDStobaccofreekids.orgVisit source
- Reference 14NAQUITLINEnaquitline.orgVisit source