Despite a significant decline from its peak, the 2023 National Youth Tobacco Survey reveals that 1 in 10 high school students are currently using e-cigarettes, underscoring a persistent public health crisis.
Key Takeaways
- In 2023, 2.13 million U.S. middle and high school students (7.7%) reported current e-cigarette use in the past 30 days according to the National Youth Tobacco Survey (NYTS)
- Among high school students in 2023 NYTS, 10.0% (1.84 million) reported current e-cigarette use, with a significant portion using daily
- Middle school current e-cigarette use was 1.8% (290,000 students) in 2023 per NYTS, showing a slight decline from prior years
- E-cigarette use causes acute lung injury (EVALI) with over 2,800 hospitalizations among youth by 2020 per CDC
- Youth vapers have 2.7 times higher odds of cough or bronchitis per 2022 cross-sectional study
- Nicotine in e-cigs harms adolescent brain development, affecting attention and learning per Surgeon General 2020 report
- High school males 12% more likely to vape than females, with 10.8% vs 9.4% in 2023 NYTS
- Non-Hispanic White youth highest e-cig use at 11.4% among high schoolers 2023 NYTS
- Hispanic middle school students 2.1% current e-cig use in 2023 NYTS
- 89.4% of youth e-cig users preferred flavored products in 2023 NYTS
- Disposable e-cigarettes used by 86.9% of current youth vapers in 2023 NYTS
- Fruit flavors top choice for 55.6% of high school e-cig users 2023 NYTS
- 68% of U.S. youth aware of e-cigarette harms per 2023 Truth Initiative survey
- 78% of youth support flavor bans on e-cigs per 2022 American Lung Association poll
- Only 22% of high school vapers perceive e-cigs less harmful than cigs in 2023 NYTS
Youth vaping has declined but remains a serious public health crisis.
Awareness Attitudes Prevention
168% of U.S. youth aware of e-cigarette harms per 2023 Truth Initiative survey
Verified278% of youth support flavor bans on e-cigs per 2022 American Lung Association poll
Verified3Only 22% of high school vapers perceive e-cigs less harmful than cigs in 2023 NYTS
Verified4FDA's 2020 flavor enforcement reduced youth JUUL use by 60% per study
Directional545% of non-vaping youth tried to quit friends from vaping per Truth 2023
Single source6School tobacco policies cover 95% of students but enforcement varies per CDC 2022
Verified787% of youth believe e-cigs cause addiction per 2021 YRBS perceptions data
Verified8Truth Initiative campaigns reached 90% of U.S. youth with anti-vaping ads 2018-2023
Verified9Price increase of 20% on e-cigs reduces youth use by 12% per 2022 econ study
Directional1055% of parents discuss vaping risks with kids annually per 2023 ALA survey
Single source11Menthol ban support 72% among Black youth per 2022 Truth poll
Verified12E-cig warning labels increase quit intentions by 25% in youth per 2021 trial
Verified1340 states have flavor restrictions but only 10 fully enforce per 2023 ALA
Verified14Youth quitline calls up 300% post-FDA enforcement 2019-2021 per CDC
Directional1562% of vapers want to quit but only 12% succeed without help per Truth 2023
Single source16School-based interventions reduce vaping initiation by 40% per 2022 meta-analysis
Verified1775% of youth overestimate nicotine content safety in e-cigs per FDA 2022
Verified18National media campaigns cut youth e-cig use 15% 2019-2022 per eval
Verified19Retail license revocation in 5 states led to 20% drop in nearby youth use 2021-2023
Directional2081% support raising tobacco purchase age to 21, passed in 2019 per ALA 2020
Single source21Peer-led anti-vaping programs effective in 65% of schools per CDC 2023
Verified2234% of vapers cite health concerns as quit reason per 2023 NYTS follow-up
Verified23Graphic ads increase harm perceptions by 30% in youth per 2022 RCT
Verified2428 states require cessation programs in schools post-2020 per CDC
Directional25Youth support for vape taxes 69% per 2023 Cato poll
Single source26Digital interventions via apps reduce vaping by 22% in 6-month trial 2022
Verified2792% of teachers report discussing vaping in class per NEA 2023 survey
VerifiedAwareness Attitudes Prevention Interpretation
While youth are overwhelmingly aware of and agree on the harms of vaping, the chasm between their knowledge and successful quitting reveals a frustrating epidemic where awareness, support for bans, and school policies are abundant, yet accessible solutions, consistent enforcement, and effective cessation help are not.
Demographics
1High school males 12% more likely to vape than females, with 10.8% vs 9.4% in 2023 NYTS
Verified2Non-Hispanic White youth highest e-cig use at 11.4% among high schoolers 2023 NYTS
Verified3Hispanic middle school students 2.1% current e-cig use in 2023 NYTS
Verified412th graders had 12.6% past-month e-cig use in 2023 Monitoring the Future survey
Directional5Urban high school students 11.2% e-cig use vs 8.9% rural in 2023 NYTS analysis
Single source6LGBTQ+ youth 25% higher e-cig use odds per 2022 CDC Youth Risk Behavior Survey (YRBS)
Verified710th grade e-cig use 9.8% in 2023 Monitoring the Future
Verified8Black high schoolers 7.1% e-cig use, lower than whites but higher than Asians 5.6% 2023 NYTS
Verified9Females in 8th grade 2.1% vs males 2.5% middle school e-cig use 2023 NYTS
Directional10Low-income youth (<$35k household) 12.5% e-cig use vs 7.2% high-income 2023 NYTS
Single source119th graders 11.5% e-cig use highest among high school grades 2023 NYTS
Verified12Asian American high school e-cig use lowest at 5.6% in 2023 NYTS
Verified1311th graders 10.2% past-month e-cig in 2023 Monitoring the Future
Verified14Native Hawaiian/Pacific Islander youth 9.8% e-cig use 2023 NYTS subset
Directional15Suburban youth 10.5% vs exurban 9.1% high school e-cig use per 2022 YRBS
Single source168th grade e-cig use 3.7% in 2023 Monitoring the Future
Verified17Multiracial high schoolers 10.9% e-cig use 2023 NYTS
Verified18Males in rural areas 9.5% vs urban 11.0% e-cig use 2023 NYTS
Verified1920.4% of bisexual high school students vaped in 2021 YRBS
Directional2012% of youth with asthma history vape vs 8% without per 2023 Truth
Single source21Southern U.S. states average 11.3% high school e-cig use 2023 NYTS regional
Verified227th graders 1.2% e-cig use lowest middle school 2023 NYTS
Verified23Gay/lesbian youth 18.2% e-cig use vs 9.6% straight 2021 YRBS
Verified24Northeast U.S. 9.8% high school e-cig vs West 10.5% 2023 NYTS
Directional25Overweight youth 11.8% e-cig use vs normal weight 9.2% per 2022 YRBS
Single sourceDemographics Interpretation
While each demographic slice of American youth seems to have its own statistical flavor of vaping, the underlying recipe for risk reveals a disconcertingly universal addiction to inhaling uncertainty.
Flavors and Products
189.4% of youth e-cig users preferred flavored products in 2023 NYTS
Verified2Disposable e-cigarettes used by 86.9% of current youth vapers in 2023 NYTS
Verified3Fruit flavors top choice for 55.6% of high school e-cig users 2023 NYTS
Verified4Menthol/mint used by 28.1% of youth e-cig users in 2023 NYTS
Directional5Candy/dessert flavors 25.4% preference among middle school vapers 2023 NYTS
Single source6Elf Bar most popular brand used by 30.2% of high school vapers 2023 NYTS
Verified781.9% of youth users vaped flavored non-tobacco e-cigs in 2023 NYTS
Verified8Pod-based systems like JUUL used by 47.1% high schoolers before decline 2019-2023 NYTS trend
Verified915.3% used tobacco-flavored e-cigs, least popular in 2023 NYTS youth
Directional10Disposable vapes rose from 26.5% in 2020 to 86.9% in 2023 per NYTS
Single source11Mango flavor 22.4% among top fruits for high school vapers 2023 NYTS
Verified1262% of youth cite flavor as main reason for e-cig use per 2022 Truth survey
Verified13Puff Bar/Elf Bar disposables 55% market share among youth 2023 NYTS brands
Verified14Chocolate/candy flavors used by 20.1% middle school e-cig users 2023 NYTS
Directional15Nicotine salt pods in 38% of high school vapers' devices 2023 NYTS
Single source1690.6% of flavored e-cig users would quit if only tobacco flavors available per FDA 2021 study
Verified17Blueberry flavor 18.7% preference in disposables 2023 NYTS
Verified18Tank/mod systems used by only 4.2% youth vs disposables 86.9% 2023 NYTS
Verified195% nicotine strength most common at 45.3% among high school vapers 2023 NYTS
Directional20Menthol e-cigs 2x more used by Black youth 28% vs overall 2023 NYTS
Single source2173% of youth unaware high-nicotine disposables equal pack-a-day cigs per Truth 2023
Verified22Strawberry flavor 16.5% in top fruit choices 2023 NYTS high school
Verified23Pre-filled pods declined to 36.1% from 55% 2020-2023 NYTS
Verified2412-18 mg/ml nicotine in 30% disposables used by youth per 2022 lab analysis
Directional2595.2% of youth vapers used sweet flavors exclusively in 2021 FDA survey
Single source26Breeze flavors popular in 10.8% Elf Bar users among youth 2023 NYTS
Verified2733 states saw disposable use >80% in youth by 2023 per NYTS state data
Verified28Only 1.1% used tobacco-only flavors, showing youth aversion per 2023 NYTS
Verified2950mg/ml nicotine disposables used by 25% high schoolers 2023 NYTS
Directional3061% of youth and young adults believe e-cig flavors help quit smoking per 2021 FDA
Single sourceFlavors and Products Interpretation
The vaping industry has quite clearly weaponized a carnival of flavors and potent nicotine salts to hook a generation, given that nearly 90% of youth users choose flavored, non-tobacco products, would overwhelmingly quit if only tobacco flavors remained, and a staggering 86.9% now use disposable devices that are easy to hide and often contain as much nicotine as a pack of cigarettes—a fact most are blissfully unaware of.
Health Risks
1E-cigarette use causes acute lung injury (EVALI) with over 2,800 hospitalizations among youth by 2020 per CDC
Verified2Youth vapers have 2.7 times higher odds of cough or bronchitis per 2022 cross-sectional study
Verified3Nicotine in e-cigs harms adolescent brain development, affecting attention and learning per Surgeon General 2020 report
Verified440% of youth e-cig users report addiction symptoms like strong cravings per Truth Initiative 2023 survey
Directional5Vaping linked to 1.5 times increased asthma risk in youth per 2021 meta-analysis
Single source6EVALI outbreak 2019-2020: 68 deaths, majority under 35, many youth vapers per CDC
Verified7Youth e-cig use associated with depression: 2x odds per 2023 NYTS-linked study
Verified8Vitamin E acetate in THC vapes caused 82% of EVALI cases among youth per CDC 2020
Verified9Daily youth vaping doubles risk of future cigarette smoking per NEJM longitudinal study
Directional10E-cigs expose youth to cancer-causing chemicals like formaldehyde at levels 15x higher than cigs per study
Single source1125% of high school vapers report frequent anxiety per 2022 Truth survey
Verified12Acute nicotine poisoning cases in youth rose 91% 2018-2022 per Poison Control data
Verified13Vaping aerosols contain metals like lead at 10-50x environmental levels in youth lungs per 2021 study
Verified14Youth vapers 4x more likely to develop chronic cough per 2023 Pediatrics study
Directional15EVALI symptoms in youth: shortness of breath 83%, fever 81% per CDC case series
Single source16Nicotine dependence in non-smoker youth vapers: 30% per 2020 JAMA Pediatrics
Verified17Vaping increases heart rate by 20-30 bpm in adolescents per 2019 Circulation study
Verified1868% of hospitalized EVALI patients under 25 were daily vapers per CDC 2020 update
Verified19Youth exposed to ultrafine particles from vapes causing inflammation per 2022 Env Health study
Directional20E-cig flavorings like cinnamaldehyde toxic to lung cells at youth vaping concentrations per 2021 Tox Sci
Single source213x higher odds of myocardial ischemia in young vapers per 2023 case-control
Verified22Seizures reported in 121 youth under 25 from nicotine e-liquids 2010-2019 per FDA
Verified23COPD risk elevated 2.5x in adolescent vapers per 2022 cohort study
Verified24Oral health decline: gum inflammation 2x in youth vapers per 2021 JADA study
Directional25DNA damage from e-cig carcinogens in youth bronchial cells per 2020 Cancer Res
Single source26Sleep disruption: youth vapers 1.5x more insomnia per 2023 Sleep Med
VerifiedHealth Risks Interpretation
The vaping industry has weaponized fruity mist into a chemical assault on youth, trading their breath for profit and their futures for addiction, as the evidence now screams that each sweet cloud is a Trojan horse delivering a cocktail of disease, mental anguish, and lifelong harm straight to developing lungs and brains.
Usage Prevalence
1In 2023, 2.13 million U.S. middle and high school students (7.7%) reported current e-cigarette use in the past 30 days according to the National Youth Tobacco Survey (NYTS)
Verified2Among high school students in 2023 NYTS, 10.0% (1.84 million) reported current e-cigarette use, with a significant portion using daily
Verified3Middle school current e-cigarette use was 1.8% (290,000 students) in 2023 per NYTS, showing a slight decline from prior years
Verified4From 2019 to 2023, high school e-cigarette use dropped from 27.5% to 10.0% according to NYTS data analyzed by CDC
Directional5In 2022 NYTS, 14.1% of high school students used e-cigarettes in the past 30 days
Single source6Daily e-cigarette use among high school students reached 3.3% (about 600,000) in 2023 NYTS
Verified789.4% of youth e-cigarette users in 2023 used flavored products per NYTS
Verified8Past 30-day e-cigarette use among high school males was 10.8% vs. 9.4% females in 2023 NYTS
Verified9Non-Hispanic White high school students had 11.4% current e-cig use in 2023 NYTS, highest among races
Directional101 in 5 high school students who never smoked cigarettes regularly used e-cigarettes in 2023 per NYTS
Single source11E-cigarette use peaked at 27.5% among high schoolers in 2019 NYTS before declining
Verified12In 2021 NYTS, 11.3% high school students reported current e-cig use
Verified13Youth e-cig use associated with marijuana use: 25.7% of users also used cannabis in 2023 NYTS
Verified14Frequent use (20+ days/month) among high school e-cig users was 38.5% in 2023 NYTS
Directional152020 NYTS showed 19.6% high school current e-cig use during early pandemic
Single source16Middle school e-cig use declined from 5.3% in 2019 to 1.8% in 2023 per NYTS
Verified1785.9% of middle school e-cig users used flavored products in 2023 NYTS
Verified18Hispanic high school students had 9.2% e-cig use in 2023 NYTS
Verified19Black high school students reported 7.1% current e-cig use in 2023 NYTS
Directional20In 2018 NYTS, high school e-cig use was 20.8%
Single source211.6 million youth used e-cigarettes daily or nearly daily in 2023 equivalent per Truth Initiative analysis of NYTS
Verified222023 NYTS: 10% of 12th graders used e-cigarettes past month per Monitoring the Future cross-reference
Verified23Decline in disposable e-cig use from 89% to 86.9% among youth users 2022-2023 NYTS
Verified2426.3% of past 30-day youth e-cig users used on 20+ days in 2022 NYTS
Directional25High school e-cig use higher in urban areas at 11.2% vs. rural 8.9% in 2023 NYTS subset
Single source262017 NYTS baseline high school e-cig use 13.2%
Verified27Youth dual use of e-cigs and cigarettes: 5.2% high schoolers in 2023 NYTS
Verified28Middle school daily use 0.6% in 2023 NYTS
Verified292024 preliminary NYTS data shows continued decline to 9.4% high school use
Directional30E-cig use initiation before age 18 for 88% of adult users per 2023 CDC analysis
Single sourceUsage Prevalence Interpretation
While the trend is promising, the fact that one in ten high school students are still using e-cigarettes, with nearly 90% choosing flavored products, suggests Big Tobacco's slick rebranding is successfully recruiting a new generation of nicotine addicts.
Sources & References
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