Youth Tobacco Use

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In 2017, 8.8% of high school students were cigarette users.

Summary graph for Youth Tobacco Use, Click to see detailed view of graph

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Introduction

Cigarette smoking is the leading preventable cause of disease, disability, and death in the United States. Smoking causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon and rectum, anus, as well as acute myeloid leukemia. Tobacco use is initiated and established primarily during adolescence (defined as ages 10-19): nearly 90 percent of adult cigarette smokers in the U.S. first tried cigarettes by age 18, and 98 percent first tried cigarettes by age 26. Each day in the U.S., around 1,600 youth aged 18 or younger smoke their first cigarette and another 200 become daily cigarette smokers.

E-cigarettes (also known as vapes or Electronic Nicotine Delivery Systems) are battery-powered devices that convert a liquid (“e-liquid”) into an aerosol. E-liquids typically contain nicotine, flavorings, vegetable glycerin, propylene glycol, and other chemicals. Besides nicotine, e-cigarette aerosol may contain heavy metals, volatile organic compounds, and fine and ultrafine particles that can be inhaled deeply into the lungs by both users and bystanders. Nicotine use among youth increases the risk of lifelong tobacco addiction and can also increase the risk for future addiction to other drugs. 

Teen cigarette smoking prevalence peaked around 1996/1997 but has been declining since.  However, a substantial portion of youth use other tobacco products, including cigars, smokeless tobacco, and hookah. Youth use of more than one tobacco product (dual use) is also common.  Since 2014, e-cigarettes have been the most commonly used tobacco product among youth.  In 2019, more than 3.6 million U.S. youth, including 1 in 5 high school students and 1 in 20 middle school students, were current users of e-cigarettes. 

There are many factors associated with youth tobacco use, including social, environmental, cognitive, and genetic influences. In addition, the Surgeon General’s 2012 report concluded that tobacco advertising, promotion, and depictions of smoking in movies are causally related to youth tobacco use. Initiation of smoking during adolescence is linked to persistent smoking during adult life and the many adverse health effects caused by smoking. 

Understanding trends in youth initiation of tobacco products – including cigarettes, electronic cigarettes, cigars, and smokeless tobacco – enables policy makers to target prevention resources more effectively. Effective strategies to reduce youth initiation of tobacco use include effective federal regulation of tobacco products; significant increases in tobacco prices, including excise taxes; smokefree air laws; restrictions on tobacco advertising and promotion; restricting the availability of tobacco products to youth; mass-media public education campaigns; and full implementation of comprehensive state and community tobacco control programs. On December 20, 2019, the President signed legislation to amend the Federal Food, Drug, and Cosmetic Act, and raise the federal minimum age of sale of tobacco products from 18 to 21 years.

Measure

The percentage of high school students (grades 9–12) who reported use of cigarettes, cigars, smokeless tobacco, or e-cigarettes on at least 1 day during the 30 days before the survey.

Note: To be consistent with the Healthy People 2020 Targets, measures for all products except e-cigarettes are based on data from YRBSS.

Healthy People 2020 Target

  • Reduce to 21 percent the proportion of adolescents in grades 9–12 who used tobacco products in the past 30 days.
  • Reduce to 16 percent the proportion of adolescents in grades 9–12 who smoked cigarettes in the past 30 days.
  • Reduce to 6.9 percent the proportion of adolescents in grades 9–12 who used smokeless (chewing tobacco or snuff) tobacco in the past 30 days.
  • Reduce to 8 percent the proportion of adolescents in grades 9–12 who smoked cigars in the past 30 days.

There is no Healthy People 2020 target for use of e-cigarettes.

Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.

Data Source

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System (YRBSS), 1999–2017.

E-Cigarettes Data: Centers for Disease Control and Prevention, National Youth Tobacco Survey (NYTS), 2011–2019.

Trends and Most Recent EstimatesHelp with navigating the graphs and data tables

By Type of Tobacco Product, Excluding E-cigarettes

Percentage of high school students (grades 9-12) who used cigarettes, cigars, or smokeless tobacco in the past 30 days by type of tobacco product, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used cigarettes, cigars, or smokeless tobacco in the past 30 days by type of tobacco product, 1999-2017 Cigarettes, Cigars and Smokeless TobaccoClick to see the detailed trend graph for Cigarettes, Cigars and Smokeless Tobacco 14.0 12.2 - 15.9
CigarettesClick to see the detailed trend graph for Cigarettes 8.8 7.2 - 10.7
Smokeless tobaccoClick to see the detailed trend graph for Smokeless tobacco 5.5 4.4 - 6.7
CigarsClick to see the detailed trend graph for Cigars 8.0 7.2 - 8.9

Cigarettes, Cigars and Smokeless Tobacco

By Sex
Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 14.0 12.2 - 15.9
MaleClick to see the detailed trend graph for Male 17.3 15.3 - 19.4
FemaleClick to see the detailed trend graph for Female 10.7 8.9 - 12.7
By Race/Ethnicity
Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who were current users of cigarettes, cigars, or smokeless tobacco by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 14.0 12.2 - 15.9
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 16.8 14.3 - 19.7
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 10.2 8.5 - 12.3
HispanicClick to see the detailed trend graph for Hispanic 10.5 9.1 - 12.2

Cigarettes

By Sex
Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 8.8 7.2 - 10.7
MaleClick to see the detailed trend graph for Male 9.8 8.3 - 11.6
FemaleClick to see the detailed trend graph for Female 7.8 6.0 - 9.9
By Race/Ethnicity
Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigarettes in the past 30 days by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 8.8 7.2 - 10.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 11.1 9.0 - 13.6
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 4.4 3.2 - 5.9
HispanicClick to see the detailed trend graph for Hispanic 7.1 5.8 - 8.6

Smokeless Tobacco

By Sex
Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 5.5 4.4 - 6.7
MaleClick to see the detailed trend graph for Male 9.0 7.3 - 11.0
FemaleClick to see the detailed trend graph for Female 1.9 1.4 - 2.6
By Race/Ethnicity
Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used smokeless tobacco in the past 30 days by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 5.5 4.4 - 6.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 6.8 5.3 - 8.7
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 3.6 2.5 - 5.1
HispanicClick to see the detailed trend graph for Hispanic 3.7 2.8 - 5.0

Cigars

By Sex
Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by sex, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by sex, 1999-2017 Both SexesClick to see the detailed trend graph for Both Sexes 8.0 7.2 - 8.9
MaleClick to see the detailed trend graph for Male 10.5 9.4 - 11.7
FemaleClick to see the detailed trend graph for Female 5.4 4.6 - 6.4
By Race/Ethnicity
Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by race/ethnicity, 1999-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who smoked cigars in the past 30 days by race/ethnicity, 1999-2017 All RacesClick to see the detailed trend graph for All Races 8.0 7.2 - 8.9
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 9.0 7.8 - 10.3
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 7.4 6.0 - 9.1
HispanicClick to see the detailed trend graph for Hispanic 6.4 5.3 - 7.5

E-cigarettes

By Sex
Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by sex, 2011-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by sex, 2011-2018 Both SexesClick to see the detailed trend graph for Both Sexes 27.5 25.3 - 29.7
MaleClick to see the detailed trend graph for Male 27.6 25.1 - 30.3
FemaleClick to see the detailed trend graph for Female 27.4 25.0 - -29.9
By Race/Ethnicity
Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by race/ethnicity, 2011-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of adolescents 95% Confidence Interval
Thumbnail of graph for Percentage of high school students (grades 9-12) who used electronic cigarettes in the past 30 days by race/ethnicity, 2011-2018 All RacesClick to see the detailed trend graph for All Races 27.5 25.3 - 29.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 32.4/td> 29.8 - 35.2
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 17.7 14.5 - 21.4
HispanicClick to see the detailed trend graph for Hispanic 23.2 20.6 - 26.0

Evidence-based Resources

The Cancer Control P.L.A.N.E.T. web portal contains tobacco control resources that support collaboration, identify evidence-based approaches, and list research-tested interventions. To identify high-risk populations and prioritize cancer control efforts, state and county-level tobacco data can be found on State Cancer Profiles.

Additional Information on Youth Tobacco Use

For the public

For tobacco users

For health professionals

Scientific reports

Year Range

1999-2017

Recent Summary Trend Year Range

2013-2017

Summary Tables

Smoking

Recent Summary Trend

Falling

Desired Direction

Falling