About 13% of middle and high school students — 2.55 million youths — reported current use of tobacco products in 2021, according to a new report.
E-cigarettes were the most common product used for the eighth consecutive year, and most youth tobacco users reported using flavored products.
“Youth use of tobacco products is unsafe in any form — combustible, smokeless, or electronic,” Karen Hacker, M.D., M.P.H., director of the Centers for Disease Control and Prevention’s (CDC’s) National Center for Chronic Disease Prevention and Health Promotion, said in a news release. “This report provides critical insights needed to combat this serious public health concern and help protect our nation’s youth from the harmful effects of tobacco.”
The data come from the 2021 National Youth Tobacco Survey, a nationally representative survey of 20,413 middle and high school students who provided information on use of nine tobacco products. The CDC and Food and Drug Administration (FDA) reported their findings Thursday in the Morbidity and Mortality Weekly Report. About half of the students completed the survey outside of school due to the pandemic, so the results cannot be compared to previous years.
The data showed about 34% of high school students and 11% of middle school students (a combined 6.6 million) reported ever having used a tobacco product. About 13% and 4%, respectively, reported current (past 30 days) use. About 79% of students using tobacco said they used a flavored product.
E-cigarettes continue to be the most common product, with current use reported by 11% of high school students and 3% of middle school students. About 58% of those who had ever used an e-cigarette said they did so because a friend used them.
Friends also were the most common source of tobacco products. About one-third of youths said they got their tobacco products from friends, and close to the same percentage bought products themselves despite the legal age being 21 years.
The survey showed students who identified as lesbian, gay or bisexual had higher rates of tobacco use than those who were heterosexual. Use by transgender students also was higher than for non-transgender students. In addition, students reporting severe psychological distress were more likely to use tobacco products than those not reporting distress.
Racial differences also were found. Current tobacco use was highest among White students (11%) followed by Black (8%) and Hispanic (7%). Black students had the highest rates of combustible product use.
Study authors called for improving enforcement of the legal tobacco age of 21 years, increasing tobacco product prices, enacting comprehensive clean indoor air policies, implementing media campaigns to warn about the dangers of tobacco and restricting the sale of flavored e-cigarettes. They also called on health care providers to screen patients for tobacco use and assist those who want to quit. About 65% of the youths surveyed said they were seriously thinking about quitting.
“It’s revealing that about two-thirds of current youth users expressed a desire to quit tobacco products and that three-quarters of youth reported having seen or heard a tobacco prevention ad,” FDA Center for Tobacco Products Director Mitch Zeller, J.D., said in a news release. “But the 2021 use data are still concerning and will be valuable for policymakers and educators committed to protecting the next generation from tobacco-related disease and death.”
Resources
- Information from the AAP on tobacco control and prevention
- AAP policy E-Cigarettes and Similar Devices
- AAP policy Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke
- Information for parents from HealthyChildren.org about e-cigarettes
- Surgeon general’s interactive website about e-cigarettes geared toward parents and others who work with youths
- FDA’s The Real Cost campaign
