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Study: 1 in 9 U.S. middle, high school students using tobacco

November 10, 2022

Results from the 2022 National Youth Tobacco Survey (NYTS) show an estimated 3 million U.S. middle and high school students (about 11%) currently use a tobacco product.

The survey data were analyzed by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) and revealed an estimated 2.5 million high school students (16.5%) and 530,000 middle school students (4.5%) reported using tobacco in the past 30 days.

The NYTS was conducted from January through May 2022, and the findings were published today in Morbidity and Mortality Weekly Report. Comparisons with previous years’ findings were limited due to changes in survey methodology.

For the ninth consecutive year, electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among high school and middle school students (14.1% and 3.3%, respectively). In 2022, 24.8% of middle and high school students reported ever having used any tobacco product, and about 3.7% of all students reported currently smoking any combustible tobacco product.

Other tobacco products reported to be used by U.S. youths in the past 30 days included cigars (about 500,000 students), cigarettes (440,000), smokeless tobacco (330,000), hookah (290,000), nicotine pouches (280,000), heated tobacco products (260,000) and pipe tobacco (150,000). The term “tobacco product” refers to commercial tobacco products and not sacred and traditional use of tobacco by some American Indian communities.

Among all racial and ethnic groups, non-Hispanic American Indian or Alaska Native students had the highest percentage of tobacco product use in the past 30 days (13.5%), while non-Hispanic White students reported the highest percentage of e-cigarette use (11%). Non-Hispanic Black students reported the highest percentage of combustible tobacco product use (5.7%), including cigar use (3.3%).

Current tobacco product use also was higher among certain groups, including 27.2% of students with low academic achievement; 18.3% of students reporting severe psychological distress; 16.6% of students identifying as transgender; 16% of students identifying as lesbian, gay or bisexual; and 12.5% of students with low family affluence.

Commercial tobacco product use remains the leading cause of preventable disease, disability and death in the United States. Nearly all tobacco product use begins during youth and young adulthood. Tobacco product use among youths is particularly concerning, the authors said, because it is associated with nicotine dependence, which increases the likelihood of continued tobacco use in adulthood.

“It’s clear we’ve made commendable progress in reducing cigarette smoking among our nation’s youth,” Brian King, Ph.D., M.P.H., director of the FDA’s Center for Tobacco Products, said in a statement. “With an ever-changing tobacco product landscape, there’s still more work to be done. We must continue to tackle all forms of tobacco product use among youth, including meaningfully addressing the notable disparities that continue to persist.”

Study authors said implementation of evidence-based tobacco-control strategies and FDA regulation can help prevent and reduce use of tobacco products among youths.

The NYTS had several limitations. First, the data were self-reported. In addition, fewer students than expected participated, and survey respondents attended only public or private high schools. Finally, the sample size was small, which could have affected estimates for racial and ethnic populations.


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