While the number of U.S. youths using e-cigarettes has dropped to its lowest level in a decade, health officials stress there is still more work to do to ensure further declines.
Half a million fewer U.S. youths reported use of e-cigarettes in 2024 than in 2023, according to results from the annual National Youth Tobacco Survey (NYTS).
Approximately 1.63 million youths reported using e-cigarettes in 2024 compared to 2.13 million in 2023. Survey results were published today in the Morbidity and Mortality Weekly Report.
The NYTS is a nationally representative sample of middle and high school students in grades 6-12. Data from 283 schools gathered from Jan. 22 to May 22, 2024 were analyzed by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).
“The continued decline in e-cigarette use among our nation’s youth is a monumental public health win,” Brian King, Ph.D., M.P.H., director of the FDA’s Center for Tobacco Products, said in a statement.
The AAP has long advocated for legislation to safeguard children from purchasing and using e-cigarettes. The Academy has supported a ban on flavored tobacco and in June said it was “profoundly disappointed” by an FDA decision to authorize several menthol-flavored e-cigarettes, adding the decision will have “serious health consequences for children and young people.” In August, the AAP and partners urged the FDA to act on its 2009 statutory mandate and regulate online sales of e-cigarettes.
E-cigarette use
An estimated 5.9% of middle and high school students reported current e-cigarette use, including 7.8% of high school students and 3.5% of middle school students. Among students who currently use e-cigarettes, 38.4% reported frequent use, and 26.3% reported daily use.
The vast majority of youths using e-cigarettes used flavored products (87.6%), with fruit (62.8%), candy (33.3%) and mint (25.1%) being the most common flavor type.
Among youths who used e-cigarettes, the most commonly reported brands used were Elf Bar (36.1%), Breeze (19.9%), Mr. Frog (15.8%), Vuse (13.7%) and JUUL (12.6%).
Nicotine pouch use
Sales of nicotine pouches (small, dissolvable, flavored pouches containing nicotine that users place between the lip and gum) have risen nationally since 2016. An estimated 480,000 students reported using nicotine pouches in 2024, about the same number as in 2023.
In 2024, 2.4% of high school students and 1% of middle school students reported current nicotine pouch use. About 29% reported frequent use, and 22% reported daily use. More than 85% of users reported using a flavored product, with mint (53.3%), fruit (22.4%) and menthol (19.3%) being most frequently reported.
Study authors said the implementation of comprehensive tobacco control strategies, regulations and enforcement are needed to prevent and reduce youth tobacco product use, which can lead to a lifetime of nicotine addiction.
Last year, the AAP released a policy statement, clinical report and technical report, each titled Protecting Children and Adolescents from Tobacco and Nicotine. The AAP will host a webinar "Design and Effectiveness of a Vaping Cessation Intervention for Adolescent E-Cigarette Users: Results from a Randomized Trial" at noon CDT Sept. 12. Register for the webinar here.
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