Youth tobacco leverage in the United States has reached its lowest point in 25 years, a significant public health victory, according to newly released data. In 2024, 2.25 million middle and high school students reported current use of any tobacco product, a substantial decrease from the 2.80 million students who reported use in 2023. This decline is particularly notable given the ongoing challenges of addressing nicotine addiction and the evolving landscape of tobacco products marketed to young people.
The most dramatic shift has been in e-cigarette use, which fell from 2.13 million youth in 2023 to 1.63 million in 2024. Alongside this, hookah use similarly saw a considerable drop, decreasing from 290,000 to 190,000 students. Even traditional cigarette smoking continues to decline, reaching a record low of just 1.4% of students reporting current use. These figures, released by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA), represent a positive trend in protecting the health of the nation’s youth.
Despite this overall progress, experts caution that the fight is far from over. More than 2 million young people still use tobacco products, and concerning disparities persist across different demographic groups. “Reaching a 25-year low for youth tobacco product use is an extraordinary milestone for public health,” said Deirdre Lawrence Kittner, Ph.D., M.P.H., director of CDC’s Office on Smoking and Health. “However, with more than 2 million youth using tobacco products and certain groups not experiencing declines in use, our mission is far from complete. We must remain committed to public health efforts to ensure all youth can live healthy, tobacco-free lives.”
The Rise of Nicotine Pouches and Shifting Product Preferences
While e-cigarette use remains the most common form of tobacco product among youth—accounting for 5.9% of current users in 2024—a fresh trend is emerging. Nicotine pouches have quickly grow the second most popular choice, with 1.8% of students reporting current use. This rise is particularly noteworthy as pouches deliver high levels of nicotine without the aerosol associated with vaping, potentially circumventing some regulations and appealing to a different segment of young people. Following nicotine pouches, cigarettes (1.4%), cigars (1.2%), smokeless tobacco (1.2%), other oral nicotine products (1.2%), heated tobacco products (0.8%), hookahs (0.7%), and pipe tobacco (0.5%) round out the list of products used by students.
The FDA has been actively working to regulate the tobacco marketplace, conducting premarket reviews and enforcing compliance across the supply chain. These efforts, alongside public health campaigns like The Real Cost Campaign, aim to educate youth about the dangers of all tobacco products. Resources are also available to help young people quit, including Smokefree Teen, a website from the National Cancer Institute.
Disparities in Youth Tobacco Use: A Growing Concern
The recent data reveals a troubling pattern of uneven progress. While overall rates are declining, certain populations are experiencing increases in tobacco use. Between 2023 and 2024, current use of any tobacco product, e-cigarettes, oral nicotine products, any combustible tobacco product, and multiple tobacco products all increased among American Indian or Alaska Native students. Similarly, nicotine pouch use increased among White students. This contrasts sharply with declines observed among female and Hispanic students, where current use of several tobacco products decreased.
These disparities highlight the require for targeted interventions that address the specific factors driving tobacco use within these communities. Factors can include cultural norms, socioeconomic conditions, and targeted marketing practices. Brian King, Ph.D., M.P.H., director of the FDA’s Center for Tobacco Products, emphasized the importance of addressing these inequities. “We’re headed in the right direction when it comes to reducing tobacco product use among our nation’s youth,” King said. “But we can’t take our foot off the gas. Continued vigilance is needed to continue to reduce all forms of tobacco product use among youth. Addressing disparities remains an essential part of these efforts to ensure that we don’t leave anyone behind.”
Understanding the Factors Driving Declines
The observed decline in youth tobacco use is likely the result of a combination of factors. Increased awareness of the health risks associated with vaping and other tobacco products, coupled with stricter regulations and enforcement, have likely played a role. Price increases on tobacco products, comprehensive smoke-free policies, and mass media campaigns educating youth about the harms of nicotine are all evidence-based strategies that have been implemented at the national, state, and local levels. The CDC provides additional information on e-cigarettes and vaping and youth tobacco use.
The shift in product preferences, particularly the rise of nicotine pouches, also presents a new challenge for public health officials. These products, often marketed with appealing flavors and discreet packaging, may be perceived as less harmful than traditional cigarettes, leading to increased experimentation among young people. The long-term health effects of nicotine pouch use are still being studied, but experts agree that any form of nicotine exposure can be detrimental to adolescent brain development.
The data underscores the importance of continued monitoring and research to understand the evolving patterns of youth tobacco use. Public health officials must remain vigilant in their efforts to protect young people from the harmful effects of nicotine and tobacco, and address the disparities that exist across different populations. The ongoing analysis of data from the National Youth Tobacco Survey will be crucial in informing future prevention and control strategies.
The FDA and CDC are expected to release further analysis of the 2024 NYTS data in the coming months, providing a more detailed understanding of the trends and disparities observed. These findings will be critical in guiding future public health interventions and ensuring that all young people have the opportunity to live tobacco-free lives.
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