Tobacco Use Among Middle and High School Students—United States, 2013

November 14, 2014 / Vol. 63 / No. 45

MMWR Introduction

CDC analyzed data from the 2013 National Youth Tobacco Survey (NYTS) to determine the prevalence of ever and current (past 30 days) use of 10 tobacco products (cigarettes, cigars, hookahs, smokeless tobacco, electronic cigarettes, pipes, snus, bidis, kreteks and dissolvable tobacco) among US middle school (grades 6–8) and high school (grades 9–12) students. In 2013, 22.9% of high school students reported current use of any tobacco product and 12.6% reported current use of ≥2 tobacco products. The prevalence of high school students who reported having ever tried a tobacco product was 46.0%, and the prevalence of high school students who reported ever trying ≥2 tobacco products was 31.4%. Among all high school students, cigarettes (12.7%) and cigars (11.9%) were the most prevalent tobacco products currently used. Cigar use among black high school students was nearly 50% higher than cigarette use (14.5% vs 9.0%). Cigarettes and cigars were followed by smokeless tobacco (5.7%); hookahs and (5.2%) e-cigarettes (4.5%); pipes (4.1%); snus (1.8%); kreteks (0.8%); bidis (0.6%); and dissolvable tobacco (0.4%).

Among middle school students, 6.5% reported current use any tobacco product and 2.9% reported current use of >2 tobacco products. The prevalence of middle school students who reported ever having tried a tobacco product was 17.7%, and the prevalence of middle school students who reported ever having tried >2 tobacco products was 9.4%. Cigars (3.1%) and cigarettes (2.9%) were the most prevalent tobacco products currently used by middle school students, followed by pipes (1.9%); smokeless tobacco (1.4%); e-cigarettes (1.1%); and bidis, kreteks, and snus (0.4%).

Combustible tobacco products were the most prevalent form of tobacco used among both current and ever tobacco users; 9 of 10 high school current and ever tobacco users used a combustible tobacco product. Combustible tobacco use causes the majority of tobacco-related disease and death in the United States. However, smokeless tobacco is not a safe alternative to combustible tobacco and causes cancer and nicotine addiction. In addition, while the effect of electronic cigarette use on public health overall remains uncertain, the 2014 Surgeon General’s report found that nicotine use can have adverse effects on adolescent brain development. Therefore, nicotine use by young people in any forms—combusted, smokeless, or electronic—is unsafe.