Frequency of Tobacco Use Among Middle and High School Students—United States, 2014

October 2, 2015 / Vol. 64 / No. 38

MMWR Introduction

The CDC and the Food and Drug Administration (FDA) analyzed data from the 2014 National Youth Tobacco Survey (NYTS) to determine how frequently (the number of days in the past 30 days) US middle and high school students used cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among current users (≥1 day during the past 30 days), frequent use (≥20 days during the past 30 days) for high school students was most prevalent among smokeless tobacco users (42 .0%), followed by cigarette smokers (31.6%), e-cigarette users (15.5%), and cigar smokers (13.1%); a similar pattern was observed for those who used during all 30 days. Frequent use among middle school students was greatest among smokeless tobacco users (29.2%), followed by cigarette smokers (20.0%), cigar smokers (13.2 %) and e-cigarette users (11.8%). Current use of ≥2 tobacco products in the past 30 days was common, even among young people who used select tobacco products infrequently (1-5 days during past 30 days); the prevalence of current use of ≥2 tobacco products among infrequent users was 77.3% for cigar smokers, 76.9% for cigarette smokers, 63.4% for smokeless tobacco users, and 54.8% for e-cigarettes users.

Studies have shown that early age onset of cigarette smoking increases the risk for heavier use, long-term use, and greater difficulty quitting. The effects of early initiation also might hold true for users of other tobacco products, given that exposure to nicotine is the main cause of tobacco product dependence. Studies have documented that even among US adolescent tobacco users who only used a single tobacco product on 1-2 days during the previous month, many reported symptoms of tobacco dependence, including strong cravings (14%), irritability and restlessness when not using tobacco (11%), strong desire to use the product (6%), and wanting to use the tobacco product within 30 minutes of awakening (1%). This report highlights the importance of understanding not only frequency of tobacco product use, but also patterns of using multiple products. Preventing youths from beginning use of any tobacco product is important to tobacco use prevention and control strategies in the United States. Greater understanding of the types of tobacco products and patterns of use of these products among youths is important for ensuring that proven tobacco prevention and control strategies, including increasing tobacco product prices, adopting comprehensive smoke-free laws, and implementing public education media campaigns, address the diverse types of tobacco products used by young people.