In October 2024, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) released the latest findings from the 2024 National Youth Tobacco Survey (NYTS) in the Morbidity and Mortality Weekly Report (MMWR), titled “Tobacco Product Use Among Middle and High School Students — United States, 2024.” The report highlights encouraging trends in youth tobacco use, with a notable decline in e-cigarette and hookah use and historically low cigarette smoking rates among middle and high school students.
Key Findings: Youth Tobacco Use Trends
According to the 2024 NYTS, approximately 2.25 million middle and high school students reported current use of at least one tobacco product in the past 30 days, down from 2.80 million in 2023. This decline largely reflects a reduction in e-cigarette use, which fell from 2.13 million in 2023 to 1.63 million in 2024. Hookah use also decreased significantly, from 290,000 in 2023 to 190,000 in 2024. Cigarette use reached an all-time low, with only 1.4% of students reporting current use.
Current use of multiple tobacco products (two or more) was reported by 3.0% of students, while combustible tobacco product use remained at 2.8%. These numbers underscore a broader trend of declining tobacco initiation among youth, reflecting the impact of public health interventions and educational campaigns.
Breakdown by School Level
- High School Students: 10.1% (1.58 million) reported using any tobacco product
- Middle School Students: 5.4% (640,000) reported using any tobacco product
Most Commonly Used Tobacco Products
- E-cigarettes: 5.9%
- Nicotine pouches: 1.8%
- Cigarettes: 1.4%
- Cigars: 1.2%
- Smokeless tobacco: 1.2%
- Other oral nicotine products: 1.2%
- Heated tobacco products: 0.8%
- Hookahs: 0.7%
- Pipe tobacco: 0.5%
Demographics
The survey also highlighted differences in usage among racial and ethnic groups:
- 16.3% of non-Hispanic American Indian or Alaska Native (AI/AN) students
- 10.0% of Black students
- 8.4% of Hispanic students
- 9.0% of Multiracial students
These figures indicate areas where targeted prevention strategies may be necessary to address disparities in tobacco use.
E-Cigarette Use Among Youth
E-cigarettes remain the most widely used tobacco product among youth, but their use is declining. In 2024:
- 5.9% of students (1.63 million) reported current e-cigarette use
- 7.8% of high school students and 3.5% of middle school students reported using e-cigarettes
- Frequency and Patterns of Use
- 26.3% of youth e-cigarette users reported daily use
- 38.4% reported using e-cigarettes on at least 20 of the past 30 days
Flavored E-Cigarette Use
- 87.6% of current users preferred flavored e-cigarettes
- Most popular flavors: Fruit, candy/desserts/sweets, mint, menthol
- 54.6% used products with “ice” or “iced” flavors
Device Types and Brands
- Prefilled/refillable pods or cartridges: 15.6%
- Disposables: 55.6%
- Top brands: Elf Bar (36.1%), Breeze (19.9%), Mr. Fog (15.8%), Vuse (13.7%), JUUL (12.6%)
These findings suggest that flavorings and convenient disposable devices continue to play a role in youth e-cigarette use.
Nicotine Pouch Use
Nicotine pouches, another popular alternative, remained relatively stable in 2024:
- 1.8% of students (480,000) reported current use
- Daily use: 22.4%
- Use at least 20 of 30 days: 29.3%
- Flavored use: 85.6%, primarily mint and fruit
Common Brands
- Zyn (68.7%)
- on! (14.2%)
- Rogue (13.6%)
- Velo (10.7%)
- Juice Head ZTN (9.8%)
These statistics highlight the continued popularity of flavored nicotine products among youth, emphasizing the importance of monitoring marketing and access.
FDA and Public Education Campaigns
The FDA implements multiple public education campaigns to prevent youth tobacco initiation. Its longest-running campaign, “The Real Cost,” educates teens on the health risks of smoking, with a recent focus on e-cigarette prevention.
- 2021 NYTS: 75.2% of students reported seeing anti-tobacco campaign ads in the past year
- “The Real Cost” campaign recognition: 60.9% of students (15.8 million)
Despite these efforts, youth remain exposed to tobacco marketing through everyday activities, such as:
- Convenience stores, supermarkets, and gas stations
- Television, streaming services, and movies
- Social media, where 73.5% of students reported encountering e-cigarette–related content
These findings underscore the challenge of counteracting pervasive marketing messages targeting youth.
FDA Actions and Leadership
In December 2024, Dr. Brian King, Director of the FDA Center for Tobacco Products (CTP), highlighted the 2024 NYTS results in a blog post titled “Youth Tobacco Product Use Continues to Decline as FDA Actions Build Momentum.” Dr. King emphasized that the declining trends represent a public health victory while outlining ongoing FDA strategies to further reduce youth tobacco use.
FDA actions include:
- Enforcement of age restrictions for tobacco product sales
- Monitoring emerging products, such as disposable e-cigarettes and nicotine pouches
- Supporting research on the health effects of youth tobacco use
- Collaborating with CDC and other public health partners on prevention initiatives
- Goals and Importance of the NYTS
The NYTS is a nationally representative survey of middle and high school students designed to provide reliable data on:
- Tobacco use behaviors
- Patterns of product use
- Risk factors associated with initiation
- Effectiveness of prevention strategies
The survey informs evidence-based policy, public education, and program evaluation to reduce tobacco-related morbidity and mortality among youth.
Frequently Asked Questions:
What is the National Youth Tobacco Survey (NYTS)?
The NYTS is an annual, nationally representative survey conducted by the CDC and FDA to monitor tobacco use among middle and high school students in the United States. It tracks trends in cigarettes, e-cigarettes, hookahs, nicotine pouches, and other tobacco products.
What are the key findings of the 2024 survey?
In 2024, approximately 2.25 million students reported using tobacco in the past 30 days, showing a decline from 2023. E-cigarette and hookah use dropped significantly, while cigarette smoking reached historically low levels at 1.4%.
Which tobacco product is most commonly used by youth?
E-cigarettes remain the most commonly used product, with 5.9% of students reporting current use. Flavored products, especially fruit, candy, mint, and “ice” flavors, are particularly popular.
Are there differences in tobacco use among different student groups?
Yes. The survey revealed that non-Hispanic American Indian or Alaska Native students reported the highest usage (16.3%), followed by Black (10.0%), Multiracial (9.0%), and Hispanic (8.4%) students.
How often do youth use e-cigarettes?
More than 26% of current youth e-cigarette users vape daily, and over 38% use e-cigarettes on at least 20 of the past 30 days.
What are the most popular e-cigarette and nicotine pouch brands?
For e-cigarettes, popular brands include Elf Bar, Breeze, Mr. Fog, Vuse, and JUUL. Nicotine pouches are commonly used from brands like Zyn, on!, Rogue, Velo, and Juice Head ZTN.
How does the FDA work to reduce youth tobacco use?
The FDA runs public education campaigns like “The Real Cost”, enforces age restrictions, monitors emerging products, and collaborates with CDC and other partners to prevent youth initiation.
Conclusion
The 2024 National Youth Tobacco Survey reveals a promising decline in youth tobacco use, with e-cigarettes, hookahs, and cigarettes showing significant reductions. Despite these encouraging trends, flavored products and pervasive marketing continue to pose challenges, highlighting the need for ongoing prevention, education, and regulatory efforts. By leveraging these insights, parents, educators, and policymakers can take informed action to protect youth, promote healthier choices, and ensure that the next generation grows up tobacco-free.