February 12, 2019 – About 4.9 million middle and high school students were current users (used in the past 30 days) of some type of tobacco product in 2018, up from 3.6 million in 2017. This increase—driven by a surge in e-cigarette use—erased past progress in reducing youth tobacco product use, according to a new Vital Signs report published by the Centers for Disease Control and Prevention (CDC).

With the exception of e-cigarettes, no change was found in the use of other tobacco products, including cigarettes, resulting in a net increase in overall tobacco product use during 2017-2018. There were 1.5 million more youth
e-cigarette users in 2018 than 2017, and those who were using e-cigarettes were using them more often, as was previously reported in November 2018. Frequent use (more than 20 days in the past 30 days) of e-cigarettes, increased from 20 percent in 2017 to 28 percent in 2018 among current high school e-cigarette users.

More than 1 in 4 (27.1%) high school students and about 1 in 14 (7.2%) middle school students currently used a tobacco product in 2018. For the fifth year in a row, e-cigarettes (20.8%) were the most commonly used tobacco product among high schoolers, followed by cigarettes (8.1%), cigars (7.6%), smokeless tobacco (5.9%), hookah (4.1%), and pipe tobacco (1.1%). Among middle schoolers, e-cigarettes (4.9%) were also the most commonly used tobacco product, followed by cigarettes (1.8%), smokeless tobacco (1.8%), cigars (1.6%), hookah (1.2%), and pipe tobacco (0.3%).

Many youth tobacco product users are also using multiple products. Among current tobacco users, about 2 in 5
(1.68 million) high school students and 1 in 3 (270,000) middle school students used two or more tobacco products in 2018. The most commonly used tobacco product combination was e-cigarettes and conventional cigarettes among both middle and high school students.

Robert Redfield, M.D., CDC Director

“The skyrocketing growth of young people’s e-cigarette use over the past year threatens to erase progress made in reducing youth tobacco use. It’s putting a new generation at risk for nicotine addiction,” said CDC Director Robert R. Redfield, M.D. “Despite this troubling trend, we know what works and we must continue to use proven strategies to protect America’s youth from this preventable health risk. Youth use of any tobacco product, including e-cigarettes, is unsafe.”

Additional key findings:

  • Among high school students in 2018, any tobacco product use was reported by 32.4 percent of non-Hispanic white, 21.7 percent of Hispanic, 18.4 percent of non-Hispanic other race, and 17.4 percent of non-Hispanic black students.
  • Among middle school students in 2018, any tobacco product use was reported by 9.5 percent of Hispanics, 6.8 percent of non-Hispanic blacks, 6.6 percent of non-Hispanic whites, and 3.8 percent of non-Hispanic students of other races.
  • By sex in 2018, use of any tobacco product, two or more tobacco products, e-cigarettes, cigarettes, cigars, smokeless tobacco, and pipe tobacco was higher among male high school students than females.
  • By race/ethnicity in 2018, e-cigarettes were the most commonly used product among all racial/ethnic groups except black high school students, among whom cigars were the most commonly reported product.