On this page:
- 2023 Findings on Youth Tobacco Use
- NYTS 2023 Methodology
- Public Health Education
- Goals of NYTS
- Previous National Youth Tobacco Survey
In November 2023, FDA and Centers for Disease Control and Prevention (CDC) released data from the 2023 National Youth Tobacco Survey (NYTS) on youth tobacco use in the Morbidity and Mortality Weekly Report: “Tobacco Product Use among Middle and High School Students — United States, 2023.”
Among U.S. high school students, current overall tobacco product use declined during 2022-2023 (16.5% to 12.6%). This decline was primarily driven by e-cigarettes (14.1% to 10.0%), which translates to 580,000 fewer high school students who currently used e-cigarettes in 2023.Among high school students, declines were also observed during 2022-2023 for cigars and overall combustible tobacco smoking, representing all-time lows. Although a decrease in e-cigarette use was observed among high school students, there was an increase in current overall tobacco product use among middle school students (4.5% to 6.6%) and multiple tobacco product use (1.5% to 2.5%). However, among middle school students overall, no significant change was observed during 2022-2023 for any individual tobacco product type, including e-cigarettes.
10.0% of students (2.80 million) reported current use of any tobacco product
12.6% (1.97 million) high school students and 6.6% (800,000) middle school students reported current use of any tobacco product.
3.4% of students (920,000) reported current use of any combustible tobacco product
3.4% of students (940,000) reported current use of multiple (≥2) tobacco products
Most Commonly Used Types of Devices
- E-cigarettes (7.7%)
- Cigars (1.6%)
- Cigarettes (1.6%)
- Nicotine Pouches (1.5%)
- Smokeless (chewing tobacco, snuff, dip, or snus) (1.2%)
- Other oral nicotine products (lozenges, discs, tablets, gums, dissolvable tobacco products, and other products) (1.2%)
- Hookahs (1.1%)
- Heated Tobacco Products (1.0%)
- Pipe Tobacco (0.5%)
- 7.7% of students (2.13 million) reported current use of e-cigarettes
- 10.0% (1.56 million) high school students and 4.6% (550,000) middle school students reported current use of e-cigarettes
Frequency of Use
- More than 1 in 4 (25.2%) of current youth e-cigarette users use an e-cigarette product every day
- More than 1 in 3 (34.7%) youth e-cigarette users report using e-cigarettes at least 20 of the last 30 day
Flavored E-Cigarette Use
- Almost 9 out of 10 current e-cigarette users (89.4%) used flavored e-cigarettes, with fruit flavors being the most popular, followed by candy, desserts, or other sweets; mint; and menthol
- Over half (57.9%) of students currently using e-cigarettes reported using flavors with “ice” or “iced” in the name
Type of Device
- The most commonly used device among current e-cigarette users was disposables (60.7%), followed by prefilled/refillable pods or cartridges (16.1%)
Commonly Used Brands
- The most commonly reported brands reported among current e-cigarette users were: Elf Bar (56.7%), Esco Bars (21.6%), Vuse (20.7%), JUUL (16.5%), and Mr. Fog (13.6%)
The 2023 data was collected between March 9 to June 16, 2023. The NYTS is a cross-sectional, school-based, self-administered questionnaire administered to U.S. middle (grades 6-8) and high school (grades 9-12) students since 1999. A stratified, three-stage, cluster sampling procedure was used to generate a nationally representative sample of U.S. students attending private or public schools in grades 6-12. In 2023, data were collected from 22,069 students, with an overall response rate of 30.5%. Weighted prevalence estimates, 95% confidence intervals, and population totals were provided for ever use and current use (use on ≥1 day during the past 30 days) of nine tobacco products. Current e-cigarette use was reported by frequency of use, device type, brand, and flavor. Data on flavored e-cigarette use by device type and flavored product use overall and by flavor type used by tobacco product were also reported.
FDA conducts several public education campaigns aimed at young audiences to prevent youth from tobacco initiation and use. FDA’s longest-running campaign, “The Real Cost,” educates teens on the health consequences of smoking cigarettes and in recent years has prioritized e-cigarette prevention messaging.
In the 2021 NYTS, 75.2% of middle and high school students reported having seen or heard any antitobacco public education campaign ad within the past year. An estimated 15.8 million (60.9%) students reported recognizing the FDA’s “The Real Cost” campaign ad: by school level, almost two-thirds (65.8%) of high school students and more than half (54.8%) of middle school students reported recognizing “The Real Cost” campaign ad.
However, public health education campaigns are not the only messaging about tobacco products that youth receive and notice.
They might see advertisements for tobacco products while engaging in common activities – such as going to a convenience store, supermarket, or gas station; using the Internet; watching television or streaming services or going to the movies; or reading newspapers or magazines. In the 2021 NYTS, among youth who reported engaging in those common activities, 75.7% reported exposure to marketing or advertising for any tobacco product.
Among students who reported using social media, 73.5% had ever seen e-cigarette–related content.
FDA is committed to a science-based approach that addresses public health issues associated with tobacco use. We collaborate with CDC on this nationally representative survey of middle and high school students that focuses exclusively on tobacco use behaviors and associated factors.
NYTS was designed to provide national data on long-term, intermediate, and short-term indicators key to the design, implementation, and evaluation of comprehensive tobacco prevention and control programs.
For a deeper look at the agencies’ collaboration on the study over the years, see CDC’s “Historical NYTS Data and Documentation.”