Drop in E-Cig Use Drives Decline in Youth Tobacco Use

ATLANTA — Tobacco use among U.S. youth declined from 2015 to 2016, according to new numbers released by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration’s (FDA) Center for Tobacco Products.

The 2016 National Youth Tobacco Survey found that the number of middle and high school students who say they are current tobacco users — defined as having used a tobacco product in the past 30 days — dropped from 4.7 million in 2015 to 3.9 million in 2016.

The drop was primarily driven by the decline in electronic cigarette use among those youths: 3 million in 2015 to just under 2.2 million in 2016. 

In addition, declines were also seen during that timeframe among high school students who used two or more tobacco products, any combustible tobacco products, and hookah, according to the CDC.

"Far too many young people are still using tobacco products, so we must continue to prioritize proven strategies to protect our youth from this preventable health risk," said CDC Acting Director Anne Schuchat.

According to the two agencies, tobacco prevention and control strategies at the national, state, and local levels likely contributed to the reduction in tobacco use, particularly for e-cigarettes. 

However, the report notes that continued surveillance of all forms of youth tobacco product use is important to help determine whether the current downward trend in youth tobacco use continues.

"While the latest numbers from the 2016 National Youth Tobacco Survey are encouraging, it is critical that we work to ensure this downward trend continues over the long term across all tobacco products," said FDA Commissioner Scott Gottlieb. 

"Every day in the U.S., more than 2,500 youth under the age of 18 smoke their first cigarette and more than 400 youth become daily cigarette smokers. It is also clear from these most recent numbers that youth are continuing to experiment with, or becoming regular users of, a wide range of other tobacco products," he added.

In 2014, the FDA launched "The Real Cost" campaign, its first youth tobacco prevention campaign, which has helped prevent nearly 350,000 kids from smoking cigarettes, and continues to enforce important youth access restrictions, according to Gottlieb. "We plan to build on these vital efforts to reduce tobacco-related disease and death," he said.

The study also found that many youth report using multiple tobacco products. Specifically, 1.8 million middle and high school students reported using two or more tobacco products in the past 30 days.

Among current tobacco users in 2016, 47.2 percent of high school students and 42.4 percent of middle school students used two or more tobacco products.

The report also found that 20.2 percent of high school students and 7.2 percent of middle school students reported current use of any tobacco product. E-cigarettes remained the most commonly used tobacco product among youth for the third consecutive year, used by 11.3 percent of high school and 4.3 percent of middle school students. 

Although the data reflects a decline during 2015-2016, current use of any tobacco product did not change significantly during 2011–2016, because of the sharp increases in e-cigarettes and hookah during 2011–2014, according to the agencies.

Other key findings in the 2016 National Youth Tobacco Survey include:

• Among all high school students, the most commonly used products after e-cigarettes were: cigarettes (8 percent), cigars (7.7 percent), smokeless tobacco (5.8 percent), hookah (4.8 percent), pipe tobacco (1.4 percent) and bidis (0.5 percent).
• Among all middle school students, the most commonly used products after e-cigarettes were: cigarettes (2.2 percent), cigars (2.2 percent), smokeless tobacco (2.2 percent), hookah (2 percent), pipe tobacco (0.7 percent) and bidis (0.3 percent).
• Among non-Hispanic white and Hispanic high school students, e-cigarettes were the most commonly used tobacco product. Among non-Hispanic black high school students, cigars were most commonly used.
• Cigarette use was higher among non-Hispanic whites than among non-Hispanic blacks; smokeless tobacco use was higher among non-Hispanic whites than other races.

Bidis are small, thin, hand-rolled cigarettes imported to the United States, primarily from India and other Southeast Asian countries, according to the CDC.

"Tobacco use in any form, including e-cigarettes, is unsafe for youth," said Corinne Graffunder, director of CDC's Office on Smoking and Health. "Tobacco products contain nicotine, which is highly addictive and can harm the developing adolescent brain."