U.S. teen tobacco use has hit a record low
A drop in vaping is behind the decline, but new nicotine products are raising concerns
These young people gathered at an anti-tobacco rally in the Harlem neighborhood of New York City. They were taking part of a national event recognizing young people’s efforts to prevent tobacco use.
Richard Levine/Alamy
Tobacco products are attracting fewer U.S. teen and tween users than at any other time in the last 25 years.
The latest numbers come from the 2024 National Youth Tobacco Survey, or NYTS. It collected data from January to May of that year. Only 8 percent of middle and high school students — about 2.25 million teens and tweens — reported using tobacco products in the previous month.
That was a big difference from just a few years before. In 2019, 23 percent — just over 6 million teens and tweens — said they were currently using tobacco products.
E-cigarettes, or vapes, are the most popular tobacco products among young people. A drop in the number of high schoolers who currently vape is a big reason for the overall decline in tobacco use.
In 2023, 10 percent of high school students said they had vaped in the past month. A year later, just under 8 percent did. That amounted to 350,000 fewer high-school students.
The overall decrease in tobacco use by young people is good news, says Rachel Boykan. She’s a pediatric doctor at Stony Brook Children’s Hospital in New York.
Exposure to nicotine, the addictive substance in tobacco products, is especially unhealthy for adolescents. It harms teens’ ability to learn, remember and pay attention. It can also make it harder to quit a nicotine addiction later in life.
What’s behind the drop in tobacco use?
Laws that limit who can buy tobacco products has helped limit teen use, Boykan says.
In 2005, Needham, Mass., became the first town to raise the age required to purchase tobacco products to 21. Over time, more cities and states followed. In 2019, this rule became national law.
When Needham raised the purchase age for tobacco products, regular cigarettes were the main concern. The law significantly cut smoking among Needham’s high schoolers compared to those living nearby. When older teens were no longer able to legally buy cigarettes, that curbed their own use. It also knocked out a main supply of cigarettes to younger kids.
It’s now possible to buy e-cigarettes illegally online. That makes it harder to restrict sales, Boykan says.
Another approach that has helped is a campaign called The Real Cost. It’s run by the U.S. Food and Drug Administration. This campaign has boosted awareness of the harms of nicotine, vaping and smoking among teens and tweens, research has shown. It also has made young people less open to tobacco products.
In one research trial, more than 1,500 13- to 17-year olds watched videos on vaping. Some were prevention ads by The Real Cost. Those clips centered on health risks or addiction problems related to vaping. Other participants watched neutral videos about vaping.
Teens who watched The Real Cost ads were less curious about vaping than those who watched neutral videos. This Real Cost group also was less open to smoking.
Reports of serious lung injuries and deaths related to vaping have gotten people’s attention as well. Cases of vaping-related injuries peaked in September 2019. By January 2020, almost 2,700 people had been hospitalized for such injuries.
One survey of 11th and 12th graders found these vaping injuries increased their view that vaping was risky.
What are the dangers of newer products?
Nicotine pouches are now the second most popular tobacco product among teens and tweens, the new NYTS reports. Some 480,000 middle and high school students used them in 2024. These small pouches hold a powder containing nicotine, appealing flavorings and other ingredients. When a user places one between their lips or cheeks and their gum, nicotine seeps into their bloodstream through the lining of their mouth.
The number of teens and tweens using nicotine pouches stayed steady from 2023 to 2024. That’s worrying, Boykan says. It seems these pouches are “not perceived as harmful.”
Vapes that look like a gaming devices or smartphones pose a new risk, too. Some come with games styled after classics like Tetris and Pac-Man. One brand offers a virtual pet that the user feeds by taking puffs, plus a puff-count competition game.
These devices are not legal in the United States. The new devices are “combining gaming — which is already a concerning addiction — and vaping, in a way that is really scary,” Boykan says.
Boykan wants teens and tweens to know that the nicotine in tobacco products poses a “really significant” risk to the adolescent brain. Nicotine can impair brain development, leading to a rewiring that may damage a teen’s ability to think and focus.
When Boykan talks to young people, she asks them about their dreams and goals. A nicotine addiction can get in the way of those plans. “I can point them to videos of kids who had to drop out of college,” She says, “because they were so addicted.”
