|Year collected||10th Grade||12th Grade|
Tobacco products used by adolescents include cigarettes (both store-bought and hand-rolled), cigars, pipes, hookahs, smokeless tobacco, and newer oral products such as pouches, lozenges, strips, and sticks. All of these products deliver tobacco’s toxic effects.
- Cigarettes: More than 80% of adult smokers begin smoking before 18 years of age and 16 percent of high school seniors reported smoking in the last month. Learn more.
- Smokeless tobacco: Use of smokeless tobacco among adolescents is less common than cigarette smoking. Learn more.
- Hookahs: Hookahs are no safer than other forms of tobacco smoking and may deliver even higher levels of toxic substances. Learn more.
- Flavored little cigars and flavored cigarettes: Of middle and high schoolers who smoke, more than 40 percent smoke flavored little cigars or flavored cigarettes.
- E-cigarettes: During 2011–2012, middle and high school students who had ever used an e-cigarette increased from 3.3% to 6.8%.
Almost four out of every ten high school seniors reports ever having smoked cigarette.  However, in 2013 almost one in 11 (9 percent) 12th graders were regular, daily smokers—a number that has declined dramatically from its recent peak of 25 percent in 1997, but more slowly since 2002 (see Figure 1). Cigarette smoking by adolescents (measured as use in the past month) in grades 8, 10, and 12 combined has declined by more than half since its most recent peak in the late 1990s. In 2013, one in ten adolescents (10 percent) reported smoking cigarettes in the past month, compared with more than one in four (28 percent) in 1996-97 (see Figure 2).,
Although we may not know all of the factors playing a role in this decline, the 1990s were years when funds from tobacco companies (the result of a legal settlement between the tobacco companies and the federal government) supported a number of local, state, and national anti-tobacco campaigns. In addition, during this time, new restrictions on tobacco advertising were instituted, smoke-free laws and policies were widely implemented, and additional taxes were placed on cigarettes, which inhibited demand. However, after 2002, most states did not allocate funds to maintain the proven anti-tobacco efforts shown to deter youth tobacco use.
Use of smokeless tobacco products (snuff, chewing tobacco) among adolescents is less common than cigarette smoking. However, adolescents increased their use of smokeless tobacco between 2008 and 2010. Rates remained fairly steady from 2010 to 2013. Although 8.1 percent of 12th graders used smokeless tobacco in the past 30 days (in 2011), this is not as high as during the mid-1990s (peaking at 12 percent in 1995). This rate is still higher than levels seen during most of the 2000s (see Figure 3). For smokeless tobacco use, the highest rates of initiation are in the seventh through 11th grades. Although approximately equal proportions of male and female adolescents smoke cigarettes, users of smokeless tobacco products are nearly all males.
|Year collected||10th Grade||12th Grade|
Hookahs (water pipes) are popular among some adolescents; typically used in groups, and sometimes in “hookah cafés,” the hookah mouthpiece is passed around from person to person. Hookahs are no less addictive than other forms of tobacco smoking, and at least as toxic as cigarette smoking. There are currently no national estimates of hookah smoking among adolescents.
Other Oral Tobacco Products
Newer forms of oral tobacco products including pouches, lozenges, strips, and sticks are also cause for concern. Most of these are designed to dissolve in the user’s mouth, and are offered in candy-like flavors; however, they all contain potent toxins that can lead to cancer and other serious diseases. Unfortunately, there are no reliable data yet on how many adolescents use these newer products.
Substance Abuse & Mental Health Services Administration Office of Applied Studies. (2013). Results from the 2012 National Survey on Drug Use and Health: Detailed tables. Tables 2.2A-2.4A. Washington, DC: U.S. Department of Health and Human Services. Retrieved October 10, 2014, from http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/DetTabs/NSDUH-DetTabsSect2peTabs1to42-2012.htm#Tab2.2A
Johnston, L. D., O'Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2014). Monitoring the Future national survey results on drug use: 1975-2013: Overview of key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. Retrieved October 10, 2014, from http://www.monitoringthefuture.org//pubs/monographs/mtf-overview2013.pdf
Centers for Disease Control and Prevention. (2014). Youth Risk Behavior Surveillance-United States, 2013. Morbidity and Mortality Weekly Report, 63(4). Retrieved October 10, 2014, from http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf
Substance Abuse and Mental Health Services Administration. (2013). Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. Retrieved, October 10, 2014, from http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/Index.aspx
King, B. A., Tynan, M. A., Dube, S. R., & Arrazola, R. (2013). Flavored-little-cigar and flavored-cigarette use among US middle and high school students. Journal of Adolescent Health.
Centers for Disease Control and Prevention (2013). Notes from the field: electronic cigarette use among middle and high school students-United States, 2011-2012. MMWR. Morbidity and mortality weekly report, 62(35), 729.
Jones, W.J., & Silvestri, G.A. (2010). The Master Settlement Agreement and its impact on tobacco use 10 years later: lessons for physicians about health policy making. Chest.137, 692–700.
Centers for Disease Control and Prevention. (2003). Tobacco use among middle and high school students—United States, 2002. MMWR, 52(45), 1096-1098. Retrieved October 10, 2014, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5245a2.htm
U.S. Department of Health and Human Service. (2012). Preventing tobacco use among youth and young adults: A report of the Surgeon General. Rockville, MD. Retrieved October 10, 2014, from http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf
National Institute on Drug Abuse. (2011). Facts on drugs: Tobacco addiction. NIDA for Teens. Retrieved October 10, 2014, from http://teens.drugabuse.gov/facts/facts_nicotine1.php