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Our Voice & Actions

Youth Cigarette Smoking at Historic Low

April 2022

Ed

Regulatory Affairs

Altria Client Services
Youth smoking in the United States has declined dramatically over the past two decades and persistently through a changing tobacco product landscape. The magnitude of decline is best appreciated by tracing back to the last peak prevalence year, 1997.

In that year, 28.3% of 8th, 10th and 12th graders reported current smoking1 according to data from the University of Michigan’s Monitoring the Future survey.2 Since that time, smoking has declined by more than 90 percent to just 2.3% in 2021. In other terms, smoking declined from nearly 3 in 10 students in 1997 to about 1 in 50 students in 2021. As a researcher who has closely followed these data for almost 20 years, these results are very promising and gratifying to observe.

Youth smoking has
declined more than

90
percent

over the past
two decades

Indeed, youth smoking is at historically low levels. Just 1.5% of middle and high school students, less than 1 in 50 students, reported current smoking in 2021, according to results from the Centers for Disease Control and Prevention’s National Youth Tobacco Survey (NYTS).3 While the Covid pandemic altered the NYTS methodology precluding direct comparisons, this result is consistent with the long-term trend.

Less than 1 in 50 middle and high school students smoke cigarettes

For example, current smoking among middle and high school students declined from 10.8% in 20114 to 3.3% in 20205 (before the pandemic). Whereas approximately 2.9 million students were current smokers in 20114, an estimated 910,000 smoked in 20205, and only about 410,000 smoked in 2021.3

The long-standing decline in youth smoking has persisted amidst the emergence of new tobacco products. Prevalence of e-vapor use among middle and high school students surged past cigarettes in 2014 and, following a brief decline, peaked in 2019, when 20% of students reported current e-vapor use.6 E-vapor use dropped to 13.1% in 20205 and was recorded at 7.6% in 2021.3 In addition, NYTS began reporting on heated tobacco products in 2020 and nicotine pouches in 2021; prevalence of current use of either product was low (<1.0%).3 To date, there is little evidence that new tobacco products have increased cigarette smoking prevalence among youth.

 

Remarkably, prevalence of youth smoking is already below the Office of Disease Prevention and Health Promotion's Healthy People 2030 goal.

 

The dramatic and sustained decline in youth smoking is a very positive public health outcome. Remarkably, prevalence of youth smoking is already below the Office of Disease Prevention and Health Promotion's Healthy People 2030 goal.7 Recent evidence of declines in e-vapor use and low levels of other tobacco product use among youth are also encouraging. Prevention, however, is a constant pursuit. Achieving tobacco harm reduction requires continued vigilance and focus on preventing youth from using tobacco. Today, the data show reason for optimism: efforts by many stakeholders are working.

1 Current smoking is defined as smoking on at least one day in the 30 days prior to assessment.

2 Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2022). Monitoring the Future national survey results on drug use 1975-2021: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, University of Michigan.

3 Gentzke, AS; Wang, TW; Cornelius, M; et al. Tobacco product use and associated factors among middle and high school students – National Youth Tobacco Survey, United States, 2021. MMWR Surveill Summ 2022; 71(No. SS-5):1-29.

4 ALCS Analyses of 2011 National Youth Tobacco Survey data.

5 Gentzke, AS; Wang, TW; Jamal, A; et al. Tobacco product use among middle and high school students – United States, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1881-1888.

6 Wang, TW; Gentzke, AS; Creamer, MR; et al. Tobacco product use and associated factors among middle and high school students – National Youth Tobacco Survey, United States, 2019. MMWR Surveill Summ 2019; 68(No. SS-12):1-22.

7 The 2030 Healthy People goal is a smoking prevalence of 3.4% among middle and high school students based on NYTS data. Reduce current cigarette smoking in adolescents — TU 06 - Healthy People 2030 | health.gov