Since 2014, e-cigarettes have been the most commonly used tobacco product among U.S. middle and high school students.
Most e-cigarettes contain nicotine, which is highly addictive, can harm the developing adolescent brain, and can increase risk for future addiction to other drugs.
Among middle and high school current e-cigarette users (i.e., use on ≥1 day during the past 30 days), use of disposable e-cigarette devices* increased significantly between 2019 and 2020 (3) and was the most commonly used device type reported in 2021 (4). In 2020 and 2021, approximately eight in 10 middle and high school students who used e-cigarettes reported using flavored e-cigarettes (4,5). CDC and the Food and Drug Administration (FDA) analyzed nationally representative data from the 2022 National Youth Tobacco Survey (NYTS), a school-based, cross-sectional, self-administered survey conducted during January 18–May 31, 2022,† using a web-based survey instrument and administered to U.S. middle school (grades 6–8) and high school (grades 9–12) students.§ Participating students could complete the survey whether they were physically in school or at home engaging in remote learning; 99.3% of students reported completing the survey in school. Current e-cigarette use was assessed overall and by frequency of use, device type, flavors, and brands used (any brand used and usual brand used).¶ Weighted prevalence estimates and population totals were calculated.** The NYTS study protocol was reviewed and approved by CDC’s institutional review board.††
In 2022, 14.1% of high school students and 3.3% of middle school students reported current e-cigarette use (Table). Among current e-cigarette users, 42.3% reported using e-cigarettes frequently,§§ including 46.0% of high school students and 20.8% of middle school students; daily use was reported among 27.6% of current e-cigarette users, including 30.1% of high school students and 11.7% of middle school students. Among current e-cigarette users, the types of devices most often used were disposables (high school = 57.2%; middle school = 45.8%), followed by prefilled or refillable pods or cartridges (high school = 25.7%; middle school = 21.6%), and tanks or mod systems (high school = 5.9%; middle school = 9.8%), with 11.2% of high school students and nearly 23% of middle school students reporting not knowing the type of e-cigarette device used.
Among current e-cigarette users, Puff Bar was the most commonly reported brand used in the past 30 days by both middle and high school students (29.7%), followed by Vuse (23.6%), JUUL (22.0%), SMOK (13.5%), NJOY (8.3%), Hyde (7.3%), and blu (6.5%). Among current e-cigarette users, 14.5% reported that the brand they usually used was Puff Bar, followed by Vuse (12.5%), Hyde (5.5%), and SMOK (4.0%). Approximately one fifth (21.8%) of current e-cigarette users reported “some other brand” as their usual brand.
Among current e-cigarette users overall, 84.9% used flavored e-cigarettes; of these, the reported flavor types, in descending order of use, were fruit (69.1%); candy, desserts, or other sweets (38.3%); mint (29.4%); and menthol (26.6%). A similar pattern was observed among current users of flavored disposable e-cigarettes: fruit (75.2%); candy, desserts, or other sweets (40.4%); mint (29.6%); and menthol (16.7%) (Supplementary Table, https://stacks.cdc.gov/view/cdc/121630). Among current users of flavored pods or cartridges, the reported flavor types used were fruit (58.4%); menthol (53.9%); candy, desserts, or other sweets (30.3%); and mint (27.6%). Among current users of flavored tanks or mod systems, the reported flavor types used were fruit (69.6%); candy, desserts, or other sweets (47.7%); mint (40.1%); and menthol (35.2%).
In 2022, 2.55 million U.S. middle and high school students currently used e-cigarettes. Most reported using flavored products, and, among those students, approximately seven of 10 used fruit flavors. Disposable products were the most commonly reported device type. Further, among middle and high school students who used e-cigarettes, approximately four in 10 reported frequent use, and approximately one in four reported daily use. The use of tobacco products in any form, including e-cigarettes, by middle and high school students is unsafe. Sustained implementation of comprehensive tobacco prevention and control strategies at the national, state, and local levels,¶¶ coupled with FDA regulation and enforcement, is critical to addressing e-cigarette use among middle and high school students.
U.S. Centers for Disease Control – 2022-10-07.
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