Overall Smoking Trends

This page details the decrease in cigarette and other tobacco use rates among adults and youth, including current use, quitting, and average daily cigarette consumption.

Trends in Cigarette Smoking Rates

Adults:

  • Long term, smoking rates have fallen 73% among adults, from 42.6% in 1965 to 11.6% in 2022.
  • Over the last five years, smoking rates have fallen 17% among adults, from 14.0% in 2017.
Adult Smoking Rate Trends By Sex, Race, and Age
  1965 1970 1974 1980 1985 1990 1995 1997 † 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 1965-2022 % Change 1997-2022
Total 42.4 37.4 37.1 33.2 30.1 25.5 24.7 24.7 24.1 23.5 23.3 22.8 22.5 21.6 20.9 20.9 20.6 19.8 20.6 20.6 19.3 19.0 18.1 17.8 16.8 15.1 15.5 14.0 13.7 14.0 12.5 11.5 11.6 -72.6 -53.0
Sex
Male 51.9 44.1 43.1 37.6 32.6 28.4 27.0 27.6 26.4 25.7 25.7 25.2 25.2 24.1 23.4 23.9 23.6 22.3 23.1 23.5 21.5 21.6 20.5 20.5 18.8 16.7 17.5 15.8 15.6 15.3 14.1 13.1 13.2 -74.5 -52.1
Female 33.9 31.5 32.1 29.3 27.9 22.8 22.6 22.1 22.0 21.5 21.0 20.7 20.0 19.2 18.5 18.1 17.8 17.4 18.3 17.9 17.3 16.5 15.8 15.3 14.8 13.6 13.5 12.2 12.0 12.7 11.0 10.1 10.0 -70.4 -54.6
Race
Non-Hispanic
White 42.1 37.0 36.4 32.9 29.6 25.6 25.6 25.3 25.0 24.3 24.1 24.0 23.6 22.7 22.2 21.9 21.8 21.5 22.0 22.2 21.1 20.7 19.8 19.5 18.3 16.6 16.7 15.3 15.0 15.5 13.3 12.9 12.7 -69.9 -50.0
Black 45.8 41.4 44.0 36.9 34.9 26.2 25.8 26.7 24.7 24.3 23.2 22.3 22.4 21.5 20.2 21.5 22.6 19.8 21.3 21.3 20.5 19.6 18.2 18.5 17.8 16.8 16.9 15.1 14.6 14.9 14.4 11.7 14.2 -68.9 -46.7
American Indian/ Alaska Native NA NA NA NA NA NA NA 34.1 40.0 40.8 36.0 32.7 40.8 39.7 33.4 32.0 32.2 36.4 32.4 23.2 31.4 31.5 21.8 26.1 29.2 21.9 34.1 24.6 25.9 20.9 27.1 19.0 19.3 NA -43.4
Asian NA NA NA NA NA NA NA 16.9 13.7 15.1 14.4 12.4 13.3 11.7 11.3 13.3 10.3 9.6 9.9 12.0 9.2 9.9 10.7 9.6 9.5 7.0 9.4 7.0 7.4 7.2 8.0 5.4 4.6 NA -72.8
Hispanic NA NA NA NA NA NA NA 20.4 19.1 18.1 18.6 16.7 16.7 16.4 15.0 16.2 15.1 13.3 15.8 14.5 12.5 12.9 12.5 12.1 11.2 10.1 10.7 9.9 9.8 8.8 8.0 7.7 8.0 NA -61.0
Age
18-24 45.5 38.0 37.8 33.3 29.3 24.5 24.8 28.7 27.9 27.9 26.8 26.9 28.5 23.9 23.6 24.4 23.7 22.2 21.4 21.8 20.1 18.9 17.3 18.7 16.7 13.0 13.1 10.4 7.8 8.0 7.4 5.3 4.9 -89.3 -83.1
25-44 51.2 44.6 44.5 37.8 34.8 29.7 28.6 28.6 27.5 27.3 27.0 25.8 25.7 25.6 23.8 24.1 23.2 22.8 23.7 24.0 22.0 22.1 21.6 20.1 20.0 17.7 17.6 16.1 16.5 16.7 14.1 12.6 12.5 -75.6 -56.3
45-64 41.6 38.6 37.7 35.6 31.6 27.0 25.5 24.4 25.0 23.3 24.0 23.8 22.7 22.0 22.4 21.9 21.5 21.0 22.5 21.9 21.1 21.4 19.5 19.9 18.0 17.0 18.0 16.5 16.3 17.0 14.9 14.9 15.1 -63.7 -38.2
≥65 17.9 16.1 17.3 17.2 16.0 12.8 13.0 12.0 10.9 10.6 9.7 10.1 9.3 9.1 8.8 8.6 10.0 8.3 9.3 9.5 9.5 7.9 8.9 8.8 8.5 8.4 8.8 8.2 8.4 8.2 9.0 8.3 8.7 -51.7 -27.9

Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey 1965-2022. Analysis for years 1997-2022 by the American Lung Association Research Team using SPSS software.

  • NA - Not Available
  • † Due to the redesign of the NHIS survey in 1997, comparisons with data from prior years must be conducted with caution.

Youth:

  • Long term, smoking rates have fallen 86% among youth, from 36.4% in 1997 to 3.8% in 2021.
  • Over the last five years, smoking rates have fallen 57% among youth, from 8.8% in 2017
High School Cigarette Smoking Rate Trend by Sex and Race
  1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 % Change 1991-2021 ‡
Total 27.5 30.5 34.8 36.4 34.8 28.5 21.9 23.0 20.0 19.5 18.1 15.7 10.8 8.8 6.0 3.8 -86.2
Sex
Male 27.6 29.8 35.4 37.7 34.7 29.2 21.8 22.9 21.3 19.8 19.9 16.4 11.8 9.8 6.9 3.9 -85.9
Female 27.3 31.2 34.3 34.7 34.9 27.7 21.9 23.0 18.7 19.1 16.1 15.0 9.7 7.8 4.9 3.7 -86.4
Race
Non-Hispanic
White 30.9 33.7 38.3 39.7 38.6 31.9 24.9 25.9 23.2 22.5 20.3 18.6 12.4 11.1 6.7 4.8 -84.5
Black 12.6 15.4 19.1 22.7 19.7 14.7 15.1 12.9 11.6 9.5 10.5 8.2 6.5 4.4 3.3 1.7 -86.5
American Indian/ Alaska Native N/A 35.8 N/A 44.4 N/A 45.1 23.1 31.5 37.0 37.1 31.2 24.6 12.2 18.7 20.6 6.7 -31.3
Asian 14.6 20.5 24.7 21.1 22.9 15.2 13.0 9.9 9.9 7.5 7.6 10.3 7.0 2.2 2.3 0.6 -95.9
Hispanic 25.3 28.7 34.0 34.0 32.7 26.6 18.4 22.0 16.7 18.0 17.5 14.0 9.2 7.0 6.0 3.1 -87.7

Trends in Number of People Who Smoke Cigarettes and Have Quit

In 2022, there were approximately twice as many adult smokers who had successfully quit as current adult smokers.

Trends in Average Number of Cigarettes Smoked Per Day

Between 1974 and 2022, among current smokers:

Percent of Adult Cigarette Smokers by the Number of Cigarettes Smoked Daily
  1974 1980 1985 1990 1995 1997 † 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 1974-2022
<15 31.6 29.1 31.6 34.5 40.9 42.3 42.4 45.2 45.8 46.7 48.6 51.1 50.4 51.7 52.6 55.0 55.1 58.0 58.9 59.5 60.3 63.2 65.5 63.9 64.6 65.3 65.8 56.9 57.1 58.1 58.4 84.8
15-24 43.2 42.1 41.8 42.6 39.0 39.7 39.9 39.1 38.8 38.5 37.0 36.1 37.2 36.6 35.3 34.1 34.9 32.9 33.7 31.8 33.2 30.5 28.2 29.7 28.6 29.3 28.1 35.7 35.7 35.3 33.5 -22.5
>24 25.3 28.8 26.6 22.9 20.1 18.0 17.7 15.7 15.4 14.8 14.4 12.9 12.3 11.7 12.1 10.9 10.1 9.1 7.4 8.6 6.5 6.3 6.3 6.4 6.7 5.4 6.1 7.5 7.2 6.6 8.1 -68.0
  • The proportion of people smoking more than 24 cigarettes a day decreased 68% from 25% to 8%.
  • The proportion of people smoking 15-24 cigarettes a day decreased 22% from 43% to 34%.
  • The proportion of people smoking fewer than 15 cigarettes a day increased 85% from 32% to 58%.

Decreases in heavy smoking rates (more than 24 cigarettes a day) from 1974 to 2022 have not been equal across the demographic groups depicted in the table.

Percent of Adults Who Smoked >24 Cigarettes Daily by Sex, Race, Hispanic Origin, Age and Education
  1974 1980 1985 1990 1995 1997 † 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 1974-2022 ‡
Sex
Male 31.1 33.7 32.4 28.5 25.5 21.9 23.5 20.2 20.7 18.6 18.2 16.1 16.5 16.4 15.4 13.1 12.2 11.7 12.6 13.5 9.7 10.3 10.7 11.4 10.5 9.1 9.7 10.3 9.5 8.6 10.3 -66.9
Female 18.7 23.2 20.6 16.6 14.1 13.5 13.1 12.6 11.7 10.6 10.1 9.2 9.9 9.0 8.1 7.8 7.2 5.7 5.7 7.7 6.0 5.1 4.7 4.5 5.9 4.3 5.3 4.4 4.6 4.3 5.4 -71.1
Race
White 27.6 31.6 29.5 25.4 22.2 20.4 20.5 18.3 18.5 16.7 16.3 14.2 14.9 14.5 13.6 12.1 11.3 10.1 10.3 12.4 9.0 9.2 8.6 9.1 9.5 7.6 8.6 8.8 8.7 8.1 9.2 -66.7
Black 8.7 9.4 9.3 6.0 7.7 5.0 9.1 7.6 5.5 5.4 5.8 4.9 5.3 5.3 4.9 3.0 3.3 3.2 3.2 3.1 2.8 1.2 4.2 2.4 2.0 3.0 4.5 2.0 1.2 0.7 3.3 -62.1
Hispanic Origin
Hispanic NA 13.4 15.8 6.8 8.6 5.3 5.7 5.8 5.9 4.5 4.0 3.0 3.4 4.3 2.9 2.4 1.9 1.5 3.8 4.5 1.4 2.6 3.7 0.7 1.2 3.3 2.4 3.4 2.8 1.0 2.6 -80.6
Non-Hispanic NA 29.6 27.2 24.1 21.0 19.1 19.7 17.5 17.4 15.7 15.4 13.9 14.6 14.0 13.1 11.5 10.8 9.8 9.8 11.3 8.6 8.4 8.2 8.7 9.1 7.1 8.2 7.9 7.6 7.2 8.7 -70.6
Age
18-24 15.1 17.0 13.6 9.1 10.5 8.8 10.0 6.1 6.7 5.2 4.9 4.8 4.5 7.7 5.0 4.4 2.5 2.3 3.8 3.5 1.2 1.8 2.3 2.1 4.2 0.5 4.5 4.3 2.5 1.3 2.0 -86.8
25-44 29.2 31.5 29.5 22.9 18.1 17.4 16.4 15.9 15.9 14.3 14.1 11.5 12.0 11.0 10.5 9.0 9.0 7.3 7.0 8.2 5.1 6.8 6.0 6.1 6.3 4.4 5.9 5.4 6.5 3.8 5.2 -82.2
45-64 27.3 34.5 31.1 30.8 27.5 24.1 26.2 23.3 22.0 20.8 20.7 18.3 18.5 17.8 16.0 14.1 13.4 13.1 12.5 14.6 11.7 10.3 10.1 9.7 10.5 9.9 9.5 9.4 8.9 8.0 10.2 -62.6
≥65 17.7 18.2 19.4 18.9 22.6 16.9 19.2 16.1 16.9 12.4 10.7 13.7 16.1 14.3 17.2 16.5 11.0 10.1 13.0 14.4 12.8 10.1 12.1 13.3 10.5 7.3 8.6 8.4 6.3 9.9 9.8 -44.6
Education (Years)
Less than High School 25.8 29.4 29.0 24.5 27.5 20.3 23.5 19.0 19.0 16.0 19.1 14.3 15.3 14.1 15.6 14.5 12.3 13.1 13.0 13.6 10.9 10.1 10.9 13.1 9.3 9.6 10.3 13.3 8.5 9.1 8.6 -66.7
High School Diploma or GED 27.8 31.6 29.0 25.7 22.9 19.4 19.3 17.5 18.3 17.0 15.0 14.1 15.6 15.6 14.1 12.7 11.8 8.7 8.9 11.2 8.4 8.2 8.3 7.6 10.3 7.6 8.5 7.3 8.1 6.6 8.6 -69.1
Some College 32.5 32.7 29.3 25.5 17.2 15.6 15.7 15.3 13.6 13.8 12.8 12.2 11.1 11.3 9.7 7.0 7.3 8.4 8.6 10.2 5.8 7.3 6.7 6.3 6.8 4.3 5.6 5.9 6.4 6.0 8.0 -75.4
Bachelors Degree or Higher 27.3 33.3 28.7 22.6 13.5 13.0 12.3 11.4 11.0 8.4 8.2 8.2 9.3 6.9 5.9 7.5 6.8 4.8 5.4 5.5 7.7 5.1 4.2 5.8 5.2 6.7 7.1 3.2 2.9 5.1 6.0 -78.0

Trends in Electronic Cigarette Use

From 2014 to 2022, the number of adults:

Adult Electronic Cigarette Ever and Current Use Trends by Sex, Race, and Age*
  2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 2014-2022 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 2014-2022
  Ever Use Current Use
Total 12.6 13.1 15.2 14.4 11.7 16.9 17.4 17.5 19.6 55.6 3.7 3.2 3.2 2.8 3.2 4.5 3.7 4.5 6.0 62.2
Sex
Male 14.1 15.2 17.7 16.5 13.5 19.6 20.6 20.5 22.8 61.7 4.1 4.1 3.8 3.3 4.3 5.5 4.6 5.1 6.9 68.3
Female 11.1 11.1 12.9 12.4 10.0 14.4 14.3 14.8 16.6 49.5 3.4 2.5 2.6 2.4 2.3 3.5 2.8 4.0 5.2 52.9
Sex Orientation
Straight 12.4 13.1 14.9 14.0 11.3 16.3 16.6 16.5 18.4 48.4 3.7 3.2 3.1 2.6 3.1 4.2 3.5 4.1 5.5 48.6
LGB 24.0 30.4 22.6 27.1 25.7 37.6 36.7 40.3 42.2 75.8 7.3 8.7 4.1 7.5 7.0 11.5 8.7 13.2 14.1 93.2
Race
Non-Hispanic
White 13.3 14.9 17.3 16.3 13.2 19.1 19.1 19.5 21.8 63.9 4.5 3.9 3.7 3.3 3.7 5.1 4.2 5.2 6.9 53.3
Black 7.6 9.6 12.4 10.6 8.4 12.4 13.0 11.2 15.9 109.2 2.0 1.9 2.0 2.3 1.9 3.4 1.6 2.4 4.7 135.0
American Indian/ Alaska Native 20.2 15.1 25.0 18.7 17.1 16.2 23.9 23.7 32.6 61.4 10.7 2.9 9.1 3.7 5.2 3.7 4.1 5.9 10.5 -1.9
Asian 6.2 7.6 8.3 7.9 8.4 9.4 11.2 11.2 10.1 62.9 1.5 2.1 2.7 0.9 2.2 2.7 3.4 2.9 2.4 60.0
Hispanic 8.6 9.7 11.0 11.7 9.0 13.0 14.1 15.4 15.6 81.4 2.1 1.9 1.6 1.8 2.5 2.8 2.8 3.3 4.1 95.2
Age
18-24 21.6 21.3 23.6 25.5 18.1 30.9 32.4 30.2 36.2 67.6 5.1 4.9 4.7 5.2 7.6 9.3 9.4 11.0 15.3 200.0
25-44 15.1 17.8 21.0 19.2 16.9 24.2 25.2 26.4 29.0 92.1 4.7 4.0 4.2 3.6 4.2 6.4 5.2 6.5 9.0 91.5
45-64 10.1 10.6 12.6 11.7 8.9 12.6 12.4 12.5 13.9 37.6 3.5 3.1 2.8 2.4 2.1 3.0 2.2 2.7 3.0 -14.3
≥65 3.7 3.8 4.4 4.2 3.8 4.2 4.4 4.9 5.0 35.1 1.4 1.1 1.0 0.7 0.8 0.8 0.6 0.9 1.0 -28.6
  • Who had ever used electronic cigarettes increased 56% from 12.6% to 19.6%.
  • Who were current users of electronic cigarettes increased 62% from 3.7% to 6.0%.
  • These changes were not consistent across the demographic groups depicted in the table.

From 2011 to 2022, current use of electronic cigarettes:

Electronic Cigarettes
Middle School High School
2011 2012 2013 2014 2015 2016 2017 2018 2019 2011 2012 2013 2014 2015 2016 2017 2018 2019
Total 0.6 1.1 1.1 3.9 5.3 4.3 3.3 4.9 10.5 1.5 2.7 4.5 13.4 16.0 11.3 11.7 20.7 27.5
Male 0.7 1.4 1.4 4.5 5.9 5.1 3.7 5.1 10.2 2.3 3.6 5.5 15.0 19.0 13.1 13.3 22.6 27.6
Female 0.4 0.8 0.9 3.3 4.8 3.4 2.9 4.8 10.8 0.7 1.9 3.5 11.9 12.8 9.5 9.9 18.8 27.4
Non-Hispanic White 0.6 0.9 0.9 3.1 4.4 3.7 3.4 4.9 10.3 1.8 3.3 4.8 15.3 17.2 13.7 14.2 26.8 32.4
Non-Hispanic Black N/A N/A N/A 3.8 4.1 4.0 2.2 3.0 8.6 N/A 1.1 2.7 5.6 8.9 6.2 4.9 7.5 17.7
Hispanic N/A 1.9 1.8 6.2 8.3 5.6 4.0 6.6 13.1 1.3 2.6 5.3 15.3 16.4 10.3 10.1 14.8 23.2
  • Increased 667% among middle school students, from 0.6% to 4.6%.
  • Increased 567% among high school students, from 1.5% to 10.0%. This was a 64% decrease from the peak rate of 27.5% in 2019.

In 2022, more than 825,000 children started using e-cigarettes, or more than 2,200 per day.

In 2022, most e-cigarette-using youth reported using a disposable type (54%), followed by pre-filled ore refillable pods or cartridges (25%) most often. Most reported using some other brand (which includes brands with less than 1% use), followed by Puff Bar (18.9%) and Vuse (14.0%).

Adult

Any Tobacco Product
From 2002 to 2022, current use of any tobacco product (cigarettes, cigars, pipe tobacco, smokeless tobacco, and vaping nicotine for 2020-2022):

Any Tobacco †
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 2002-2022
Total
18-25 45.3 44.8 44.6 44.3 43.9 41.8 41.4 41.6 40.8 39.5 38.1 37.0 35.0 33.0 30.0 29.1 25.8 24.6 25.1 25.5 30.4 -32.9
≥26 29.9 29.3 28.5 29.0 29.4 28.5 28.3 27.3 27.2 26.3 27.0 25.7 25.8 24.5 24.6 23.4 22.8 22.7 21.1 24.3 23.4 -21.7
Male
18-25 52.1 51.7 51.7 51.6 51.0 50.0 48.8 49.9 48.9 47.5 46.6 46.3 43.7 40.0 37.5 36.2 31.4 30.7 30.0 29.6 33.4 -35.9
≥26 37.3 36.0 35.7 36.0 36.9 35.6 35.0 33.1 33.8 32.3 33.6 31.3 31.8 30.7 30.7 30.2 28.5 28.3 25.7 29.4 28.8 -22.8
Female
18-25 38.4 37.8 37.4 36.9 36.8 33.6 33.8 33.3 32.7 31.4 29.4 27.7 26.3 25.9 22.4 21.8 20.2 18.4 20.2 21.4 27.3 -28.9
≥26 23.2 23.1 22.0 22.6 22.5 22.0 22.2 21.9 21.1 20.8 21.0 20.6 20.2 18.8 19.1 17.2 17.5 17.5 16.9 19.5 18.2 -21.6

Sources:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2022.

  • N/A - Not Available
  • * Current use ( within last month).
  • † Any tobacco refers to cigarettes, cigars, pipe tobacco, smokeless tobacco (or chewing tobacco and snuff), and vaping nicotine for 2020-2022.
  • Decreased 33% among those ages 18-25, from 45.3% to 30.4%.
  • Decreased 22% among those aged 26 or older, from 29.9% to 23.4%.
  • Decreased 36% among males ages 18-25, from 52.1% to 33.4%.
  • Decreased 23% among males aged 26 or older, from 37.3% to 28.8%.
  • Decreased 29% among females ages 18-25, from 38.4% to 27.3%.
  • Decreased 22% among females aged 26 or older, from 23.2% to 18.2%.

Smokeless Tobacco
From 2002 to 2022, current use of smokeless tobacco:

Smokeless Tobacco
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 2002-2022
Total
18-25 4.8 4.7 4.9 5.1 5.2 5.3 5.4 6.1 6.4 5.4 5.5 5.8 5.6 5.4 5.2 4.8 4.4 5.0 3.9 3.0 2.5 -47.9
≥26 3.2 3.2 2.7 3.0 3.2 3.0 3.3 3.1 3.1 3.0 3.3 3.1 3.0 3.2 3.1 3.1 2.8 3.1 2.4 2.9 2.4 -25.0
Male
18-25 9.4 8.9 9.5 9.7 9.9 9.9 10.3 11.4 11.9 10.3 10.5 10.8 10.7 10.0 9.6 8.8 7.4 8.6 6.9 4.7 4.1 -56.4
≥26 6.3 6.0 5.3 5.8 6.3 5.9 6.5 6.2 6.2 5.8 6.5 6.1 6.0 6.1 6.1 6.0 5.4 5.8 4.5 5.4 4.6 -27.0
Female
18-25 0.3 0.4 0.4 0.5 0.4 0.5 0.4 0.4 0.7 0.6 0.5 0.8 0.5 0.8 0.8 0.7 1.3 1.3 1.0 1.3 0.9 200.0
≥26 0.5 0.6 0.3 0.4 0.3 0.3 0.3 0.2 0.3 0.4 0.4 0.4 0.3 0.6 0.4 0.5 0.4 0.5 0.4 0.6 0.4 -20.0

Sources:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2022.

  • N/A - Not Available
  • * Current use ( within last month).
  • † Any tobacco refers to cigarettes, cigars, pipe tobacco, smokeless tobacco (or chewing tobacco and snuff), and vaping nicotine for 2020-2022.
  • Decreased 48% among those ages 18-25, from 4.8% to 2.5%.
  • Decreased 25% among those aged 26 or older, from 3.2% to 2.4%.
  • Decreased 56% among males ages 18-25, from 9.4% to 4.1%.
  • Decreased 27% among males aged 26 or older, from 6.3% to 4.6%.
  • Increased 200% among females ages 18-25, from 0.3% to 0.9%.
  • Decreased 20% among females aged 26 or older, from 0.5% to 0.4%.

Cigars
From 2002 to 2022, current use of cigars:

Cigars
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 2002-2022
Total
18-25 11.0 11.4 12.7 12.0 12.1 11.8 11.3 11.4 11.3 10.9 10.7 10.0 9.7 8.9 8.8 9.1 8.5 7.7 6.0 5.4 5.4 -50.9
≥26 4.6 4.5 4.6 4.7 4.6 4.4 4.4 4.4 4.4 4.2 4.5 4.1 3.9 4.3 4.2 4.2 4.1 4.1 3.8 3.8 3.8 -17.4
Male
18-25 16.8 17.3 19.7 18.3 18.7 18.4 17.2 17.4 16.8 16.0 16.4 14.9 14.1 12.6 12.6 13.2 11.77735415 10.7 7.9 7.6 7.1 -57.7
≥26 8.5 7.9 8.4 8.6 8.1 7.8 8.0 7.6 7.6 7.3 7.8 7.0 6.9 7.3 7.1 7.2 6.8 6.7 5.8 6.3 6.0 -29.4
Female
18-25 5.2 5.5 5.8 5.6 5.5 5.1 5.3 5.4 5.7 5.7 5.1 5.0 5.3 5.1 5.0 5.1 5.2 4.6 4.0 3.3 3.6 -30.8
≥26 1.0 1.3 1.1 1.1 1.4 1.2 1.1 1.4 1.5 1.4 1.5 1.6 1.2 1.5 1.5 1.5 1.7 1.7 1.9 1.5 1.6 60.0

Sources:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2022.

  • N/A - Not Available
  • * Current use ( within last month).
  • † Any tobacco refers to cigarettes, cigars, pipe tobacco, smokeless tobacco (or chewing tobacco and snuff), and vaping nicotine for 2020-2022.
  • Decreased 51% among those ages 18-25, from 11.0% to 5.4%.
  • Decreased 17% among those aged 26 or older, from 4.6% to 3.8%.
  • Decreased 58% among males ages 18-25, from 16.8% to 7.1%.
  • Decreased 29% among males aged 26 or older, from 8.5% to 6.0%.
  • Decreased 31% among females ages 18-25 at 3.6%.
  • Increased 60% among females aged 26 or older, from 1.0% to 1.6%.

Pipe Tobacco
From 2002 to 2022, current use of pipe tobacco:

Pipe Tobacco
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 % Change 2002-2022
Total
18-25 1.1 0.9 1.2 1.5 1.3 1.2 1.4 1.7 1.8 1.9 1.8 2.2 1.9 1.8 1.7 1.6 1.9 1.3 1.1 1.1 1.1 0.0
≥26 0.8 0.6 0.7 0.8 0.9 0.8 0.6 0.7 0.7 0.7 0.9 0.7 0.7 0.8 0.7 0.8 0.7 0.7 0.7 0.6 0.7 -12.5
Male
18-25 1.7 1.4 2.1 2.3 2.2 NA NA NA NA NA NA NA NA NA NA NA 2.7 1.9 1.8 1.8 1.7 0.0
≥26 1.3 1.2 1.3 1.6 1.7 NA NA NA NA NA NA NA NA NA NA NA 1.1 1.1 0.9 1.1 1.2 -7.7
Female
18-25 0.4 0.4 0.4 0.6 0.5 NA NA NA NA NA NA NA NA NA NA NA 1.1 0.7 0.5 0.5 0.5 25.0
≥26 0.2 0.1 0.1 0.2 0.2 NA NA NA NA NA NA NA NA NA NA NA 0.3 0.3 0.5 0.2 0.1 -50.0

Sources:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2022.

  • N/A - Not Available
  • * Current use ( within last month).
  • † Any tobacco refers to cigarettes, cigars, pipe tobacco, smokeless tobacco (or chewing tobacco and snuff), and vaping nicotine for 2020-2022.
  • Remained stable among those aged 18-25 at 1.1%.
  • Decreased 13% among those aged 26 or older, from 0.8% to 0.7%.
  • Remained stable among males aged 18-25 at 1.7%.
  • Decreased 8% among males aged 26 or older, from 1.3% to 1.2%.
  • Increased 25% among females aged 18-25, from 0.4% to 0.5%.
  • Decreased 50% among females aged 26 or older, from 0.2% to 0.1%.

Electronic Cigarette or Vaping Device Containing Nicotine
From 2020 to 2022, current use of electronic cigarettes or vaping device containing nicotine:

Electronic Cigarette or Vaping Device Containing Nicotine
  2020 2021 2022 % Change 2002-2022
Total
18-25 11.8 14.8 24.2 105.1
≥26 2.4 3.5 6.1 154.2
Male
18-25 13.4 16.2 25.4 89.6
≥26 2.5 3.7 7.2 188.0
Female
18-25 10.3 13.4 23.1 124.3
≥26 2.2 3.3 5.1 131.8

Sources:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2022.

  • N/A - Not Available
  • * Current use ( within last month).
  • † Any tobacco refers to cigarettes, cigars, pipe tobacco, smokeless tobacco (or chewing tobacco and snuff), and vaping nicotine for 2020-2022.
  • Increased 105% among those aged 18-25, from 11.8% to 24.2%.
  • Increased 154% among those aged 26 or older, from 2.4% to 6.1%.
  • Increased 90% among males aged 18-25, from 13.4% to 25.4%.
  • Increased 188% among males aged 26 or older, from 2.5% to 7.2%.
  • Increased 124% among females aged 18-25, from 10.3% to 23.1%.
  • Increased 132% among females aged 26 or older, from 2.2% to 5.1%.
Youth

Any Tobacco Product
From 2002 to 2023, current use of any tobacco product:

Any Tobacco*
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Total 13.3 11.8 9.5 8.2 7.5 6.9 6.9 8.1 7.9 8.0 6.4 8.1 12.5 6.9 4.2 4.8 6.6 28.2 27.4 25.6 23.9 24.2 23.7 23.7 25.4 26.3 20.2 21.5 28.6 31.2 23.8 13.9 16.8 12.6
Male 14.7 12.7 10.9 9.6 9.0 8.1 7.0 9.3 9.0 9.6 7.6 9.2 12.5 6.8 3.8 4.0 5.7 32.6 30.7 30.2 29.4 29.4 28.9 28.3 29.4 31.4 23.5 25.3 31.1 31.8 24.9 13.5 15.7 11.2
Female 11.7 10.7 8.2 6.7 5.9 5.7 6.7 7.0 6.8 6.4 5.1 7.0 12.4 7.0 4.6 5.6 7.5 23.7 24.1 21.3 18.2 19.0 18.3 19.0 21.6 21.0 17.0 17.8 26.1 30.6 22.8 14.3 18.0 14.1
Non-Hispanic White 13.2 11.2 9.2 7.1 6.1 5.3 5.7 6.4 6.5 6.4 5.4 7.1 11.4 5.8 3.5 4.3 4.1 30.9 30.8 28.4 26.7 26.6 24.9 24.5 27.1 26.8 23.0 23.7 33.4 35.6 26.0 16.6 18.8 13.6
Non-Hispanic Black 13.5 12.3 9.8 8.3 8.5 8.0 7.4 7.8 7.1 9.3 6.0 7.6 12.3 7.0 5.2 6.8 8.5 21.7 16.8 15.7 14.0 18.9 23.1 21.9 18.3 23.3 16.4 18.3 19.2 25.4 18.5 11.5 16.0 9.8
Hispanic 12.5 14.8 10.9 11.1 11.5 10.8 10.6 12.7 11.7 10.7 9.1 11.0 16.1 9.6 5.8 5.9 10.3 24.1 25.7 24.7 24.8 23.8 22.9 24.9 27.9 26.6 18.3 20.2 24.2 26.6 23.8 9.6 15.7 12.4

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • * Any tobacco use is defined as use of any one or more of the products listed in this section for that year. Electronic cigarettes, hookah, snus, and dissolvable tobacco were added in 2011. Kreteks were removed after 2013. Heated tobacco products were added in 2019. Nicotine pouches were added in.
  • Page Last Updated: June 10, 2019
  • Decreased 50% among middle school students, from 13.3% to 6.6%.
  • Increased 55% among high school students, from 28.2% to 12.6%.

Cigarettes
From 2002 to 2023, current use of cigarettes:

Cigarettes
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Total 9.8 8.1 6.3 5.2 4.3 3.5 12.7 2.5 2.3 2.2 2.1 1.8 2.3 1.6 1.0 1.0 1.1 22.5 21.7 19.7 17.2 15.8 14.0 12.7 9.2 9.3 8.0 7.6 8.1 5.8 4.6 1.9 2.0 1.9
Male 9.8 7.7 6.3 5.6 4.5 3.8 14.1 3.0 2.3 2.5 2.0 2.1 2.1 1.3 0.9 0.8 N/A 23.9 21.6 21.2 19.6 17.7 16.3 14.1 10.6 10.7 9.1 7.6 8.8 7.3 5.4 2.0 2.3 2.3
Female 9.7 8.6 6.4 4.7 4.0 3.2 11.2 2.0 2.2 1.8 2.2 1.5 2.5 2.0 1.2 1.1 1.1 21.0 21.8 18.4 14.8 13.8 11.7 11.2 7.9 7.7 6.9 7.5 7.3 4.1 3.9 1.8 1.8 1.5
Non-Hispanic White 10.1 8.3 6.5 4.3 3.8 3.1 2.6 2.2 2.1 1.9 1.7 1.6 2.1 1.3 1.0 N/A 0.8 25.2 24.8 22.3 19.4 17.6 15.4 14.0 10.8 10.2 9.9 9.5 9.9 7.1 5.3 2.2 2.5 2.2
Non-Hispanic Black 9.0 7.5 5.5 5.2 3.6 2.6 1.7 1.7 N/A N/A 2.1 N/A N/A 2.1 N/A N/A N/A 13.8 10.9 9.9 7.4 10.6 9.6 9.0 4.5 5.7 3.9 2.8 3.2 N/A N/A N/A N/A N/A
Hispanic 8.7 9.4 6.8 6.7 6.7 5.4 5.1 3.7 2.8 2.5 3.5 2.4 3.1 2.2 1.2 1.2 N/A 19.8 20.5 18.8 19.2 15.8 14.3 13.4 8.8 9.0 6.4 6.2 7.2 3.8 4.6 1.6 2.0 2.2

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 89% among middle school students, from 9.8% to 1.1%.
  • Decreased 92% among high school students, from 22.5% to 1.9%.

Cigars
From 2002 to 2023, current use of cigars:

Cigars
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Total 6.0 5.2 4.0 3.9 3.4 2.8 3.1 1.9 1.6 2.2 1.5 1.7 2.3 1.5 0.6 0.6 1.1 11.6 12.9 11.8 10.9 11.6 12.6 11.9 8.2 8.6 7.7 7.7 7.5 7.6 5.1 2.1 2.8 1.8
Male 7.9 6.6 5.3 4.6 4.3 3.2 3.3 2.4 1.8 2.7 1.6 1.7 2.7 1.4 0.6 0.6 1.0 16.9 18.4 16.6 15.0 15.7 16.7 15.4 10.8 11.5 9.9 9.0 9.0 9.0 5.4 2.6 3.5 2.3
Female 4.1 3.8 2.7 3.2 2.5 2.4 2.9 1.4 1.4 1.7 1.4 1.6 2.0 1.6 0.5 0.6 1.2 6.2 7.6 7.2 6.7 7.4 8.4 8.3 5.5 5.6 5.6 6.3 6.0 6.2 4.7 1.5 2.1 1.4
Non-Hispanic White 5.5 4.4 3.1 3.0 2.3 1.6 2.2 1.4 1.2 1.4 1.1 1.1 1.8 0.8 0.5 N/A N/A 11.8 13.7 12.5 11.9 12.1 12.2 11.4 8.3 8.4 7.9 8.4 7.8 7.6 4.2 2.1 2.9 1.4
Non-Hispanic Black 7.3 6.9 5.8 4.7 5.7 5.0 4.5 2.0 2.0 4.5 1.9 2.9 N/A 3.1 1.4 1.7 N/A 12.0 10.0 8.9 7.1 11.7 16.7 14.7 8.8 12.8 9.5 7.8 9.2 12.3 9.2 4.4 4.4 1.9
Hispanic 6.3 8.0 6.1 6.2 6.1 4.9 4.7 2.9 2.2 2.8 2.4 2.2 3.1 1.8 0.6 0.8 1.8 10.8 13.5 12.4 11.8 11.3 12.4 12.1 8.0 7.3 7.2 6.7 7.3 6.2 5.6 1.2 2.2 2.3

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 82% among middle school students, from 6.0% to 1.1%.
  • Decreased 84% among high school students, from 11.6% to 1.8%.

Hookah
From 2011 to 2022, current use of hookahs:

Hookah
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Total -- -- -- -- 1.0 1.2 1.1 2.5 2.0 2.0 1.3 1.2 1.6 1.3 0.4 0.5 1.0 -- -- -- -- 4.0 5.2 5.2 9.3 7.2 4.8 3.2 4.1 3.4 2.7 1.2 1.5 1.1
Male -- -- -- -- 1.0 1.5 0.9 2.4 1.9 2.1 1.6 1.5 1.3 1.2 N/A 0.4 0.8 -- -- -- -- 4.5 5.9 5.6 8.9 7.4 4.5 3.3 4.0 3.6 2.6 1.2 1.7 0.9
Female -- -- -- -- 0.9 1.0 1.3 2.6 2.0 1.9 1.1 1.0 1.8 1.5 N/A 0.6 N/A -- -- -- -- 3.4 4.4 4.8 9.8 6.9 5.1 3.2 4.1 3.2 2.9 1.3 1.3 1.4
Non-Hispanic White -- -- -- -- 0.9 0.8 0.7 1.4 1.6 0.9 0.6 0.8 N/A 0.7 N/A N/A 0.4 -- -- -- -- 4.1 5.9 5.3 9.4 6.9 4.5 2.8 3.3 2.5 1.8 0.8 1.1 N/A
Non-Hispanic Black -- -- -- -- N/A N/A N/A N/A N/A 2.8 1.8 N/A N/A N/A N/A N/A N/A -- -- -- -- N/A 2.1 2.4 5.6 6.4 4.1 3.1 3.7 6.4 3.9 3.2 3.3 N/A
Hispanic -- -- -- -- 1.5 2.9 2.4 5.6 3.2 3.7 2.7 2.2 2.4 2.4 N/A 0.9 1.8 -- -- -- -- 4.8 6.3 7.1 13.0 8.7 6.4 4.6 6.0 4.0 4.4 1.3 1.7 1.0

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Remained the same at less than 2% among middle school students.
  • Decreased 73% among high school students, from 4.0% to 1.1%.

Smokeless Tobacco
From 2002 to 2022, current use of smokeless tobacco:

Smokeless Tobacco (Chewing Tobacco, Snuff, or Dip)
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Total 3.6 2.9 2.6 2.6 2.2 1.7 1.4 1.6 1.4 1.8 1.4 1.3 1.8 0.9 0.5 0.5 5.9 5.5 6.1 6.7 7.3 6.4 5.7 5.5 5.6 4.3 4.1 4.3 4.8 2.7 1.0 1.2
Male 5.3 3.9 4.1 3.7 3.0 2.2 1.9 2.1 1.9 2.4 2.0 2.2 2.7 1.2 0.7 0.6 10.5 9.9 11.0 11.6 12.9 11.2 9.6 9.9 9.4 7.2 6.8 7.5 7.5 4.5 1.6 1.8
Female 1.6 1.9 1.2 1.4 1.4 1.2 0.8 N/A 0.8 1.1 0.8 0.3 N/A 0.6 N/A 0.4 1.2 1.2 1.5 1.8 1.6 1.5 1.7 1.2 1.6 1.4 1.3 1.3 1.8 0.8 N/A 0.7
Non-Hispanic White 3.8 3.1 2.8 2.5 2.3 1.6 1.4 1.7 1.2 1.6 1.2 1.4 1.9 1.1 0.4 0.4 7.3 6.9 7.5 8.5 9.2 8.1 7.5 7.8 7.5 5.7 5.7 6.0 6.5 3.7 1.3 1.6
Non-Hispanic Black 2.3 1.8 1.7 1.7 1.0 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1.8 1.4 1.8 1.7 3.0 2.2 2.4 1.1 1.9 1.6 N/A N/A N/A N/A N/A N/A
Hispanic 2.7 3.7 3.4 2.5 2.9 2.4 1.8 1.3 1.9 2.4 2.3 1.4 N/A N/A N/A N/A 3.3 3.2 4.6 4.8 5.1 5.1 4.0 3.1 3.8 2.7 2.2 2.5 2.5 1.8 N/A 1.1

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 86% among middle school students, from 3.6% to 0.5%.
  • Decreased 80% among high school students, from 5.9% to 1.2%.

Snus
From 2011 to 2022, current use of snus:

Snus
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Total -- -- -- -- 0.8 0.7 0.4 0.5 0.5 0.9 0.6 0.5 0.6 0.4 0.2 0.3 -- -- -- -- 2.8 2.4 1.8 1.9 1.2 2.2 2.0 2.4 1.7 1.0 0.5 0.6
Male -- -- -- -- 0.9 0.9 0.7 0.7 N/A 1.3 0.5 0.5 0.9 N/A N/A 0.3 -- -- -- -- 4.8 3.8 2.7 3.0 2.2 2.7 2.1 2.8 2.5 1.4 0.6 1.0
Female -- -- -- -- 0.7 0.5 0.2 0.3 N/A 0.5 0.6 0.6 N/A N/A N/A N/A -- -- -- -- 0.7 0.9 0.9 0.8 1.2 1.8 1.9 1.9 0.8 0.5 N/A 0.2
Non-Hispanic White -- -- -- -- 0.9 0.7 N/A N/A N/A 1.0 0.5 0.6 0.6 N/A N/A N/A -- -- -- -- 3.6 3.2 2.4 2.4 1.5 2.7 2.7 2.9 2.2 1.3 0.6 0.9
Non-Hispanic Black -- -- -- -- N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A -- -- -- -- N/A N/A N/A 0.6 N/A N/A N/A N/A N/A N/A N/A N/A
Hispanic -- -- -- -- 0.9 1.1 N/A 1.1 N/A 1.2 1.1 0.8 N/A N/A N/A N/A -- -- -- -- 2.2 1.8 1.3 1.5 1.3 1.8 1.5 2.0 1.0 N/A N/A 0.3

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 63% among middle school students, from 0.8% to 0.3%.
  • Decreased 79% among high school students, from 2.8% to 0.6%.

Dissolvable Tobacco
From 2011 to 2022, current use of dissolvable tobacco:

Dissolvable Tobacco
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Total -- -- -- -- 0.3 0.5 N/A 0.3 N/A 0.4 0.3 0.3 0.3 N/A N/A 0.2 -- -- -- -- 0.4 0.8 0.4 1.9 0.4 0.9 0.6 0.7 0.5 0.3 0.2 0.3
Male -- -- -- -- N/A 0.6 N/A 0.4 N/A 0.5 N/A N/A 0.5 N/A N/A N/A -- -- -- -- 0.6 1.0 0.6 3.0 0.7 1.0 0.7 0.9 0.6 N/A N/A 0.4
Female -- -- -- -- N/A 0.4 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A -- -- -- -- N/A 0.6 N/A 0.8 N/A 0.8 0.5 0.5 0.3 N/A N/A 0.2
Non-Hispanic White -- -- -- -- N/A 0.4 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A -- -- -- -- N/A 0.6 0.3 2.4 N/A 0.8 0.5 0.8 0.2 N/A N/A 0.4
Non-Hispanic Black -- -- -- -- N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A -- -- -- -- N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Hispanic -- -- -- -- N/A 0.9 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A -- -- -- -- N/A 1.4 N/A 1.5 N/A 1.2 1.0 0.9 N/A N/A N/A 0.3

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Remained the same at less than 1% among middle school students.
  • Remained the same at less than 1% among high school students.

Pipes
From 2002 to 2022, current use of pipes:

Pipes
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Total 3.5 2.6 2.2 2.3 2.2 1.8 1.9 0.5 0.4 0.7 0.4 0.3 N/A N/A N/A 0.3 0.4 3.2 3.2 3.7 3.9 3.9 4.5 4.1 1.5 1.0 1.4 0.8 1.1 1.1 0.7 0.4 0.7 0.6
Male 5.1 3.3 3.0 2.7 2.7 1.9 1.6 0.6 N/A 0.8 0.6 N/A N/A N/A N/A 0.3 N/A 5.0 4.8 5.6 5.3 5.1 5.8 5.0 2.1 1.4 1.8 1.0 1.4 1.5 1.0 N/A 0.9 0.7
Female 1.9 1.8 1.3 1.7 1.8 1.7 2.2 0.5 N/A 0.6 N/A 0.4 N/A N/A N/A N/A N/A 1.4 1.5 1.8 2.5 2.8 3.2 3.3 0.9 0.7 0.9 0.5 0.8 N/A N/A N/A 0.5 0.5
Non-Hispanic White 2.8 2.2 1.9 1.5 1.5 1.2 1.2 0.5 N/A N/A N/A N/A N/A N/A N/A N/A N/A 2.8 3.1 3.6 3.3 3.5 4.5 3.7 1.9 1.0 1.4 0.7 1.1 1.3 0.9 0.5 0.7 0.6
Non-Hispanic Black 3.9 2.0 1.5 1.9 1.3 -- 1.7 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 3.7 1.7 2.2 3.6 2.4 2.9 3.5 N/A N/A 1.2 N/A N/A N/A N/A N/A N/A N/A
Hispanic 4.3 5.3 4.3 4.5 5.0 3.7 4.3 0.9 N/A 1.7 N/A 0.6 N/A N/A N/A N/A N/A 4.6 4.8 5.3 6.8 6.3 6.2 6.5 1.5 1.5 1.2 1.3 1.4 N/A N/A N/A 0.8 N/A

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 82% among middle school students, from 3.5% to 0.4%.
  • Decreased 85% among high school students, from 3.2% to 0.6%.

Bidis
From 2002 to 2022, current use of bidis:

Bidis
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Total 2.4 2.4 1.7 1.6 1.7 0.6 0.4 0.5 N/A 0.3 0.3 0.3 0.4 N/A 0.2 0.2 3.2 2.7 2.9 2.4 2.0 0.9 0.6 0.9 0.6 0.5 0.6 0.7 0.4 0.2 0.5 0.5
Male 3.1 2.8 1.9 2.0 1.9 0.7 N/A 0.7 N/A 0.4 N/A N/A 0.5 N/A N/A N/A 5.0 3.7 3.3 2.7 2.9 1.2 0.8 1.2 0.9 0.7 0.7 0.9 0.5 N/A 0.3 0.6
Female 1.7 1.7 1.5 1.2 1.4 0.4 N/A 0.3 N/A N/A N/A N/A N/A N/A N/A 0.3 1.4 1.6 2.4 2.1 1.0 0.5 0.5 0.6 N/A N/A 0.6 0.6 N/A N/A 0.4 0.5
Non-Hispanic White 1.8 1.8 1.2 1.1 1.0 0.3 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 2.8 2.4 2.6 1.7 1.4 0.7 0.6 0.8 0.5 N/A 0.5 0.8 N/A N/A 0.4 0.4
Non-Hispanic Black 3.1 3.1 2.3 1.9 1.9 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 3.7 2.1 2.7 3.7 2.0 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Hispanic 2.9 2.9 3.3 2.6 3.5 1.2 N/A 0.6 N/A N/A N/A N/A N/A N/A N/A N/A 4.6 4.8 4.6 3.7 3.7 1.3 0.7 1.1 0.9 0.6 1.1 1.0 N/A N/A N/A 0.6

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 92% among middle school students from 2.4% to 0.2%.
  • Decreased 84% among high school students, from 3.2% to 0.5%.

Cloves/Kreteks
From 2002 to 2013, current use of cloves/kreteks:

Cloves/Kreteks
  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2002 2004 2006 2009 2011 2012 2013
Total 2.0 1.5 1.4 1.2 1.1 0.5 0.4 2.7 2.5 2.8 2.4 1.6 0.9 0.8
Male 2.7 1.9 1.7 1.6 1.3 0.5 0.5 3.5 3.4 3.6 2.9 2.4 1.4 1.2
Female 1.1 1.2 1.0 0.7 0.9 0.4 N/A 1.8 1.6 2.0 1.9 0.8 0.4 0.5
Non-Hispanic White 1.5 1.2 1.0 0.8 0.6 N/A N/A 2.7 2.5 3.0 2.4 1.4 1.1 1.0
Non-Hispanic Black 2.3 1.6 1.7 1.4 N/A N/A N/A 1.9 1.3 1.7 1.8 N/A N/A N/A
Hispanic 2.6 3.0 2.6 1.8 2.5 1.0 N/A 3.0 3.6 3.2 2.9 2.5 0.9 N/A

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2013. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.

  • -- Survey did not ask about product that year.
  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 80% among middle school students from 2.0% to 0.4%.
  • Decreased 70% among high school students, from 2.7% to 0.8%.

Heated Tobacco Products
From 2019 to 2022, current use of heated tobacco products:

Heated Tobacco Products
  Middle School High School
  2019 2020 2021 2022 2023 2019 2020 2021 2022 2023
Total 1.4 1.3 0.4 0.7 0.8 1.7 1.4 0.8 1.1 1.0
Male 1.6 1.3 0.4 0.6 N/A 1.8 1.3 0.9 1.3 1.4
Female 1.2 1.2 0.4 0.7 0.8 1.6 1.5 0.7 1.0 0.7
Non-Hispanic White 1.0 0.9 N/A 0.5 N/A 1.6 1.2 0.9 1.0 N/A
Non-Hispanic Black N/A N/A N/A N/A N/A 2.3 N/A N/A N/A N/A
Hispanic 2.2 2.1 N/A 0.9 1.3 1.9 1.9 N/A 1.4 1.6

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Decreased 43% among middle school students, from 1.4% to 0.8%.
  • Decreased 41% among high school students, from 1.7% to 1.0%.

Nicotine Pouches
From 2021 to 2022, current use of nicotine pouches:

Nicotine Pouches
  Middle School High School
  2021 2022 2021 2022
Total 0.3 0.5 1.1 1.4
Male N/A 0.4 1.6 2.1
Female N/A 0.5 0.6 0.8
Non-Hispanic White N/A N/A 1.4 1.9
Non-Hispanic Black N/A N/A N/A N/A
Hispanic N/A 0.6 N/A 1.1

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2022. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009, 2023 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Page Last Updated: June 10, 2019
  • Remained at less than 1% among middle school students.
  • Increased 27% among high school students, from 1.1% to 1.4%.

Page last updated: May 30, 2024

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