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Tobacco use rates have generally decreased over time. This page describes the change in cigarette and other tobacco rates among adults and youth, including current use, quitting, and average number of cigarettes smoked per day.

Trends in Cigarette Smoking Rates

Long term, cigarette smoking rates have fallen:

  • 68 percent among adults, from 42.6 percent in 1965 to 13.7 percent in 2018.

    Adult Cigarette Smoking Rate Trend 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 % Change
    1965-2018
    % Change
    1997-2018
    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 -67.7 -44.5
    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 -69.9 -43.5
    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 -64.6 -45.7
    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 -64.4 -40.7
    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 -68.1 -45.3
    American Indian/ Alaska Native N/A N/A N/A N/A N/A N/A N/A 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 N/A -24.0
    Asian N/A N/A N/A N/A N/A N/A N/A 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 N/A -56.2
    Hispanic N/A N/A N/A N/A N/A N/A N/A 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 N/A -52.0
    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 -82.9 -72.8
    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 -67.8 -42.3
    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 -60.8 -33.2
    ≥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 -53.1 -30.0
      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 % Change
    1965-2018
    % Change
    1997-2018

    Source:
    Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey 1965-2018. Analysis for years 1997-2018 by the American Lung Association Research Team using SPSS software.

    • N/A - Not Available
    • * Persons 18 years or older.
    • † Due to the redesign of the NHIS survey in 1997, comparisons with data from prior years must be conducted with caution.
  • 68 percent among youth, from 27.5 percent in 1991 to 8.8 percent 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 % Change
    1991-2017‡
    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 -75.8
    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 -64.5
    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 -71.4
    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 -64.1
    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 -65.1
    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 -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 -84.9
    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 -72.3
      1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 % Change
    1991-2017‡

    Source:
    Centers for Disease Control and Prevention. National Center for Health Statistics. Youth Risk Behavior Survey, 1991-2017.

    • N/A - Not Available
    • ‡ Percent change for American Indians/Alaska Natives is from 1993-2017.

Over the last five years, cigarette smoking rates have fallen:

  • 23 percent among adults, from 17.8 percent in 2013.  

    Adult Cigarette Smoking Rate Trend 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 % Change
    1965-2018
    % Change
    1997-2018
    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 -67.7 -44.5
    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 -69.9 -43.5
    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 -64.6 -45.7
    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 -64.4 -40.7
    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 -68.1 -45.3
    American Indian/ Alaska Native N/A N/A N/A N/A N/A N/A N/A 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 N/A -24.0
    Asian N/A N/A N/A N/A N/A N/A N/A 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 N/A -56.2
    Hispanic N/A N/A N/A N/A N/A N/A N/A 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 N/A -52.0
    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 -82.9 -72.8
    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 -67.8 -42.3
    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 -60.8 -33.2
    ≥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 -53.1 -30.0
      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 % Change
    1965-2018
    % Change
    1997-2018

    Source:
    Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey 1965-2018. Analysis for years 1997-2018 by the American Lung Association Research Team using SPSS software.

    • N/A - Not Available
    • * Persons 18 years or older.
    • † Due to the redesign of the NHIS survey in 1997, comparisons with data from prior years must be conducted with caution.
  • 44 percent among youth, from 15.7 percent in 2013.  

    High School Cigarette Smoking Rate Trend by Sex and Race

      1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 % Change
    1991-2017‡
    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 -75.8
    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 -64.5
    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 -71.4
    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 -64.1
    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 -65.1
    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 -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 -84.9
    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 -72.3
      1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 % Change
    1991-2017‡

    Source:
    Centers for Disease Control and Prevention. National Center for Health Statistics. Youth Risk Behavior Survey, 1991-2017.

    • N/A - Not Available
    • ‡ Percent change for American Indians/Alaska Natives is from 1993-2017.

Trends in Number of People Who Smoke Cigarettes and Have Quit

The 34.2 million current cigarette smokers in 2018 marked the fifth time in a row there were less than 40 million current cigarette smokers in the United States since the government began collecting this date in 1997.


Trends in Average Number of Cigarettes Smoked Per Day

Between 1974 and 2018, among current cigarette 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 % Change 1974-2018
<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 65.8 108.1
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 -35.0
>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 -75.7
  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 % Change 1974-2018

Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey 1965-2018. Analysis for years 1997-2018 by the American Lung Association Research Team using SPSS software.

  • † Due to the redesign of the NHIS survey in 1997, comparisons with data from prior years must be conducted with caution.
  • The proportion of people smoking more than 24 cigarettes a day decreased 76 percent from 25 percent to 6 percent.
  • The proportion of people smoking 15-24 cigarettes a day decreased 35 percent from 43 percent to 28 percent.
  • The proportion of people smoking fewer than 15 cigarettes a day increased 108 percent from 32 percent to 66 percent.
Decreases in heavy smoking rates (more than 24 cigarettes a day) from 1974 to 2018 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 % Change
1974-2018‡
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 -68.8
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 -71.5
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 -69.0
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 -48.7
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 -82.4
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 -72.1
Age (Years)                                                        
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 -70.4
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 -79.8
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 -65.1
≥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 -51.6
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 -60.1
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 -69.6
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 -82.8
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 -74.0
  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 % Change
1974-2018‡

Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey 1965-2018. Analysis for years 1997-2018 by the American Lung Association Research Team using SPSS software.

  • N/A - Not Available
  • † Due to the redesign of the NHIS survey in 1997, comparisons with data from prior years must be conducted with caution.
  • ‡ Percent changes for Hispanic origin are from 1980-2018.


Trends in Electronic Cigarette Use

From 2014 to 2018, the number of adults:

Adult Electronic Cigarette Ever and Current Use Trends by Sex, Race, and Age*

  2014 2015 2016 2017 2018 % Change
2014-2018
2014 2015 2016 2017 2018 % Change
2014-2018
  Ever Use Current Use
Total 12.6 13.1 15.2 14.4 11.7 -7.2 3.7 3.2 3.2 2.8 3.2 -12.4
Sex                        
Male 14.1 15.2 17.7 16.5 13.5 -4.3 4.1 4.1 3.8 3.3 4.3 4.6
Female 11.1 11.1 12.9 12.4 10.0 -9.8 3.4 2.5 2.6 2.4 2.3 -33.4
Sex Orientation                        
Straight 12.4 13.1 14.9 14.0 11.3 -8.9 3.7 3.2 3.1 2.6 3.1 -16.2
LGB 24.0 30.4 22.6 27.1 25.7 7.1 7.3 8.7 4.1 7.5 7.0 -4.1
Race                        
Non-Hispanic                        
White 13.3 14.9 17.3 16.3 13.2 -0.7 4.5 3.9 3.7 3.3 3.7 -17.8
Black 7.6 9.6 12.4 10.6 8.4 10.5 2.0 1.9 2.0 2.3 1.9 -5.0
American Indian/ Alaska Native 20.2 15.1 25.0 18.7 17.1 -15.3 10.7 2.9 9.1 3.7 5.2 -51.4
Asian 6.2 7.6 8.3 7.9 8.4 35.5 1.5 2.1 2.7 0.9 2.2 46.7
Hispanic 8.6 9.7 11.0 11.7 9.0 4.1 2.1 1.9 1.6 1.8 2.5 19.0
Age                        
18-24 21.6 21.3 23.6 25.5 18.1 -16.2 5.1 4.9 4.7 5.2 7.6 49.0
25-44 15.1 17.8 21.0 19.2 16.9 11.9 4.7 4.0 4.2 3.6 4.2 -10.6
45-64 10.1 10.6 12.6 11.7 8.9 -11.9 3.5 3.1 2.8 2.4 2.1 -40.0
≥65 3.7 3.8 4.4 4.2 3.8 2.7 1.4 1.1 1.0 0.7 0.8 -42.9
  2014 2015 2016 2017 2018 % Change
2014-2018
2014 2015 2016 2017 2018 % Change
2014-2018

Sources:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey 2014-2018. Analysis by the American Lung Association Research Team using SPSS software.

  • N/A Not Available
  • * Persons 18 years or older.
  • Who had ever used electronic cigarettes decreased 7 percent from 12.6 percent to 11.7 percent.
  • Who were current users of electronic cigarettes decreased 12 percent from 3.7 percent to 3.2 percent.
  • These changes were not consistent across the demographic groups depicted in the table.
From 2011, to 2019, 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
  2011 2012 2013 2014 2015 2016 2017 2018 2019 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Increased 1650 percent among middle school students, from 0.6 percent to 10.5 percent.
  • Increased 1733 percent among high school students, from 1.5 percent to 27.5 percent. This was a 33 percent increase from the 2018 rate of 20.7 percent.
  • In 2019, close to 2.9 million children started using e-cigarettes, or more than 7,900 per day. This was an increase from more than 2.2 million in 2018 and close to 2.1 million in 2017.
  • In 2019, 69 percent of youth who used an e-cigarette reported using a flavored e-cigarette. Rates were higher among high school (72%) than middle school (60%) students.
  • In 2019, most e-cigarette-using youth reported using a type with refillable pods or cartridges, such as JUUL (54%), followed by a refillable tank system (24%) most often. This matches most e-cigarette-using youth reporting their usual brand being JUUL (58%), followed by some other brand (19%) or no usual brand (15%) which could align with users of refillable tank systems.
 
 


Trends in Adult Use of Other Tobacco Products

Any Tobacco Product

From 2002 to 2018, current use of any tobacco product (cigarettes, cigars, pipe tobacco, and smokeless tobacco):
 

Percent of Adults Who Use Any Tobacco† by Age and Sex, 2002-2018*

  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018
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 -43.0
≥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 -23.7
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 -39.7
≥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 -23.6
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 -47.4
≥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 -24.6
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018

Source:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2018.

  • N/A - Not Available
  • * Current use ( within last month).
  • † Any tobacco refers to cigarettes, cigars, pipe tobacco, and smokeless tobacco (or chewing tobacco and snuff).
  • Decreased 43 percent among those ages 18-25, from 45.3 percent to 25.8 percent.
  • Decreased 24 percent among those aged 26 or older, from 29.9 percent to 23.4 percent.
  • Decreased 40 percent among men ages 18-25, from 52.1 percent to 36.2 percent.
  • Decreased 24 percent among men aged 26 or older, from 37.3 percent to 30.2 percent.
  • Decreased 47 percent among women ages 18-25, from 38.4 percent to 21.8 percent.
  • Decreased 25 percent among women aged 26 or older, from 23.2 percent to 17.5 percent.

Smokeless Tobacco

From 2002 to 2018, current use of smokeless tobacco:
 

Percent of Adults Who Use Smokeless Tobacco by Age and Sex, 2002-2018*

  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018
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 -8.7
≥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 -12.1
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 -21.1
≥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 -13.6
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 1.3 341.7
≥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 -22.4
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018

Source:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2018.

  • N/A - Not Available
  • * Current use ( within last month).
  • Decreased 9 percent among those ages 18-25, from 4.8 percent to 4.4 percent.
  • Decreased 12 percent among those aged 26 or older, from 3.2 percent to 2.8 percent.
  • Decreased 21 percent among men ages 18-25, from 9.4 percent to 7.4 percent.
  • Decreased 14 percent among men aged 26 or older, from 6.3 percent to 5.4 percent.
  • Increased 342 percent among women ages 18-25, from 0.3 percent to 1.3 percent.
  • Decreased 22 percent among women aged 26 or older, from 0.5 percent to 0.4 percent.

Cigars

From 2002 to 2018, current use of cigars:
 

Percent of Adults Who Use Cigars by Age and Sex, 2002-2018*

  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018
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 -22.8
≥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 -10.1
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 11.8 -29.9
≥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 -20.0
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 -0.5
≥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 67.6
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018

Source:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2018.

  • N/A - Not Available
  • * Current use ( within last month).
  • Decreased 23 percent among those ages 18-25, from 11.0 percent to 8.5 percent.
  • Decreased 10 percent among those aged 26 or older, from 4.6 percent to 4.1 percent.
  • Decreased 30 percent among men ages 18-25, from 16.8 percent to 11.8 percent.
  • Decreased 20 percent among men aged 26 or older, from 8.5 percent to 6.8 percent.
  • Remained stable among women ages 18-25 at 5.2 percent.
  • Increased 68 percent among women aged 26 or older, from 1.0 percent to 1.7 percent.

Pipe Tobacco

From 2002 to 2018, current use of pipe tobacco:
 

Percent of Adults Who Use Pipe Tobacco by Age and Sex, 2002-2018*

  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018
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 68.8
≥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 -11.6
Male                                    
18-25 1.7 1.4 2.1 2.3 2.2 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 2.7 55.9
≥26 1.3 1.2 1.3 1.6 1.7 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1.1 -13.3
Female                                    
18-25 0.4 0.4 0.4 0.6 0.5 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1.1 164.5
≥26 0.2 0.1 0.1 0.2 0.2 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 0.3 59.5
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % Change
2002-2018

Source:
Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2018.

  • N/A - Not Available
  • * Current use ( within last month).
  • Increased 69 percent among those ages 18-25, from 1.1 percent to 1.9 percent.
  • Decreased 12 percent among those aged 26 or older, from 0.8 percent to 0.7 percent.

Trends in Youth Use of Other Tobacco Products

Any Tobacco Product

From 2002 to 2019, 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 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019
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 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
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 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
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 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
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 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
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 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
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 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
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 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.
  • Decreased 6 percent among middle school students, from 13.3 percent to 12.5 percent.
  • Increased 11 percent among high school students, from 28.2 percent to 31.2 percent.

Cigarettes

From 2002 to 2019, current use of cigarettes:
 

Cigarettes

  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019
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 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
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 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
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 21.0 21.8 18.4 14.8 13.8 11.7 11.2 7.9 7.7 6.9 7.6 7.3 4.1
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 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
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 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
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 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
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Decreased 77 percent among middle school students, from 9.8 percent to 2.3 percent.
  • Decreased 74 percent among high school students, from 22.5 percent to 5.8 percent.

Cigars

From 2002 to 2019, current use of cigars:
 

Cigars

  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019
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 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
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 16.9 18.4 16.6 15.0 15.7 16.7 15.4 10.8 11.5 9.0 9.0 9.0 9.0
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 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
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 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
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 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
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 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
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.

  • Decreased 62 percent among middle school students, from 6.0 percent to 2.3 percent.
  • Decreased 34 percent among high school students, from 11.6 percent to 6.5 percent.

Hookah

From 2011 to 2019, current use of hookahs:
 

Hookah

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

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Remained the same at less than 2 percent among middle school students.
  • Remained the same at about four percent among high school students.

Smokeless Tobacco

From 2002 to 2019, current use of smokeless tobacco:
 

Smokeless Tobacco

  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019
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 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
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 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
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 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
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 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
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 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
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 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
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Decreased 50 percent among middle school students, from 3.6 percent to 1.8 percent.
  • Decreased 19 percent among high school students, from 5.9 percent to 4.8 percent.

Snus

From 2011 to 2019, current use of snus:
 

Snus

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

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Remained the same at less than 1 percent among middle school students.
  • Decreased 39 percent among high school students, from 2.8 percent to 1.7 percent.

Dissolvable Tobacco

From 2011 to 2019, current use of dissolvable tobacco:
 

Dissolvable Tobacco

  Middle School High School
  2011 2012 2013 2014 2015 2016 2017 2018 2019 2011 2012 2013 2014 2015 2016 2017 2018 2019
Total 0.3 0.5 N/A 0.3 N/A 0.4 0.3 0.3 0.3 0.4 0.8 0.4 1.9 0.4 0.9 0.6 0.7 0.5
Male N/A 0.6 N/A 0.4 N/A 0.5 N/A N/A 0.5 0.6 1.0 0.6 3.0 0.7 1.0 0.7 0.9 0.6
Female N/A 0.4 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
Non-Hispanic White N/A 0.4 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
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
Hispanic N/A 0.9 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
  2011 2012 2013 2014 2015 2016 2017 2018 2019 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Remained the same at less than 1 percent among middle school students.
  • Remained the same at less than 2 percent among high school students.

Pipes

From 2002 to 2019, current use of pipes:
 

Pipes

  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019
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 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
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 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
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 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
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 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
Non-Hispanic Black 3.9 2.0 1.5 1.9 1.3 1.2 1.7 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
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 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
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Decreased from 3.5 percent to too low to measure among middle school students.
  • Decreased 66 percent among high school students, from 3.2 percent to 1.1 percent.

Bidis

From 2002 to 2019, current use of bidis:
 

Bidis

  Middle School High School
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019
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 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
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 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
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 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
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 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
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 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
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 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
  2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019 2002 2004 2006 2009 2011 2012 2013 2014 2015 2016 2017 2018 2019

Current use is defined as using the product on one or more of the past 30 days.

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Decreased 83 percent among middle school students from 2.4 percent to 0.4 percent.
  • Decreased 88 percent among high school students, from 3.2 percent to 0.4 percent.

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
  2002 2004 2006 2009 2011 2012 2013 2002 2004 2006 2009 2011 2012 2013

Current use is defined as using the product on one or more of the past 30 days.

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.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Decreased 80 percent among middle school students from 2.0 percent to 0.4 percent.
  • Decreased 70 percent among high school students, from 2.7 percent to 0.8 percent.

Heated Tobacco Products

In 2019, current use of heated tobacco products:
 

Heated Tobacco Products

  Middle School High School
  2019 2019
Total 1.4 1.7
Male 1.6 1.8
Female 1.2 1.6
Non-Hispanic White 1.0 1.6
Non-Hispanic Black N/A 2.3
Hispanic 2.2 1.9
  2019 2019

Sources:
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2019. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.

  • N/A Estimate is unreliable due to a sample size of less than 20.
  • Was at 1.4 percent among middle school students.
  • Was at 1.7 percent among high school students.

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