Although cigarette use among middle and high school students continues to decrease, overall tobacco use is still high, with 22.9% of high school students currently using tobacco products in 2013, the Centers for Disease Control and Prevention reported.
Overall, 46% of high school students reported ever using a tobacco product, and 31.4% reported ever trying two or more tobacco products, according to data from the National Youth Tobacco Survey, published online Nov. 14 (MMWR 2014;63:1021-6).
In 2013, 22.9% of high school students reported current use of a tobacco product; in 2012, 23.3% of high school students reported current tobacco use, and 24.3% used a tobacco product in 2011.
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Overall, 46% of high school students reported ever using a tobacco product.
Combustible tobacco products were the most popular form of tobacco ingestion among current and former users, as 9 out of 10 high school students reporting using them. Cigarettes were the most regularly used tobacco products at 12.7%, followed by cigars (11.9%), smokeless tobacco (5.7%), hookah (5.2%), e-cigarettes (4.5%), and pipes (4.1%).
The study’s authors, led by CDC epidemiologist René A. Arrazola, noted that the data could be influenced by self-reporting bias. The National Youth Tobacco Survey is a school-based, self-administered questionnaire.
Of 250 schools selected for the 2013 National Youth Tobacco Survey, 187 (75%) participated, with a sample of 18,406 (91%) among 20,301 eligible students; the overall response rate was 68%.
The increasing number of teens using e-cigarettes could be cause for concern, because there are few data on the long-term impact of e-cigarette use. However, the 2014 Surgeon General’s report found that adolescent nicotine use can have adverse effects on brain development, whatever the source, the authors noted.
“Considering how trends in tobacco product use and tobacco marketing change, rigorous surveillance of all available forms of tobacco use by youths, particularly use of emerging products such as e-cigarettes, is essential,” they said.
Among middle school students, 17.7% had ever used tobacco. Middle school students were more likely to smoke cigars instead of cigarettes, with 3.1% reporting current use of cigars, and 2.9% reporting current use of cigarettes; 1.1% reported recently using e-cigarettes.
In terms of ethnic demographics, cigarettes were the most prevalent tobacco product used by white and Hispanic high school students (14.0% and 13.4%), although cigars were close behind (11.4% and 12.1%). Overall cigar use among high schoolers decreased but still remains relatively high; it was 11.9% in 2013, compared with 12.6% in 2012.
Cigar use among black high school students was nearly 50% higher than cigarette use (14.7 % vs. 9.0 %), and more than twice as high as cigarette use (4.5% vs 1.7%) among black middle school students.