The use of emerging tobacco products, including e-cigarettes, is on the rise among middle and high school students in the US; however, there are significant decreases in the use of traditional products. This according to a study of middle and high school students in the 2011-2015 National Youth Tobacco Survey (NYTS) to determine the prevalence and trends of current use of 7 tobacco product types. Researchers found:

• In 2015, 1 in 4 high school students and 1 in 13 middle school students reported current use of any tobacco products Current use is defined as ≥1 day in the past 30 days.

• An estimated 4.7 million high school and middle school students reported current use of any tobacco product.

• During 2011 to 2015, substantial increases were observed in e-cigarette and hookah use among high school and middle school students, whereas significant decreases were observed in the use of cigarettes, cigars, smokeless tobacco, pipe tobacco, and bidis, resulting in no decline in tobacco use overall.

• During 2015, e-cigarettes were the most commonly used tobacco product among middle school (5.3%) and high school (16.0%) students.

Citation: Singh T, Arrazola RA, Corey CG, et al. Tobacco Use Among Middle and High School Students—United States, 2011–2015. [Published online ahead of print April 15, 2016]. MMWR Morb Mortal Wkly Rep. 2016;65:361–367. doi:http://dx.doi.org/10.15585/mmwr.mm6514a1.

Commentary: The increased use of e-cigarettes among middle and high school students is startling. The current usage rates for e-cigarettes in high school has increased from rare use with 1.5% of students using e-cigarettes in 2011 to e-cigarettes being commonly used; 16% of students in 2015. Equally surprising is the decrease in the rate of use of traditional tobacco products, with the use of cigarettes decreasing from 16% in 2011 to 9% in 2015. The use of nicotine products remains an important public health issue as tobacco use is the leading cause of preventable disease and death in the United States. Given the increasing use of e-cigarettes, a concerted effort must be made to be clear to both adults and children that e-cigarettes, while attractive to many, may not be safe for anyone. —Neil Skolnik, MD