TABLE 1. Percentage of middle and high school students who reported ever using tobacco products,* by product, overall and by school level, sex, and race and ethnicity — National Youth Tobacco Survey, United States, 2023.
| Tobacco product | % (95% CI) |
Total estimated weighted no.§ | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sex |
Race and ethnicity† |
Total | |||||||||
| Female | Male | AI/AN, NH | Asian, NH | Black or African American, NH | White, NH | Hispanic or Latino | Multiracial, NH |
||||
|
Overall
| |||||||||||
| Any tobacco product¶ |
23.7
(21.5–26.0) |
20.8
(18.9–22.8) |
22.7
(16.8–30.0) |
12.1
(6.5–21.5) |
20.1
(17.7–22.6) |
23.1
(20.2–26.2) |
23.8
(22.2–25.4) |
27.9
(22.5–33.9) |
22.2
(20.5–23.9)
|
6,210,000
|
|
| E-cigarettes |
19.4
(17.5–21.5) |
14.7
(13.2–16.3) |
15.4
(10.7–21.8) |
—** |
12.9
(11.1–14.8) |
18.4
(15.9–21.1) |
18.2
(16.3–20.2) |
20.8
(15.9–26.8) |
17.0
(15.6–18.5)
|
4,750,000
|
|
| Cigarettes |
7.0
(6.0–8.1) |
6.5
(5.4–7.7) |
9.5
(5.6–15.5) |
— |
4.1
(2.9–5.8) |
7.5
(6.3–8.9) |
7.4
(5.9–9.2) |
8.7
(6.0–12.4) |
6.7
(6.0–7.6)
|
1,840,000
|
|
| Cigars†† |
3.8
(2.9–4.8) |
5.8
(4.8–7.0) |
— |
— |
4.7
(3.4–6.4) |
5.2
(4.1–6.6) |
4.7
(4.0–5.5) |
6.9
(4.8–9.8) |
4.8
(4.0–5.6)
|
1,300,000
|
|
| Hookahs |
3.4
(2.4–4.8) |
2.7
(1.9–3.8) |
— |
— |
4.5
(2.7–7.2) |
2.5
(1.7–3.5) |
3.5
(2.7–4.5) |
3.6
(2.4–5.2) |
3.0
(2.4–3.9)
|
820,000
|
|
| Smokeless tobacco (composite)†† |
2.2
(1.7–2.9) |
3.7
(2.8–4.8) |
— |
— |
1.3
(0.8–2.1) |
3.4
(2.5–4.6) |
2.9
(2.2–3.8) |
5.0
(3.3–7.5) |
3.0
(2.4–3.6)
|
800,000
|
|
| Other oral nicotine products†† |
2.7
(2.1–3.4) |
3.2
(2.6–4.1) |
4.9
(2.8–8.5) |
— |
1.7
(1.1–2.6) |
3.2
(2.4–4.1) |
3.5
(2.7–4.6) |
4.2
(2.4–7.2) |
3.0
(2.5–3.5)
|
800,000
|
|
| Nicotine pouches |
1.7
(1.2–2.4) |
3.0
(2.2–4.1) |
— |
— |
— |
3.0
(2.3–3.9) |
2.0
(1.2–3.2) |
— |
2.3
(1.8–3.0)
|
580,000
|
|
| Pipe tobacco |
1.5
(1.1–2.0) |
1.9
(1.4–2.5) |
— |
— |
— |
1.8
(1.3–2.5) |
2.0
(1.5–2.7) |
2.3
(1.3–3.9) |
1.7
(1.4–2.0)
|
440,000
|
|
| Heated tobacco products |
1.5
(1.1–2.0) |
1.5
(1.0–2.1) |
— |
— |
1.7
(1.0–2.9) |
1.4
(0.9–2.0) |
1.8
(1.3–2.4) |
1.6
(0.9–3.0) |
1.5
(1.1–2.0)
|
370,000
|
|
| Any combustible tobacco product§§ |
10.9
(9.3–12.8) |
11.6
(10.1–13.2) |
11.1
(7.0–17.1) |
4.4
(2.4–7.8) |
11.2
(8.5–14.7) |
11.6
(9.7–13.7) |
12.0
(10.4–13.8) |
14.4
(11.0–18.5) |
11.2
(9.9–12.7)
|
3,090,000
|
|
| Multiple tobacco products¶¶ |
10.1
(8.7–11.8) |
9.6
(8.4–10.9) |
11.0
(7.2–16.3) |
3.6
(2.1–6.0) |
7.3
(5.5–9.7) |
10.8
(9.1–12.8) |
10.3
(8.9–11.8) |
13.3
(10.1–17.3) |
9.8
(8.7–11.1)
|
2,750,000
|
|
|
High school students (grades 9–12)
| |||||||||||
| Any tobacco product¶ |
30.1
(26.9–33.5) |
25.9
(23.5–28.5) |
29.0
(19.1–41.5) |
— |
21.8
(18.8–25.2) |
31.4
(28.0–34.9) |
27.3
(24.8–29.8) |
35.1
(27.3–43.7) |
27.9
(25.8–30.2)
|
4,390,000
|
|
| E-cigarettes |
26.0
(23.2–29.0) |
19.5
(17.6–21.5) |
20.3
(12.5–31.2) |
— |
14.7
(11.7–18.2) |
26.0
(23.0–29.2) |
22.3
(20.0–24.9) |
27.5
(20.9–35.3) |
22.6
(20.9–24.5)
|
3,550,000
|
|
| Cigarettes |
8.8
(7.3–10.6) |
8.3
(7.0–9.7) |
— |
— |
3.0
(1.8–5.0) |
10.5
(9.0–12.1) |
8.8
(6.9–11.1) |
10.5
(6.8–15.7) |
8.5
(7.7–9.5)
|
1,310,000
|
|
| Cigars†† |
4.8
(3.6–6.4) |
7.9
(6.3–9.9) |
— |
— |
4.8
(3.2–7.1) |
7.8
(6.1–10.0) |
5.4
(4.4–6.6) |
9.6
(6.4–14.0) |
6.4
(5.3–7.7)
|
980,000
|
|
| Hookahs |
4.0
(2.7–5.9) |
3.5
(2.3–5.4) |
— |
— |
— |
3.6
(2.5–5.3) |
3.9
(2.7–5.5) |
3.3
(1.9–5.8) |
3.7
(2.8–5.1)
|
560,000
|
|
| Smokeless tobacco (composite)†† |
2.2
(1.5–3.2) |
4.3
(3.3–5.7) |
— |
— |
— |
3.8
(2.8–5.1) |
2.9
(2.1–4.0) |
6.9
(4.1–11.4) |
3.3
(2.6–4.1)
|
500,000
|
|
| Other oral nicotine products†† |
2.8
(2.0–4.0) |
4.0
(3.1–5.3) |
— |
— |
1.6
(0.9–2.7) |
4.1
(3.0–5.4) |
3.8
(3.0–4.8) |
— |
3.5
(2.8–4.2)
|
520,000
|
|
| Nicotine pouches |
2.0
(1.4–2.9) |
4.1
(3.0–5.6) |
— |
— |
— |
4.5
(3.5–5.7) |
1.8
(1.1–2.8) |
— |
3.1
(2.4–4.0)
|
430,000
|
|
| Pipe tobacco |
1.7
(1.2–2.5) |
2.4
(1.8–3.2) |
— |
— |
— |
2.7
(2.0–3.5) |
2.2
(1.5–3.2) |
3.3
(2.0–5.5) |
2.1
(1.7–2.5)
|
310,000
|
|
| Heated tobacco products |
1.7
(1.2–2.5) |
1.6
(1.0–2.4) |
— |
— |
— |
1.8
(1.2–2.8) |
1.5
(0.9–2.3) |
— |
1.6
(1.2–2.3)
|
230,000
|
|
| Any combustible tobacco product§§ |
13.6
(11.3–16.2) |
14.9
(13.0–16.9) |
— |
— |
10.7
(8.2–14.0) |
16.4
(14.1–19.1) |
13.8
(11.7–16.3) |
17.5
(12.6–23.7) |
14.2
(12.6–16.1)
|
2,190,000
|
|
| Multiple tobacco products¶¶ |
12.8
(10.5–15.4) |
12.6
(11.1–14.2) |
14.2
(8.0–24.0) |
4.6
(2.5–8.3) |
7.1
(4.9–10.1) |
15.4
(13.1–18.1) |
11.7
(10.0–13.6) |
17.1
(12.2–23.3) |
12.7
(11.1–14.4)
|
1,990,000
|
|
|
Middle school students (grades 6–8)
| |||||||||||
| Any tobacco product¶ |
15.4
(12.9–18.3) |
13.8
(11.3–16.6) |
15.3
(9.7–23.2) |
— |
17.8
(12.9–24.0) |
12.3
(10.0–14.9) |
18.7
(16.5–21.1) |
17.6
(13.0–23.6) |
14.7
(12.5–17.1)
|
1,780,000
|
|
| E-cigarettes |
11.0
(9.1–13.3) |
8.2
(6.9–9.8) |
— |
— |
10.6
(8.5–13.1) |
8.4
(6.8–10.3) |
12.3
(10.5–14.4) |
11.3
(6.3–19.5) |
9.7
(8.3–11.3)
|
1,170,000
|
|
| Cigarettes |
4.6
(3.6–5.9) |
4.0
(2.7–5.9) |
— |
— |
5.5
(3.9–7.8) |
3.5
(2.5–5.1) |
5.3
(3.8–7.2) |
— |
4.3
(3.3–5.5)
|
510,000
|
|
| Cigars†† |
2.4
(1.6–3.6) |
2.9
(2.0–4.2) |
— |
— |
4.6
(2.8–7.4) |
1.7
(1.1–2.6) |
3.5
(2.3–5.3) |
— |
2.6
(1.9–3.7)
|
310,000
|
|
| Hookahs |
— |
1.7
(1.2–2.3) |
— |
— |
— |
0.9
(0.5–1.6) |
2.9
(2.1–4.0) |
— |
2.1
(1.4–3.2)
|
240,000
|
|
| Smokeless tobacco (composite)†† |
2.3
(1.6–3.1) |
2.7
(1.8–4.0) |
— |
— |
— |
2.9
(1.9–4.4) |
2.5
(1.6–3.9) |
— |
2.4
(1.8–3.3)
|
290,000
|
|
| Other oral nicotine products†† |
2.4
(1.8–3.2) |
2.1
(1.6–2.7) |
— |
— |
— |
2.0
(1.4–2.9) |
2.9
(1.8–4.4) |
2.9
(1.6–5.2) |
2.2
(1.8–2.7)
|
260,000
|
|
| Nicotine pouches |
— |
— |
— |
— |
— |
1.0
(0.6–1.8) |
— |
— |
—
|
—
|
|
| Pipe tobacco |
1.1
(0.6–2.0) |
1.1
(0.6–2.0) |
— |
— |
— |
— |
1.7
(1.2–2.4) |
— |
1.1
(0.7–1.6)
|
120,000
|
|
| Heated tobacco products |
1.2
(0.7–1.9) |
— |
— |
— |
— |
0.8
(0.5–1.5) |
2.1
(1.6–2.8) |
— |
1.2
(0.8–1.8)
|
130,000
|
|
| Any combustible tobacco product§§ |
7.5
(5.7–10.0) |
7.2
(5.1–9.9) |
6.6
(3.6–11.7) |
— |
11.9
(7.0–19.4) |
5.3
(3.8–7.3) |
9.3
(7.3–11.7) |
9.8
(6.4–14.8) |
7.3
(5.6–9.4)
|
870,000
|
|
| Multiple tobacco products¶¶ | 6.7 (5.3–8.6) | 5.5 (4.2–7.2) | — | — | 7.6 (4.7–12.2) | 4.7 (3.5–6.2) | 8.0
(6.0–10.6) |
7.9 (5.3–11.6) | 6.1 (4.9–7.5) | 740,000 | |
Abbreviations: AI/AN = American Indian or Alaska Native; NH = non-Hispanic.
* Ever use is defined as ever having used the product, even once or twice. Because of missing data on the ever use questions, denominators for each tobacco product might be different. For each question, response options were “yes” or “no.”
† Hispanic or Latino persons could be of any race. Estimates among NH Native Hawaiian or other Pacific Islander students, overall and by school level, were statistically unreliable for all measures and are not presented in this table.
§ Estimated weighted total number of ever tobacco product users was rounded down to the nearest 10,000 persons. Overall estimates were reported based on 22,069 U.S. middle and high school students. School level was determined by reported grade level: high school (grades 9–12; n = 10,879) and middle school (grades 6–8; n = 11,067). The sum of subgroup estimates might not sum to overall population estimates because of rounding or exclusion of students who did not report sex, race and ethnicity, or grade level.
¶ Any tobacco product use is defined as ever use of one or more of the following tobacco products: e-cigarettes, cigars, cigarettes, smokeless tobacco (composite), hookahs, nicotine pouches, heated tobacco products, pipe tobacco, bidis (small brown cigarettes wrapped in a leaf), or other oral nicotine products.
** Dashes indicate that data were statistically unreliable because of an unweighted denominator <50 or a relative SE >30%.
†† Cigars were defined as cigars, cigarillos, or little cigars. Smokeless tobacco (composite) was defined as chewing tobacco, snuff, dip, or snus. Other oral nicotine products were defined as lozenges, discs, tablets, gums, dissolvable tobacco products, and other products. In 2023, dissolvable tobacco products were reclassified from smokeless tobacco to other oral nicotine products.
§§ Any combustible tobacco product use was defined as ever use of one or more of the following tobacco products: cigarettes, cigars, hookahs, pipe tobacco, or bidis.
¶¶ Multiple tobacco product use was defined as ever use of two or more of the following tobacco products: e-cigarettes, cigars, cigarettes, smokeless tobacco (composite), hookahs, nicotine pouches, heated tobacco products, pipe tobacco, bidis, or other oral nicotine products.