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, 2021.
| Characteristic | Sex | Race and ethnicity | Total | |||||
|---|---|---|---|---|---|---|---|---|
| Female | Male | White, non-Hispanic | Black, non-Hispanic | Hispanic† | Other, non-Hispanic | |||
| % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | Estimated no. of users§ | |
| Overall | ||||||||
| Any tobacco product¶ | 24.5 (22.2–27.1) | 23.8 (21.7–26.1) | 26.7 (23.7–29.9) | 21.9 (19.2–24.9) | 22.4 (20.7–24.2) | 16.1 (11.6–21.8) | 24.1 (22.1–26.3) | 6,600,000 |
| E-cigarettes | 20.1 (17.9–22.5) | 18.8 (16.8–21.0) | 23.1 (20.3–26.2) | 12.6 (10.4–15.2) | 17.6 (15.8–19.5) | 12.7 (8.9–17.7) | 19.4 (17.5–21.5) | 5,300,000 |
| Cigarettes | 8.0 (6.9–9.1) | 8.3 (7.3–9.4) | 9.3 (8.1–10.8) | 6.2 (4.8–8.0) | 7.1 (6.0–8.4) | 5.9 (3.5–10.0) | 8.1 (7.2–9.1) | 2,180,000 |
| Cigars | 3.7 (3.2–4.3) | 6.6 (5.6–7.9) | 5.9 (4.7–7.3) | 6.8 (5.5–8.4) | 4.1 (3.4–4.9) | 1.9 (1.1–3.4) | 5.2 (4.5–6.0) | 1,400,000 |
| Smokeless tobacco | 2.2 (1.6–2.8) | 5.0 (4.1–6.2) | 4.8 (3.9–5.8) | 1.8 (1.2–2.7) | 2.3 (1.7–3.0) | —** | 3.6 (2.9–4.5) | 960,000 |
| Hookahs | 3.1 (2.5–3.8) | 2.5 (2.0–3.0) | 2.1 (1.6–2.7) | 5.0 (4.0–6.3) | 3.2 (2.3–4.3) | — | 2.8 (2.3–3.3) | 740,000 |
| Nicotine pouches | 1.2 (0.9–1.7) | 2.6 (2.0–3.2) | 2.6 (2.1–3.3) | 0.7 (0.4–1.3) | 1.3 (0.9–1.9) | — | 1.9 (1.5–2.4) | 490,000 |
| Heated tobacco products | 1.8 (1.5–2.2) | 1.7 (1.5–2.0) | 1.7 (1.4–2.1) | 1.7 (1.1–2.5) | 2.1 (1.5–2.9) | — | 1.8 (1.5–2.0) | 440,000 |
| Pipe tobacco | 0.9 (0.6–1.2) | 1.2 (0.9–1.6) | 1.3 (1.0–1.6) | — | 0.9 (0.7–1.3) | — | 1.0 (0.8–1.3) | 270,000 |
| Any combustible tobacco product†† | 11.3 (10.1–12.5) | 12.4 (11.1–13.8) | 12.6 (10.9–14.4) | 14.0 (11.8–16.4) | 10.4 (9.3–11.6) | 8.3 (5.5–12.4) | 11.9 (10.8–13.0) | 3,200,000 |
| Two or more tobacco products§§ | 9.1 (8.0–10.3) | 10.9 (9.5–12.4) | 11.8 (10.1–13.7) | 8.5 (6.8–10.5) | 8.5 (7.3–9.9) | 6.3 (4.2–9.4) | 10.0 (8.9–11.3) | 2,740,000 |
| High school (grades 9–12) | ||||||||
| Any tobacco product | 35.2 (32.4–38.1) | 33.0 (30.3–35.8) | 37.8 (34.7–41.1) | 27.7 (25.1–30.6) | 29.7 (27.2–32.4) | 27.9 (22.5–34.0) | 34.0 (31.6–36.5) | 5,220,000 |
| E-cigarettes | 30.2 (27.4–33.1) | 27.7 (25.0–30.6) | 33.8 (30.7–37.1) | 16.9 (14.5–19.7) | 25.0 (22.4–27.9) | 23.0 (17.6–29.5) | 28.9 (26.4–31.4) | 4,430,000 |
| Cigarettes | 10.8 (9.3–12.5) | 11.5 (9.9–13.3) | 13.0 (11.3–14.9) | 6.4 (4.7–8.5) | 9.5 (7.6–11.9) | 9.6 (5.6–15.8) | 11.2 (9.9–12.6) | 1,680,000 |
| Cigars | 4.9 (4.2–5.8) | 10.0 (8.6–11.7) | 8.7 (7.3–10.4) | 8.7 (7.0–10.6) | 5.4 (4.3–6.8) | — | 7.6 (6.6–8.8) | 1,140,000 |
| Smokeless tobacco | 2.4 (1.8–3.3) | 6.8 (5.5–8.4) | 6.6 (5.4–7.9) | 1.7 (1.0–2.9) | 2.2 (1.5–3.2) | — | 4.7 (3.8–5.9) | 700,000 |
| Hookahs | 4.2 (3.4–5.3) | 3.5 (2.8–4.3) | 2.9 (2.3–3.8) | 6.8 (5.3–8.7) | 4.0 (3.0–5.3) | 5.1 (2.9–8.9) | 3.8 (3.2–4.6) | 570,000 |
| Nicotine pouches | 1.7 (1.3–2.4) | 4.1 (3.3–5.1) | 4.1 (3.3–5.1) | — | 1.5 (1.0–2.2) | — | 3.0 (2.4–3.6) | 420,000 |
| Heated tobacco products | 2.5 (1.9–3.1) | 2.1 (1.8–2.5) | 2.3 (1.9–2.8) | 2.1 (1.2–3.7) | 2.4 (1.6–3.4) | — | 2.3 (2.0–2.6) | 310,000 |
| Pipe tobacco | 1.1 (0.7–1.8) | 1.7 (1.2–2.4) | 1.8 (1.3–2.4) | — | 1.1 (0.7–1.8) | — | 1.4 (1.1–1.9) | 210,000 |
| Any combustible tobacco product | 15.4 (13.6–17.2) | 17.6 (15.9–19.5) | 17.8 (15.9–19.8) | 17.4 (15.0–20.1) | 13.5 (11.3–16.2) | 14.1 (9.8–19.9) | 16.6 (15.1–18.1) | 2,500,000 |
| Two or more tobacco products | 12.8 (11.4–14.4) | 16.2 (14.3–18.4) | 17.2 (15.2–19.4) | 10.8 (8.8–13.4) | 11.6 (9.5–14.1) | 10.9 (7.6–15.5) | 14.6 (13.1–16.3) | 2,240,000 |
| Middle school (grades 6–8) | ||||||||
| Any tobacco product | 11.1 (9.3–13.2) | 11.5 (9.9–13.4) | 10.3 (8.7–12.1) | 14.0 (10.9–17.8) | 13.2 (10.5–16.5) | 6.0 (3.7–9.6) | 11.3 (9.8–13.0) | 1,340,000 |
| E-cigarettes | 7.5 (6.2–9.1) | 7.0 (5.8–8.5) | 7.5 (6.3–9.0) | 7.0 (4.9–9.8) | 8.4 (6.5–10.8) | 3.8 (2.2–6.6) | 7.3 (6.2–8.6) | 860,000 |
| Cigarettes | 4.2 (3.2–5.6) | 3.9 (3.1–5.0) | 3.8 (2.9–5.1) | 5.7 (3.8–8.4) | 4.1 (2.8–5.8) | — | 4.1 (3.2–5.1) | 480,000 |
| Cigars | 2.0 (1.5–2.7) | 2.2 (1.7–2.7) | 1.7 (1.2–2.3) | 4.3 (3.2–5.8) | 2.5 (1.6–3.8) | — | 2.1 (1.7–2.6) | 240,000 |
| Smokeless tobacco | 1.8 (1.2–2.6) | 2.5 (1.8–3.6) | 2.1 (1.5–2.8) | 1.9 (1.1–3.3) | 2.3 (1.5–3.5) | — | 2.2 (1.6–3.0) | 250,000 |
| Hookahs | 1.5 (1.0–2.3) | 1.1 (0.7–1.5) | 0.6 (0.4–1.0) | 2.7 (1.8–3.9) | 2.1 (1.2–3.7) | — | 1.3 (0.9–1.8) | 150,000 |
| Nicotine pouches | 0.6 (0.3–1.1) | 0.5 (0.3–0.8) | 0.4 (0.3–0.7) | — | — | — | 0.6 (0.4–0.8) | 60,000 |
| Heated tobacco products | 1.0 (0.7–1.4) | 1.2 (0.9–1.8) | 0.8 (0.5–1.3) | — | 1.7 (1.0–3.0) | — | 1.1 (0.9–1.5) | 120,000 |
| Pipe tobacco | — | 0.5 (0.3–0.8) | 0.4 (0.2–0.6) | — | 0.7 (0.4–1.2) | — | 0.5 (0.3–0.7) | 50,000 |
| Any combustible tobacco product | 6.0 (4.9–7.4) | 5.4 (4.5–6.5) | 4.7 (3.8–5.9) | 9.2 (6.7–12.5) | 6.5 (5.0–8.6) | — | 5.7 (4.8–6.8) | 670,000 |
| Two or more tobacco products | 4.3 (3.3–5.7) | 3.7 (2.8–4.9) | 3.6 (2.7–4.9) | 5.4 (3.6–8.1) | 4.7 (3.4–6.5) | — | 4.0 (3.2–5.1) | 480,000 |
Abbreviation: e-cigarettes = electronic cigarettes.
* Ever use of e-cigarettes was determined by asking, “Have you ever used an e-cigarette, even once or twice?” Ever use of cigarettes was determined by asking, “Have you ever smoked a cigarette, even one or two puffs?” Ever use of cigars was determined by asking, “Have you ever smoked a cigar, cigarillo, or little cigar, even one or two puffs?” Smokeless tobacco was defined as use of chewing tobacco, snuff, or dip, snus, or dissolvable tobacco products. Ever use of smokeless tobacco was determined by asking the following questions: for chewing tobacco, snuff, and dip: “Have you ever used chewing tobacco, snuff, or dip, even just a small amount?”; for snus: “Have you ever used snus, even just one time?”; and for dissolvable tobacco products: “Have you ever used dissolvable tobacco products, even just one time?” Responses from these questions were combined to derive overall smokeless tobacco use. Ever use of hookahs was determined by asking, “Have you ever smoked tobacco in a hookah or water pipe, even one or two puffs?” Ever use of nicotine pouches was determined by asking, “Have you ever used a “nicotine pouch,” even just one time?” Ever use of heated tobacco products was determined by asking, “Have you ever used a heated tobacco product, even just one time?” Ever use of pipe tobacco (not hookahs) was determined by asking, “Have you ever smoked pipes filled with tobacco (not hookah or water pipe), even just one time?” 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 persons could be of any race.
§ Estimated weighted total number of ever tobacco product users was rounded down to the nearest 10,000 persons. Overall estimates were reported among 20,413 U.S. middle and high school students. School level was determined by self-reported grade level: high school (grades 9–12; n = 10,515) and middle school (grades 6–8; n = 9,763). Overall estimates might not directly total to sums of corresponding subgroup estimates because of rounding or inclusion of students who did not self-report sex, race and ethnicity, or grade level.
¶ Any tobacco product use was defined as ever use of any tobacco product (e-cigarettes, cigarettes, cigars [cigars, cigarillos, or little cigars], smokeless tobacco [chewing tobacco, snuff, or dip, snus, or dissolvable tobacco products], hookahs, pipe tobacco, heated tobacco products, nicotine pouches, or bidis [small brown cigarettes wrapped in a leaf]), even just one time.
** Data were statistically unreliable because of unweighted denominator <50 or a relative standard error >30%.
†† Any combustible tobacco product use was defined as ever use of cigarettes, cigars (cigars, cigarillos, or little cigars), hookahs, pipe tobacco, or bidis, even just one time.
§§ Defined as ever use of two or more tobacco products (e-cigarettes, cigarettes, cigars [cigars, cigarillos, or little cigars], smokeless tobacco [chewing tobacco, snuff, or dip, snus, or dissolvable tobacco products], hookahs, pipe tobacco, heated tobacco products, nicotine pouches, or bidis), even just one time.