The results of the 2023 National Youth Tobacco Survey (NYTS) released today shows that current (past 30-day) e-cigarette use among U.S. high school students declined significantly in 2023, falling to 10% from 14.1% in 2022. Cigarette smoking among high school students remained at a record-low 1.9%, while use of cigars (1.8%) and any combustible tobacco product (3.9%) declined. Among middle school students, use of any tobacco product increased (from 4.5% to 6.6%), with a possible uptick in e-cigarette use (from 3.3% to 4.6%). Altogether, 2.1 million middle and high school students still use e-cigarettes, and nearly 90% of them use flavored products.

Yolonda C. Richardson, President and CEO of the Campaign for Tobacco-Free Kids, issued the following statement:

It is terrific news for our nation’s health that e-cigarette use among high school students fell sharply this year, while use of cigarettes, cigars and other smoked tobacco products are at record lows. These results are powerful evidence that, with the right policies and public education campaigns, we can drive down and even eliminate youth use of all tobacco products. They show that we can reduce youth e-cigarette use without a resurgence in cigarette smoking.

Despite this progress, youth e-cigarette use remains a serious public health problem in the United States, and it continues to be driven by the widespread availability of illegal and unauthorized flavored products that must be taken off the market. Over 2 million kids still use e-cigarettes and over a third of them use e-cigarettes daily or most days, a strong indication they are addicted to the high-nicotine products now on the market. The possible uptick in e-cigarette use among middle school students is also cause for concern and underscores the urgent need to eliminate flavored e-cigarettes.

The new survey makes it clearer than ever that flavored products are driving youth use. Nearly 90% of youth e-cigarette users report using flavored products, up from 85% a year ago. The survey also shows that while disposable products are the most commonly used e-cigarette device type among youth, youth are using a variety of both disposable products and cartridge-based products like Vuse and Juul. All types of flavored products must be eliminated.

Progress in reducing youth e-cigarette use is the result of a number of factors. These include growing, but still inadequate, efforts at the federal, state and local levels to end the sale of flavored e-cigarettes and the implementation of public education and cessation programs by the FDA, Truth Initiative and others.

To fully end this crisis, the FDA must clear the market of all flavored e-cigarettes. The FDA must quickly complete its review of remaining e-cigarette marketing applications and continue to deny applications for all flavored e-cigarettes, including menthol-flavored products. The FDA, with assistance from the U.S. Department of Justice, must also step up its enforcement efforts and use all its enforcement tools – including fines, injunctions and seizing illegal products being shipped into the U.S. – to clear the market of illegal e-cigarette products. In addition, states and cities must ramp up their efforts to end the sale of flavored e-cigarettes and other flavored tobacco products, especially as industry lawsuits continue to delay FDA action.

To continue reducing tobacco use among both youth and adults, it is also critical that the FDA and the Biden Administration swiftly finalize and implement rules to eliminate menthol cigarettes and flavored cigars, which are currently at the White House Office of Management and Budget for final review. The tobacco industry targets kids, Black Americans and other populations with these flavored products, contributing to significant health disparities. While the United States has made tremendous progress, we cannot let up in this fight as tobacco use remains the number one cause of preventable death and kills nearly half a million Americans every year.