Tobacco, E-Cigarette Use Among High School Students Drop: FDA, CDC

Overall tobacco product use among U.S. high school students declined in 2023, primarily attributable to reduced e-cigarette use, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention or CDC said, citing the 2023 National Youth Tobacco Survey or NYTS.

Meanwhile, there was an increase in current overall tobacco product use and multiple tobacco product use among middle school students.

The FDA said it continues with an additional round of fines against retailers for illegal e-cigarette sales as part of its efforts to curb youth tobacco use.

As per the NYTS survey on tobacco product use among U.S. youth, current overall tobacco product use among U.S. high school students declined to 12.6 percent during 2022-2023 from 16.5 percent last year.

E-cigarettes remained the most used tobacco product among both high school and middle school students for the 10th year in a row.

From 2022 to 2023, current e-cigarette use among high school students declined to 10.0 percent from 14.1 percent. This translates to 580,000 fewer high school students who reported current use of e-cigarettes in 2023.

The findings, which were collected between March and June 2023, show that 10 percent of U.S. middle and high school students, which comes to around 2.8 million youth, reported current use of any tobacco product.

Among middle school and high school students, who currently use e-cigarettes, 25.2 percent used e-cigarettes daily, and 89.4 percent used flavored e-cigarettes.

E-cigarettes, particularly disposable e-cigarette products, remained the most commonly used tobacco product among youths.

The most popular brands included both disposable and cartridge-based products. The most reported brands were Elf Bar, Esco Bars, Vuse, JUUL, and Mr. Fog.

Among youth, who reported current e-cigarette use, around 89.4 percent used flavored products, with fruit, candy, mint, and menthol being the most commonly used flavors.

Among high school students, declines in current use were also observed during 2022-2023 for cigars and overall combustible tobacco smoking, representing all-time lows.

Meanwhile, among middle school students, current overall tobacco product use increased to 6.6 percent from 4.5 percent, and multiple tobacco product use grew to 2.5 percent from 1.5 percent.

However, among middle school students overall, no significant change was observed during 2022-2023 for the current use of any individual tobacco product type, including e-cigarettes.

Brian King, director of the FDA’s Center for Tobacco Products, said, “It’s encouraging to see this substantial decline in e-cigarette use among high schoolers within the past year, which is a win for public health… The FDA remains concerned about youth tobacco product use, and we cannot and will not let our guard down on this issue… We will not stand by as bad actors place profit over the health of our nation’s youth.”

As part of its efforts to prevent youth tobacco use, the FDA plans to seek civil money penalties or CMPs against 20 additional retailers for the sale of unauthorized Elf Bar products, the most popular brand among youth according to the 2023 NYTS.

The FDA previously issued a warning letter to each of these 20 retailers cautioning them to stop selling unauthorized tobacco products, however, it was found that they had not stopped the sale.

In September, the agency announced civil money penalty actions against more than a dozen retailers for the sale of unauthorized Elf Bar/EB Design e-cigarettes and sent hundreds more warning letters to retailers for selling the same products.

Over the past year, the FDA has issued more than 135 warning letters to manufacturers and distributors of unauthorized e-cigarettes, and more than 400 warning letters to retailers for the sale of unauthorized e-cigarettes.

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