Youth E-Cigarette and Nicotine Pouch Use in the U.S., 2024

E-cigarettes remain the tobacco product most used by U.S. young people, although use has fallen considerably since 2019. At the same time, sales of nicotine pouches — small, dissolvable, flavored pouches of tobacco-derived nicotine that users tuck between lip and gum — have kept rising nationally since 2016, raising concern about their use by youths. Unlike snuff or snus, the pouches contain no tobacco leaf. All nicotine pouches and most e-cigarettes contain nicotine, which is highly addictive and can harm the developing adolescent brain.

The Food and Drug Administration and CDC analyzed the 2024 National Youth Tobacco Survey, a nationally representative online survey taken at school by 29,861 middle and high school students at 283 schools between January 22 and May 22, 2024. "Current" use means use in the past 30 days.

E-cigarettes

5.9% of middle and high school students — an estimated 1.63 million — currently used e-cigarettes in 2024, down from 7.7% (2.13 million) in 2023.

Among students currently using e-cigarettes:

• 38.4% used them frequently (on 20 or more of the past 30 days) and 26.3% daily;
• disposables were the most common device (55.6%), followed by prefilled or refillable pods or cartridges (15.6%) and tanks or mod systems (7.0%); 21.8% weren't sure;
• the brands used most were Elf Bar (36.1%), Breeze (19.9%), Mr. Fog (15.8%), Vuse (13.7%) and JUUL (12.6%);
• 87.6% used flavored products, most often fruit (62.8%), candy (33.3%) and mint (25.1%).

Nicotine pouches

1.8% of middle and high school students — about 480,000 — currently used nicotine pouches in 2024: 2.4% of high school and 1.0% of middle school students. That was not a significant change from 2023, despite rising sales, though use did rise slightly but significantly between 2022 and 2024.

Among students currently using pouches:

• 29.3% used them frequently and 22.4% daily;
• ZYN was the most used brand (68.7%), followed by on! (14.2%), Rogue (13.6%), Velo (10.7%) and Juice Head ZTN (9.8%);
• 85.6% used flavored products, most often mint (53.3%), fruit (22.4%) and menthol (19.3%).

What it means

Youth e-cigarette use has declined, but the authors stress that continued monitoring and comprehensive tobacco control — strategies, regulations and enforcement — remain critical to preventing youth use of e-cigarettes and nicotine pouches, and the lifetime of nicotine addiction that can follow. Any tobacco product use by young people is unsafe.

A note on the data: the 2024 survey's overall response rate was 33.4% (78.3% of students at 42.7% of schools), and the results were weighted to represent U.S. students nationally.

Sources

• Park-Lee E, Jamal A, Cowan H, et al. "Notes from the Field: E-Cigarette and Nicotine Pouch Use Among Middle and High School Students — United States, 2024," MMWR Vol. 73, No. 35, CDC; a work of the United States government in the public domain.