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Counting how many young people use tobacco says nothing about how hard the
habit has taken hold. The 2015–2017 National Youth Tobacco Surveys asked a
different question: of those who use a product, **how many days out of the last
30?**
Near-daily use, by product
Share of current users who used that product on **20 or more of the past 30
days**:
| High school | Middle school | ||
|---|---|---|---|
| Smokeless tobacco | 38.7% | Hookah | 24.5% |
| Cigars | 14.0% (lowest) | E-cigarettes | 13.1% (lowest) |
Two things stand out. **Smokeless tobacco has by far the highest rate of
near-daily use among high school students** — more than a third of its users —
while it is not the product with the most users. And the products differ enough
that "youth tobacco use" as a single number hides which habits are occasional
and which are entrenched.
E-cigarettes are the most used product overall — **11.7% of high school
and 3.3% of middle school students in 2017** — and among the least likely to
be used near-daily. A large number of light users is a different public health
problem from a small number of heavy ones, and needs different answers.
And almost none of them use only one thing
Share of users who also used two or more tobacco products:
| Days used in the past 30 | Range across products |
|---|---|
| 20 or more | 76.7% (e-cigarettes) to 90.9% (hookah) |
| 6–19 | 68.0% to 84.2% |
| 1–5 | 48.8% (e-cigarettes) to 77.2% (cigarettes) |
**Even among the lightest users, half to three-quarters use another product
too.** Among the heaviest, it is four in five to nine in ten.
This is the finding with the clearest consequence: a policy aimed at one
product is aimed at a fraction of one person's use. Someone who stops vaping
and keeps smoking cigars has not stopped using tobacco, and the numbers say
that describes most of them.
The context
Most tobacco use begins during adolescence or young adulthood, raising the
risk of lifelong nicotine addiction and immediate harms.
**During 2011–2017, current use of cigarettes, cigars, smokeless tobacco and
pipe tobacco fell significantly** among middle and high school students —
while e-cigarette use rose from 1.5% to 11.7%. In 2017 that was **2.95
million high school and 0.67 million middle school students** using some
tobacco product.
Hence the recommendation, with the emphasis where the multi-product data puts
it: **sustained implementation of proven tobacco control strategies focusing on
all types of tobacco products**, alongside FDA regulation.
Source: Centers for Disease Control and Prevention, MMWR.
Licens: CC0 1.0 (allmän egendom) · Bearbetat efter www.cdc.gov
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