Tobacco Use Among Middle and High School Students — United States, 2013

René A. Arrazola, MPH1, Linda J. Neff, PhD1, Sara M. Kennedy, MPH2, Enver Holder-Hayes, MPH3, Christopher D. Jones, PhD1 (Author affiliations at end of text) Tobacco use is the leading preventable cause of disease and death in the United States, and nearly all tobacco use begins during youth and young adulthood (1,2). Among U.S. youths, cigarette smoking has declined in recent years; however, the use of some other tobacco products has increased (3), and nearly half of tobacco users use two or more tobacco products (4). CDC analyzed data from the 2013 National Youth Tobacco Survey* to determine the prevalence of ever (at least once) and current (at least 1 day in the past 30 days) use of one or more of 10 tobacco products (cigarettes, cigars, hookahs, smokeless tobacco, electronic cigarettes [e-cigarettes], pipes, snus, bidis, kreteks, and dissolvable tobacco) among U.S. middle school (grades 6–8) and high school (grades 9–12) students. In 2013, 22.9% of high school students reported current use of any tobacco product, and 12.6% reported current use of two or more tobacco products; current use of combustible products (i.e., cigarettes, cigars, pipes, bidis, kreteks, and/or hookahs) was substantially greater (20.7%) than use of other types of tobacco. Also, 46.0% of high school students reported having ever tried a tobacco product, and 31.4% reported ever trying two or more tobacco products. Among middle school students, 3.1% reported current use of cigars, and 2.9% reported current use of cigarettes, with non-Hispanic black students more than twice as likely to report current use of cigars than cigarettes. Monitoring the prevalence of the use of all available tobacco products, including new and emerging products, is critical to support effective population-based interventions to prevent and reduce tobacco use among youths as part of comprehensive tobacco prevention and control programs.