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Trends Infographics

Tobacco Use Among Middle and High School Students—United States, 2011-2015

Overall tobacco use

There has been no significant change in overall tobacco use among high school students since 2011.

  • 2011—24.2%
  • 2012—23.3%
  • 2013—22.9%
  • 2014—24.6%
  • 2015—25.3%


In 2015, 3 million middle and high school students were current users of e-cigarettes, up from 2.46 million in 2014.


There was a significant decrease in current cigarette use among high school students from 2011—2015.

  • 2011—15.8%
  • 2012—14.0%
  • 2013—12.7%
  • 2014—9.2%
  • 2015—9.3%

Two or more tobacco products

About half of middle and high school students who used tobacco products in 2015 were current users of two or more tobacco products.

Specific tobacco products

In 2015, current use of tobacco products among high school students included:

  • E-cigarettes—16.0%
  • Cigarettes—9.3%
  • Cigars—8.6%
  • Hookahs—7.2%
  • Smokeless tobacco—6.0%


E-cigarette Use Among Youth is Rising as E-cigarette Advertising Grows

E-cigarette use has increased considerably among U.S. youths in recent years and corresponding increases have occurred in e-cigarette advertising expenditures.

This graphs shows that during 2011 to 2014, current e-cigarette use among high school students soared from 1.5% to 13.4%, and among middle school students from 0.6% to 3.9%. Spending on e-cigarette advertising rose from $6.4 million in 2011 to an estimated $115 million in 2014.

Youth are Exposed to E-cigarette Advertisements from Multiple Sources

Sources of e-cigarette advertisement exposure

  • 14.4 million youth are exposed to advertising in retail stores
  • 10.5 million youth are exposed to advertising through the Internet
  • 9.6 million youth are exposed through TV or movies
  • 8 million youth are exposed through newspapers or magazines

US students exposed to e-cigarette advertisements, by school type and number of sources of exposure

A high proportion of U.S. Middle and High School students saw e-cigarette advertisements in 2014 from one or more of the following four sources: retail, Internet, TV/movies, and Magazines/newspapers. Overall,

  • 66% of U.S. Middle School Students
  • 71% of U.S. High School Students
  • 69% U.S. Middle and High School Students

7 out of 10 Middle and High School Students Who Currently Use Tobacco have used a FLAVORED Product

Graphic shows that 7 out of 10 middle and high school students who currently use tobacco have used a flavored product.

  • 63% of students who currently use e-cigarettes have used flavored e-cigarettes (1.6 million)
  • 61% of students who currently use hookah have used flavored hookah (1 million)
  • 64% of students who currently use cigars have used flavored cigars (910,000)

Source:Morbidity and Mortality Weekly Report (MMWR)

A Dangerous Trend—Smokeless Tobacco Use Among High School Athletes

Graphic shows the dangerous trend of smokeless tobacco use among high school athletes. Past 30-day use of combustible tobacco products dropped from 2001 to 2013 among all high school students (31.5% to 19.5%), while past 30-day use of smokeless tobacco remained unchanged among non-athletes (5.9%) and increased among athletes (10.0% to 11.1%).

Smokeless tobacco is NOT without risk. Smokeless tobacco use can lead to nicotine addiction; cause cancer of the mouth, esophagus and pancreas; cause diseases of the mouth; increase the risk for death from heart disease and stroke.

Most Adults Favor Making 21 the Minimum Age of Sale for Tobacco Products

Three out of 4 American adults—including 7 in 10 cigarette smokers—favor raising the minimum age of sale for all tobacco products to 21, according to an article by CDC published in the American Journal of Preventive Medicine.

Poison Center Calls Involving E-Cigarettes

The number of poison center calls involving e-cigarettes went from one call per month in September 2010 to 215 calls per month in February 2014.

State Laws & E-Cigarettes

  • 16 million children live in states where they can buy e-cigarettes legally
    • 10 states and D.C. allow sales of e-cigarettes to minors
    • Only 3 states prohibit indoor e-cigarette use in private workplaces, restaurants, and bars
  • Over 300 million Americans, including 70 million children, live in states where they could be exposed to either secondhand smoke or e-cigarette aerosol in worksites, restaurants, and bars.


Trying Their First Cigarette

Each day, nearly 3,300 youth under the age of 18 try their 1st cigarette.

Current Cigarette Smoking Among U.S. High School Students Lowest in 22 Years

Percentage of high school students who smoke

  • 1991: 27.5
  • 1993: 30.5
  • 1995: 34.8
  • 1997: 36.4
  • 1999: 34.8
  • 2001: 28.5
  • 2003: 21.9
  • 2005: 23.0
  • 2007: 20.0
  • 2009: 19.5
  • 2011: 18.1
  • 2013: 15.7

Source: National Youth Risk Behavior Surveys, 1991-2013

More Than a Quarter-Million Youth Who Had Never Smoked a Cigarette Used E-Cigarettes in 2013

In 2013, more than a quarter million middle school and high school students never smoked regular cigarettes but had used e-cigarettes three times as many as 2011.