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Tobacco Product Use Among Middle and High School Students–United States, 2011 and 2012

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November 15, 2013 / Vol. 62 / No. 45

MMWR Introduction


CDC analyzed data from the 2011 and 2012 National Youth Tobacco Surveys to examine current use of cigarettes and other tobacco products, including cigars, pipes, smokeless tobacco, hookah, electronic cigarettes, snus, bidis, kreteks, and dissolvable tobacco, among US middle school and high school students.

This report's findings indicate that during 2011-2012, significant increases occurred in current use of non-conventional tobacco products, such as electronic cigarettes, hookah and dissolvable tobacco, among middle and high school students. Disparities in the use of some products also exist across subpopulations. These findings indicate that more efforts are needed to monitor and prevent the uptake of both conventional and non-conventional tobacco use across all youths

In 2012, the prevalence of current tobacco use among middle and high school students was 6.7% and 23.3%, respectively. From 2011 to 2012, a significant increase in current electronic cigarette use was observed in middle school students (0.6% to 1.1%); among high school students, significant increases were observed for current electronic cigarette (1.5% to 2.8%) and hookah (4.1% to 5.4%) use. Also from 2011 to 2012, there was a significant increase in dissolvable tobacco use among both middle school students (0.3% to 0.5%) and high school students (0.4% to 0.8%).

During this same time period, significant declines in current bidi and kretek use were observed for both middle school students; among high school students, significant declines in current bidi and kretek use were observed.

During 2011–2012, cigar use increased significantly among non-Hispanic black high school students to 16.7%, more than doubling the 2009 estimate of 7.1%. Further, cigar use among high school males (16.7%) is approximately double that of high school females (8.4%), and similar to cigarette use among high school males (16.3%). Cigars include both traditional premium cigars, cigarillos, as well as “little cigars,” which are similar to cigarettes in terms of appearance, but, depending on their weight, can be taxed at lower rates and legally sold with certain characterizing flavors that are otherwise banned from cigarettes. Young people are known to have higher rates of cigar use than adults, which may be associated with the marketing of flavored cigars that appeal to the youth of this country.