National Tobacco Use Declines Among Youth

2022 NYTS shows high school and middle school students’ smoking habits
Photograph: Shutterstock

LAKEVILLE, Minn. — The findings of the 2022 National Youth Tobacco Survey (NYTS) were recently published in the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. The 2022 data demonstrated that slightly more than 1 in 10 middle and high school students (3.1 million) had used a tobacco product during the past 30 days—including 16.5% of high-school and 4.5% of middle-school students.

The NYTS found that from 2020 to 2022 there was a decrease in tobacco use among both groups studied. The average decrease across all categories for high schoolers was 2.8% and for middle schoolers it was 2%.

Each year since 2011, the CDC and U.S. Food and Drug Administration collaborate to administer the NYTS to middle- and high-school students across the country. The NYTS was designed to provide national data on tobacco-related behaviors, attitudes, beliefs and exposure to pro- and anti-tobacco influences. Data was collected between January and May 2022 using an online survey among U.S. middle school (grades six through eighth) and high school (grades nine through 12) students. Prior to 2020, the survey was administered in a classroom with pen and paper. The COVID-19 pandemic led to a change in methodology with the survey now online and available both in the classroom or at home.

In total, 28,291 students (student participation rate of 76.1%) from 341 schools (school participation rate of 59.4%) participated, yielding an overall response rate of 45.2%.

Of the 11.3% of students who reported current use of any tobacco product, 3.7% (1 million) reported currently smoking any combustible tobacco product and 3.5% (960,000) reported current use of two or more tobacco products. The most used devices were:

  • E-cigarettes 9.4%
  • Cigars 1.9%
  • Cigarettes 1.6%
  • Smokeless 1.3%
  • Hookahs 1.1%
  • Nicotine pouches 1.1%
  • Heated tobacco products 1%
  • Pipe tobacco 0.6%

Tobacco use prevalence varied by certain demographic characteristics and indicators of social determinants of health. Current use of any tobacco product was higher among certain population groups including 13.5% of non-Hispanic American Indian or Alaska Native students; 16.0% of students identifying as lesbian, gay, or bisexual; 16.6% of students identifying as transgender; 18.3% of students reporting severe psychological distress; 12.5% of students with low family affluence; and 27.2% of students with low academic achievement.

For high school students, 16.5%, or one in six, reported use of any tobacco product with 5.0% reporting current use of multiple tobacco products. E-cigarettes were the product type most commonly used (14.1%), followed by:

  • Cigars 2.8%
  • Cigarettes 2%
  • Smokeless tobacco 1.6%
  • Hookahs 1.5%
  • Nicotine pouches 1.4%
  • Heated tobacco products 1.1%
  • Pipe tobacco 0.7%

The NYTS provides national data on the long-term, intermediate, and short-term indicators used to design, implement, and evaluate tobacco control and prevention programs. There are some limitations to the comparison to previous years’ findings. The change in methodology from being exclusively administered in the classroom on paper to online and available at home somewhat limits the ability to compare the 2022 data to previous years.

Thomas A. Briant is the executive director of NATO, a tobacco retailing association based in Lakeville, Minn. Reach him at

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