Study: Youth Tobacco Use Remains a Public Health Concern

Study: Youth Tobacco Use Remains a Public Health Concern

It is critical for pharmacists to inquire about the use of e-cigarette or vaping products in patients that present with certain symptoms.

According to the 2021 National Youth Tobacco Survey (NYTS), approximately 2.55 million US middle and high school students reported current (past 30-day) use of a tobacco product in 2021 during the COVID-19 pandemic.1,2 E-cigarettes were the most used tobacco product, with 11.3% of high school students (1.72 million) and 2.8% of middle school students (320,000) reporting use in 2021.2

Tobacco product use remains the leading cause of preventable disease, disability, and death in the United States.1 The NYTS is a cross-sectional, school-based, self-administered survey of a sample of middle and high school students in grades 6-12 in the 50 US states and the District of Columbia.2

Additionally, the study was conducted using an online survey due to COVID-19 emergency protocols.2 The CDC and the FDA analyzed data from the NYTS to assess tobacco product use patterns.

The survey included 20,413 students out of 25,149 who were sampled from 279 schools out of 508 sampled, which resulted in an overall response rate of 44.6%.2 After e-cigarette use, the most currently used tobacco products were cigarettes, cigars, smokeless tobacco, hookahs, nicotine pouches, heated tobacco products, and pipe tobacco.2

“Youth use of tobacco products is unsafe in any form-combustible, smokeless, or electronic. This report provides critical insights needed to combat this serious public health concern and help protect our nation’s youth from the harmful effects of tobacco,” said Karen Hacker, MD, MPH, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion, in a press release.1

Peer use and curiosity were the most reported reasons for trying e-cigarettes in the study among students who had ever used them.2 There are a variety of safety concerns associated with e-cigarettes because vaping devices contain and release many toxic chemicals, such as nicotine, that can be addictive.

E-cigarette or vaping product use-associated lung injury (EVALI) has been a growing concern especially among teens with symptoms that can include fever, cough, headache, and fatigue.3 It is critical for pharmacists to inquire about the use of e-cigarette or vaping products in patients that present with these symptoms.

Public health campaigns that involve pharmacists are critical to educate the pediatric population and their families about the dangers of tobacco products, especially surrounding e-cigarettes as use is on the rise. The CDC’s Tips From Former Smokers (Tips) campaign provides real life stories from individuals living with long-term health effects from smoking and secondhand smoke exposure.4 Additionally, more than 1 million individuals quit smoking because of the Tips campaign.4


  1. Approximately 2.55 million students reported currently using a tobacco product in 2021.CDC. March 15, 2022.
  2. Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR Surveill Summ 2022;71(No. SS-5):1–29. DOI:
  3. Outbreak of lung injury associated with the use of e-cigarette, or vaping, products.CDC. March 15, 2022.
  4. Tips impact and results.CDC. March 15, 2022.

Source: Pharmacy Times