New U.S. Survey Shows Youth Cigarette Smoking Is at Record Lows, but E-Cigarettes and Cigars Threate

The 2017 National Youth Tobacco Survey released today shows that youth cigarette smoking is at record lows, but far too many kids – including nearly 1 in 5 high school students – still use some form of tobacco. The continuing popularity of electronic cigarettes and cigars – products that are widely available in sweet, kid-friendly flavors – is a particular cause for concern. For the fourth year in a row, e-cigarettes are the most commonly used tobacco product among both middle and high school students, while slightly more high school students now smoke cigars than cigarettes.

KEY 2017 SURVEY FINDINGS INCLUDE:

• Cigarettes: A record-low 7.6 percent of high school students were current cigarette smokers, compared to 8 percent in 2016 (current use means use in the past 30 days). The high school smoking rate has fallen by a remarkable 73 percent since 2000, when 28 percent smoked. The dramatic, long-term decline in youth cigarette smoking is an extraordinary public health success story and translates into millions of lives saved. 
  
   
• E-cigarettes: 11.7 percent of high school students reported current use of e-cigarettes, up slightly from 11.3 percent in 2016 but down from a peak of 16 percent in 2015. This survey may understate actual youth use of e-cigarettes as it was conducted in the spring of 2017 and does not fully capture the recent, widely-reported surge in popularity of Juul e-cigarettes among teens. Juul was not specifically mentioned in the survey, and many teens refer to Juul use as “juuling,” indicating they may not consider it to be using an e-cigarette. Juul looks like a USB flash drive and is easy to hide, comes in sweet flavors like mango and fruit medley, and delivers a powerful dose of nicotine, putting kids at greater risk of addiction. 
  
   
• Cigars: 7.7 percent of high school students reported current use of cigars, the same rate as in 2016. For the first time in this survey, slightly more high school students reported smoking cigars than cigarettes (7.7 percent to 7.6 percent). Among high school boys, cigars are even more popular – 9 percent smoked cigars, compared to 7.6 percent who smoked cigarettes.

These findings underscore the need to prevent youth use of all tobacco products and keep products like e-cigarettes and cigars from addicting a new generation of kids. The Food and Drug Administration should fully implement and enforce its 2016 rule for e-cigarettes and cigars, including a prohibition on the introduction of new or changed products without prior FDA review and authorization. This is a critical tool for preventing the introduction of child-friendly tobacco products. In addition, Congress must reject pending proposals, contained in a House appropriations bill, to weaken FDA oversight of tobacco products and completely exempt some cigars.

Today’s survey is a reminder both that we know how to win the fight against tobacco and that this battle is far from over. To keep making progress, elected officials at all levels must fully implement proven strategies.

These include significantly higher tobacco taxes, comprehensive smoke-free laws, well-funded tobacco prevention and cessation programs, effective FDA oversight of all tobacco products, and hard-hitting media campaigns, like the campaigns conducted by the Centers for Disease Control and Prevention, the FDA and Truth Initiative in recent years. States and localities should also continue to raise the tobacco sale age to 21, as five states and at least 320 cities and counties have now done.

The FDA should take several critical steps to accelerate progress: implement its plan to limit nicotine in cigarettes to minimally addictive or non-addictive levels, and apply this limit to other combustible tobacco products; require graphic health warnings covering at least half of cigarette packs (as mandated by the 2009 Tobacco Control Act); and prohibit menthol cigarettes and other flavored tobacco products, which have been shown to promote youth use. Until the FDA acts on flavors, states and localities should continue their growing efforts to stop the sale of flavored tobacco products. There is strong public support for such measures, as indicated by the 68 percent of San Francisco voters who voted this week to uphold their city’s groundbreaking law ending the sale of all flavored tobacco products, including menthol cigarettes.

Despite our progress, tobacco use is still the No. 1 cause of preventable death in the United States, killing more than 480,000 Americans and costing $170 billion in health care expenses each year. We can win the fight against tobacco, but only if elected officials put America’s kids and health before the special interests of the tobacco industry.

The 2017 National Youth Tobacco Survey results were published by the CDC and the FDA in this week’s Morbidity and Mortality Weekly Report.