Cigarette smoking among middle and high school students dropped to a historic low of 1.4% in 2024, driven by heightened health awareness and shifting social norms.
The 2024 National Youth Tobacco Survey, detailed in a Morbidity and Mortality Weekly Report, found that 2.25 million students reported using any tobacco product, down from 2.80 million in 2023. The decline was largely due to a drop in e-cigarette use, from 2.13 million students in 2023 to 1.63 million in 2024. Hookah use also fell significantly, from 290,000 to 190,000 students.
“I want to attribute it to more health awareness and younger generation,” said Dr. L.A. Barlow, a Detroit Medical Center clinical psychologist, in an interview with 1080 KRLD. “They’re just a little bit more in tune with their health. And back years ago, it was kind of cool to smoke. Nowadays that’s not considered cool anymore.”
E-cigarettes remained the most used tobacco product, with 5.9% of students reporting current use, followed by nicotine pouches at 1.8%. Among e-cigarette users, 87.6% preferred flavored products, with fruit and “ice” flavors being the most popular. Disposable devices, like Elf Bar and Breeze, dominated, used by 55.6% of vapers. Nicotine pouches, led by brands like Zyn, saw 85.6% of users choosing flavored options, with mint topping the list.
“The young people I talk to, they’re like, ‘No, that’s a bad thing.’ They don’t consider it a cool or the in thing to do,” added Barlow. “They see the health impact and they’re concerned about that.”
Barlow also noted concerns about youth vaping, which can be done “more inconspicuously,” making it harder for parents to detect. Still, she credited social norms and word-of-mouth for reducing tobacco use alongside higher tobacco prices.
“I do understand that they’ve increased the price of a lot of tobacco products, too, so that could be a contributing factor,” she explained. “But mostly social norms where it’s not considered the in thing or the normal thing for young people to smoke. Word of mouth is usually… more impactful than other methods.”
The survey showed 8.1% of students used tobacco products overall, with 10.1% of high schoolers and 5.4% of middle schoolers reporting use. Non-Hispanic American Indian or Alaska Native students had the highest rate at 16.3%, followed by Black students at 10.0%.
A separate American Cancer Society report noted that adult smoking fell to 11% in 2023, though flavored tobacco products continue to attract youth, Audacy reported.