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The Centers for Disease Control and Prevention recently released good news about teen smoking.  Each year, the CDC surveys middle and high school students about their tobacco use. The 2021 National Youth Tobacco Survey included responses from over 20,000 students from 279 schools. The survey asks about tobacco product use in the prior 30 days.

For example, back in 2002, over 22% of high school students reported smoking cigarettes in the prior 30 days, and only 10 years ago the smoking rate was 15%. By 2021, the smoking rate among high school students was down to just 1.9%, and less than 0.4% smoked regularly (on 20-30 days). Among middle school students, only 1% smoked cigarettes over the previous 30 days, and less than 0.2% smoked regularly.

These are record low numbers, according to Dr. Thomas Brandon, director of the Tobacco Research and Intervention Program at Moffitt Cancer Center

I never thought I’d live to see smoking rates under 2%.
Dr. Thomas Brandon, director of the Tobacco Research and Intervention Program

“When I began my research on smoking in the early ’80s, about one in three high school seniors smoked,” said Brandon. “I never thought I’d live to see smoking rates under 2%.” 

The pandemic likely had an effect.  

“Many of the teens surveyed last year were enrolled from home because of COVID-19. I wouldn’t be surprised if the percentages tick up a bit this year when they return to school with the social influences that encourage smoking,” said Brandon.

The survey also shows that e-cigarette use among high school students dropped from a peak of 27.5% in 2019, shortly after it was declared an epidemic, to 11.3% in 2021, and to 2.8% among middle school students. Brandon says vaping seems to be replacing cigarette smoking. 

“A few years ago, we were worried that vaping would be a gateway to smoking,” he said. “But it appears that just the opposite has been happening — vaping has been pushing down smoking. Although we’d all prefer that none of our teens vape, the current scientific consensus is that vaping is far less dangerous than smoking. So until teen nicotine use drops to zero, this is a major step in the right direction.”

2021 NATIONAL YOUTH TOBACCO SURVEY

20,413 students from 279 schools responded

High School

  • 1.9% smoked cigarettes in prior 30 days (compared to 22.9% in 2002)
  • 0.4% smoked cigarettes regularly (20+ days)
  • 11.3% vaped in prior 30 days (compared to 27.5% in 2019)

Middle School

  • 1.0% smoked cigarettes in prior 30 days (compared to 10.1% in 2002)
  • 0.2% smoked cigarettes regularly (20+ days)
  • 2.8% vaped in prior 30 days (compared to 10.5% in 2019)

Multiple surveys show that most Americans erroneously believe that vaping is just as dangerous as — or even more dangerous than — smoking. Contributing to this belief was the rash of serious lung injuries that occurred in the U.S. in the summer of 2019 through early 2020, which the CDC labeled EVALI (E-cigarette or Vaping Use-Associated Lung Injury). More than 2,800 cases of EVALI were reported to the CDC by February 2020, including 68 deaths. Investigations later revealed that it was not caused from vaping commercial nicotine e-cigarettes but by inhaling vitamin E acetate, a chemical added to some illicit THC vaping products. This also explained the limited timeframe and geographic distribution of EVALI cases.

“We tend to focus on the negative, especially during these challenging times, but the most recent CDC tobacco survey is loaded with good news that really deserves to be publicized and celebrated,” said Brandon. “We still have work to do to further reduce cancer and other tobacco-related diseases, but let’s acknowledge this great progress among teens.”