Teens' Tobacco Use a Changing Landscape

Tobacco use study on teens showed increase in electronic cigarettes and hookahs

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Measuring teens' tobacco use no longer means just seeing if they smoke cigarettes. A new study suggests that teens may be increasing their use of new or different tobacco products.

The study looked at the use of tobacco products among American middle and high schoolers during 2012.

The study found that overall tobacco use dropped slightly, but increases were seen in the use of products like electronic cigarettes and hookahs.

"Seek professional help if you're struggling to quit smoking."

According to the authors of this study, who were led by René A. Arrazola, MPH, of the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health, almost 90 percent of adult smokers in the US began smoking by the time they were 18 years old, making understanding youth smoking key.

Arrazola and team used data from the 2012 National Youth Tobacco Survey, administered to middle school (grades 6 through 8) and high school (grades 9 through 12) students at 228 schools across the US. In total, 24,658 students completed the survey and the results were used to estimate national figures.

Tobacco products for the survey included cigarettes, cigars (including cigarillos), smokeless tobacco, pipes, bidis and kreteks.

Also included were hookahs, snus, dissolvable tobacco and electronic cigarettes, which were added to the definition of tobacco use starting with the 2011 survey.

Current use of a tobacco product was defined as using the product on more than one day during the previous 30 days.

The researchers found that in 2012, 6.7 percent of American middle school students and 23.3 percent of American high school students reported current use of any tobacco product.

By comparison, the 2011 results showed 7.5 percent of middle school students and 24.3 percent of high school students reporting current tobacco use.

In 2012, cigarettes were the most commonly used product, as 12.6 percent of students reported using cigarettes. Cigars were the next common tobacco product, with a prevalence of 2.8 percent.

The study authors reported that electronic cigarette use increased for the year 2012. In 2011, 0.6 percent of middle school students reported using the products, and in 2012 this number increased to 1.1 percent. Among high school students, 1.5 percent reported using electronic cigarettes in 2011 and 2.8 percent in 2012.

Hookah use also increased among high school students, from 4.1 percent in 2011 to 5.4 percent in 2012.

However, the researchers did find decreases in the use of bidis (small brown cigarettes wrapped in a leaf) and kreteks (clove cigarettes) among both middle and high school students, and a decrease in the use of dissolvable tobacco among high school students.

"A substantial proportion of youth tobacco use occurs with products other than cigarettes, so monitoring and prevention of youth tobacco use needs to incorporate other products, including new and emerging products," Arrazola and team wrote.

It is important to note that the findings were based on self-reports from students, which may leave room for error and bias.

This study was published November 15 in the CDC's Morbidity and Mortality Weekly Report. No conflicts of interest were reported.

Review Date: 
November 16, 2013
Last Updated:
November 18, 2013