Frequency of Use Among Middle and High School Student Tobacco Product Users — United States, 2015–2017

Introduction:
This text reviews a study on tobacco product use among middle and high school students in the United States. The study, conducted by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), aimed to determine past 30-day frequency of use of cigarettes, e-cigarettes, cigars, smokeless tobacco, and hookahs among U.S. high school and middle school students.

Key Points:

* The study found that during 2015-2017, the proportion of students currently using cigarettes, cigars, e-cigarettes, smokeless tobacco, or hookahs who used each product ≥20 of the past 30 days ranged from 14.0% of cigar smokers to 38.7% of smokeless tobacco users among high school students and from 13.1% of e-cigarette users to 24.5% of hookah smokers among middle school students.
* The study also found that among current users, use of two or more tobacco products ranged from 76.7% (e-cigarettes) to 90.9% (hookahs) among those using the product ≥20 of the preceding 30 days, and from 48.8% (e-cigarettes) to 77.2% (cigarettes) among those using the product for 1 to 5 of the preceding 30 days.
* The study used data from the National Youth Tobacco Surveys (NYTS) from 2015-2017 and a three-stage cluster sampling procedure to generate a nationally representative sample of U.S. students attending public and private schools in grades 6-12.
* The study found that e-cigarettes were the most commonly used tobacco product by middle and high school students in 2017, followed by cigars and cigarettes.
* The study also found that for all assessed products, most current users reported using each product for 1-5 of the past 30 days.
* The study found that among middle and high school students who used any of these five products on ≥20 of the preceding 30 days, multiple tobacco products were used by 87.5% of cigarette smokers, 76.7% of e-cigarette users, 81.6% of cigar smokers, 77.0% of smokeless tobacco users, and 90.9% of hookah smokers.

Main Message:
The study highlights the importance of understanding tobacco product use patterns among youth, including frequency of use and multiple tobacco product use. The findings can inform strategies to prevent and reduce youth tobacco product use, such as increasing the price of tobacco products, implementing advertising and promotion restrictions and national public education media campaigns, and raising the minimum age of purchase for tobacco products to 21 years. The regulation of tobacco products, along with implementing proven tobacco control and prevention strategies, can reduce the initiation and use of tobacco products among youths.

Anic, Gabriella M., Michael D. Sawdey, Ahmed Jamal, and Katrina F. Trivers. “Frequency of Use Among Middle and High School Student Tobacco Product Users — United States, 2015–2017.” MMWR. Morbidity and Mortality Weekly Report 67, no. 49 (December 14, 2018): 1353–57. https://doi.org/10.15585/mmwr.mm6749a1.