Flavored Tobacco Product Use Among Middle and High School Students - United States, 2014-2018

Abstract

The 2009 Family Smoking Prevention and Tobacco Control Act prohibits the inclusion of characterizing flavors (e.g., candy or fruit) other than tobacco and menthol in cigarettes; however, characterizing flavors are not currently prohibited in other tobacco products at the federal level.* Flavored tobacco products can appeal to youths and young adults and influence initiation and establishment of tobacco-use patterns (1). The Food and Drug Administration (FDA) and CDC analyzed data from the 2014-2018 National Youth Tobacco Surveys (NYTS) to determine prevalence of current (past 30-day) use of flavored tobacco products, including electronic cigarettes (e-cigarettes), hookah tobacco, cigars, pipe tobacco, smokeless tobacco, bidis, and menthol cigarettes among U.S. middle school (grades 6-8) and high school (grades 9-12) students. In 2018, an estimated 3.15 million (64.1%) youth tobacco product users currently used one or more flavored tobacco products, compared with 3.26 million (70.0%) in 2014. Despite this overall decrease in use of flavored tobacco products, current use of flavored e-cigarettes increased among high school students during 2014-2018; among middle school students, current use of flavored e-cigarettes increased during 2015-2018, following a decrease during 2014-2015. During 2014-2018, current use of flavored hookah tobacco decreased among middle and high school students; current use of flavored smokeless tobacco, cigars, pipe tobacco, and menthol cigarettes decreased among high school students. Full implementation of comprehensive tobacco prevention and control strategies, coupled with regulation of tobacco products by FDA, can help prevent and reduce use of tobacco products, including flavored tobacco products, among U.S. youths (2,3).

FIGURE

Percentage of current tobacco product^, users in high school and middle school who reported using flavored products during the preceding 30 days, by tobacco product — National Youth Tobacco Survey, United States, 2014–2018 * For 2014–2015, any tobacco is use of cigarettes, cigars, smokeless tobacco, e-cigarettes, hookahs, pipe tobacco, snus, or dissolvables on ≥1 day in the preceding 30 days. For 2016–2018, any tobacco is use of cigarettes, cigars, smokeless tobacco, e-cigarettes, hookahs, pipe tobacco, snus, dissolvables, or bidis on ≥1 day in the preceding 30 days. Exclusion of bidis from any tobacco use for 2016, 2017, and 2018 did not change the estimates. ^† Use of flavored bidis was only asked beginning in 2016, so estimates of flavored bidi use are not available for 2014–2015. For middle school estimates, use of flavored pipe tobacco and bidis are not shown because the individual estimates needed to be suppressed as a result of small sample size, relative standard error >30%, or both.