<i>Notes from the Field:</i> E-Cigarette and Nicotine Pouch Use Among Middle and High School Students — United States, 2024

Abstract

Current e-cigarette use among U.S. youth has declined considerably since 2019*; however, approximately 2.13 million youths used e-cigarettes in 2023 (1).As sales of nicotine pouches (small, dissolvable, flavored pouches containing nicotine derived from tobacco that users place in the mouth between the lip and gum) have continued to rise nationally since 2016, their use among U.S. youths has become concerning (2,3).All pouches and most e-cigarettes contain nicotine, which is highly addictive and can harm the developing adolescent brain (4,5). Investigation and OutcomesThe Food and Drug Administration and CDC analyzed nationally representative data from the 2024 National Youth Tobacco Survey (NYTS), a cross-sectional, school-based, self-administered web-based survey of U.S. students in middle school (grades 6-8) and high school (grades 9-12), which was conducted among 29,861 students from 283 schools during January 22-May 22, 2024. Current (i.e., past-30-day) use of e-cigarettes and nicotine pouches was assessed overall, and by frequency of use, device type used for e-cigarettes, any brand and usual brand used,** and flavor types.Weighted prevalence estimates, 95% CIs, and population totals were calculated using SAS-callable SUDAAN software (version 11.0.4;RTI International). Changes in current use since * http://dx.doi.org/10.15585/mmwr.ss6812a1 Unlike other smokeless tobacco products, such as snuff and snus, nicotine pouches do not contain any tobacco leaf. E-cigarettes: https://www.fda.gov/tobacco-products/products-ingredientscomponents/e-cigarettes-vapes-and-other-electronic-nicotine-deliverysystems-ends;nicotine pouches: https://www.fda.gov/tobacco-products/ products-ingredients-components/other-tobacco-products. In 2024, the student-level participation rate was 78.3%, and the school-level participation rate was 42.7%, for an overall response rate of 33.4%.** Brand response options were: blu, Breeze, Elf Bar, Esco Bars, Fume, JUUL, HQD, Kangvape (including Onee Stick), Logic, Mr. Fog, NJOY, SMOK (including NOVO), Suorin (including Air Bar), Vuse, "some other brand(s) not listed here," and "I don't know the brand."Those who selected "some other brand(s) not listed here" could provide a write-in response.Write-in responses were recoded into valid responses.Estimates for Geek Bar and Lost Mary were based on the write-in responses and might be underestimated. Data were weighted to account for complex survey design and to adjust for nonresponse.The weighted proportions of students in each grade matched national population proportions for U.S. public and private schools derived from data from the National Center for Education Statistics (2021-2022 Common Core of Data and 2019-2020 Private School Universe Study) and Market Data Retrieval, Inc. Population number estimates were rounded down to the nearest 10,000 students.

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