Twenty-three percent of middle and high school students in the U.S. – a total of 6.2 million youth – have used a tobacco product in the past 30 days, according to the The National Youth Tobacco Survey results released yesterday.

Why that matters: Most long-term tobacco product use begins during adolescence – and tobacco use is the leading cause of preventable disease, disability, and death in this country and many others.

e-Cigarettes are the favorite

The data shows an overwhelming preference among young people for for e-cigarettes, which were used by 27.5 percent of high school students and 10.5 percent of middle school students followed in order by cigars, cigarettes, smokeless tobacco, hookahs, and pipe tobacco.

Among students who reported ever having tried e-cigarettes, the three most commonly selected reasons for use were “I was curious about them” (55.3 percent), “friend or family member used them” (30.8 percent), and “they are available in flavors, such as mint, candy, fruit, or chocolate” (22.4 percent).

Many of the respondents saw little or no harm in intermittent tobacco use of e-cigarettes (28.2 percent), hookahs (16.4 percent), smokeless tobacco products (11.5 percent) and cigarettes (9.5 percent).

"Predatory targeting" of youth

The report also details how young people are targeted by the tobacco industry, with nearly 9 out of 10 middle and high school students (22.9 million) reporting exposure to advertisements for tobacco products, 69.3 percent of which reported exposure to e-cigarette marketing specifically.

In response to the report, the American Cancer Society (ACS) issued a statement slamming “Big Tobacco” for continuing “to market e-cigarettes to kids and lie about the health threats of these products, the numbers tell the real story. Most of the young people surveyed said they had been exposed to ads and promotions from the tobacco industry…it is clear that the tobacco industry continues with its predatory targeting of our youth.”

The authors of the report urge public health professionals, health care providers, policymakers, educators, parents, and others who influence youths to help protect youths from the harms of all tobacco products. “In addition, the comprehensive and sustained implementation of evidence-based tobacco control strategies, combined with FDA’s regulation of tobacco products, is important for reducing all forms of tobacco product use among U.S. youths.”

Health group wants government action

That’s not enough for the ACS, which wants the FDA to take steps to crack down on “tobacco companies’ aggressive targeting of children,” including:

  • Immediately removing flavored e-cigarettes from the market;
  • Banning all other flavored tobacco products, including flavored cigars and menthol cigarettes;
  • Prohibiting all marketing practices, including those on social media, that are shown to appeal to children;
  • Suspending online sales of e-cigarettes until effective age verification mechanisms are established; and
  • Enforcing rules that prevent the sale of products that were not commercially marketed as of August 8, 2016, or were modified after that date, without premarket review.

“This report is further evidence that the tobacco industry is succeeding in addicting a new generation to nicotine. Absent immediate and urgent action, the epidemic of youth tobacco use will further spiral into an even greater public health crisis.”

The AHA recently launched a major three-pronged initiative to battle the growing epidemic of youth e-cigarette use addressing nicotine addiction through scientific research investment, policy and advocacy development and support for students and school leaders in communities across the country. Learn more at