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Tobacco Use Among Middle and High School Students: 2025 National Youth Tobacco Survey
1Retired UCSF Professor of Medicine.
Background And Objectives:
This paper summarizes 2025 findings of the National Youth Tobacco Survey regarding middle and high-school students use of tobacco and compares these findings with historical information on the two most common products used by youth, e-cigarettes and nicotine pouches.
Methods:
Prevalence estimates from the NYTS public use data set accounting for complex survey design.
Results:
Tobacco use continued declining through 2025, when 7.2% of youth used tobacco. Only nicotine pouches increased, doubling from 0.8% in 2021 to 1.7% in 2025. Pouches were the second most used tobacco product, after e-cigarettes (5.2%). Most youth used flavored tobacco products. E-cigarette use intensity increased over time, with daily use growing from 9.4% in 2014 to 35.4% in 2025. Dual and poly use is common among e-cigarette and pouch users.
Conclusions:
Although progress continued in reducing overall youth tobacco use, nicotine pouch use doubled. The changing market, elimination of CDC's Office on Smoking and Health, and pro-tobacco FDA regulatory decision threaten progress in youth tobacco control, increasing the importance of state and local tobacco control policies, including comprehensive flavor bans, smokefree laws, and consistent higher taxes across all tobacco products.
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