Work

Trends in exclusive and dual cigarette and electronic cigarette use among United States middle and high school students from 2017 to 2024: A cross-sectional analysis

Year: 2026

Type: article

Abstract: Introduction: The increase in electronic cigarette (e-cigarette) use among United States (US) middle and high school students raises public health concerns. Understanding cigarette and e-cigarette use patterns is crucial for targeted tobacco control policies. This study aimed to identify and characterize changes in trends of exclusive and dual use of cigarettes and e-cigarettes among US middle and high school students from 2017 to 2024, by grade and sex. Methods: We conducted a secondary analysis of the Monitoring the Future (MTF) survey, an annual, nationally representative cross-sectional survey of US students in Grades 8, 10, and 12 (2017-2024; N=227966). Students self-reported past 30-day cigarette and e-cigarette use via school-administered questionnaires. The survey's complex sampling design incorporated clustering, stratification, and weighting. We conducted joinpoint regression analyses by grade (8, 10, or 12) and sex (boys or girls). Results: The prevalence of daily cigarette use in the past 30 days between 2017 and 2024 decreased with annual percent changes (APCs) of -23.3% among Grade 12 boys (95% confidence interval [CI]: -31.7 - -13.9) and -29.5% among girls (95% CI: -35.6 - -22.9). Exclusive cigarette use declined significantly among Grade 12 boys from 2017 to 2024 (APC= -23.0%; 95% CI: -32.8 - -11.6) and girls from 2017 to 2020 (APC= -49.3%; 95% CI: -63.6 - -29.5). E-cigarette use increased sharply until 2019-2020, particularly among girls, then declined significantly mainly among boys; girls' use remained above 2017 levels (e.g. regular use among Grade 12 girls: average annual percent change [AAPC]=19.7%; 95% CI: 9.6-30.7). From 2017 to 2024, any dual use fell, especially among Grade 10 boys (APC= -16.2%; 95% CI: -22.1 - -9.9) and girls (APC= -14.3%; 95% CI: -18.4 - -9.9). Conclusions: Cigarette and dual use of cigarettes and e-cigarettes among US middle and high school students declined significantly from 2017 to 2024, suggesting positive shifts in tobacco use behavior, but stable e-cigarette use highlights an ongoing challenge in nicotine control among youth.

Source: Tobacco Induced Diseases

DOI: 10.18332/tid/231124

Authors: Yixian Chen, Evelyn Jimenez-Mendoza, Jihyoun Jeon, Rafael Meza

Institutions: University of Michigan, Rutgers, The State University of New Jersey, University of British Columbia, Rutgers Cancer Institute

Language: English

Topic: Smoking Behavior and Cessation

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,372