In 2020, the number of middle and high school students who use e-cigarettes decreased by 1.8 million compared to 2019, the Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) reported in the results of the 2020 National Youth Tobacco Survey. However, the results also showed that youth tobacco use is still an epidemic in the United States.

  • 19.6% of high school students (3.02 million) and 4.7% of middle school students (550,000) are e-cigarette users.
  • Among users, 38.9% of high school students and 20% of middle school students report using e-cigarettes on 20 or more of the past 30 days.
  • 22.5% of high school users and 9.4% of middle school users report daily use.
  • Both middle (41.3%) and high school students (48.5%) most commonly use prefilled pods or cartridges.

 The annual survey collects responses from students in grades 6–12 across the United States and measures factors like demographics, a minor’s access to tobacco, and exposure to secondhand smoke. Historic data are also available. The survey is designed to gauge:

  • Prevalence of tobacco products
  • Knowledge and attitudes toward tobacco products
  • Attempts and successes to quit
  • Exposure to pro- and antitobacco influences

Tobacco usage continues in youth populations in part because sweet flavors are still aggressively marketed toward minors. The U.S. Congress and House of Representatives are responding to pleas from CDC and FDA, but a further decline in youth vaping is unlikely unless they enact stronger federal regulations around advertising and distribution.

ONS advocates for smoking cessation legislation and stricter regulations. View ONS’s position statement on e-cigarettes and vaping, and get involved through the ONS Center for Advocacy and Health Policy.