About 1 in 6 high school students vaped, smoked cigars or cigarettes, or used other tobacco products this year despite federal and state efforts to crack down on underage tobacco use, according to a federal study released Thursday.
The study analyzed data from the 2022 National Youth Tobacco Survey that showed vaping is far and away the most popular option for school-age kids: 14.1% of high school students and 3.3% of middle school students vaped nicotine-delivering devices at least once over the past 30 days.
Public health officials also worry that 3.7% of middle or high school students – about 1 million in all – smoked "combustible tobacco" products such as cigars or cigarettes, according to the Centers for Disease Control and Prevention and Federal Drug Administration study that's based on the survey data.
In all, nearly 3.1 million students in middle and high school vaped or used other tobacco products in the past month, according to the survey done Jan.18 through May 31.
Federal officials said survey changes make it difficult to compare this year's survey with prior years.
Erika Sward, the American Lung Association's assistant vice president of national advocacy, said the data shows the importance of enforcing existing laws and enacting new ones such as California's Proposition 31, approved by voters Tuesday to ban the sale of flavored and menthol tobacco products.
"These data continue to be extraordinarily troubling to us," Sward said. "Because having 3 million kids use these products is truly alarming."
Which tobacco products are kids using?
More than than 2.5 million students used e-cigarettes, the most popular tobacco product for underage users over the past nine years. Among teen vapers, 85% said they used flavored vapes and more than half used disposable e-cigarettes.
A half million teens smoked cigars, the second-most popular tobacco option, followed by cigarettes, smokeless tobacco, hookah, nicotine pouches, heated tobacco and pipe tobacco.
A small percentage of kids reported using multiple tobacco products over the past 30 days.
Expert: Who uses tobacco products 'directly correlated' to industry advertising
A look at notable demographics:
American Indian or Alaska Native students had the highest percentage of any tobacco product use at 13.5%.
White students had the highest vaping rate, 11%, among all racial and ethnic groups.
At 5.7%, Black students were more likely than other racial or ethnic groups to use combustible tobacco products such as cigars and hookahs.
16.6% kids who identified as transgender and 16% of kids who identified as lesbian, gay or bisexual reported vaping or tobacco use in the past month.
Kids with failing grades or psychological distress had higher rates of vaping or other tobacco use.
Matthew L. Myers, president of Campaign for Tobacco-Free Kids, a nonprofit that works to reduce tobacco use, said the higher use among some groups of students underscores the the importance of countering the tobacco industry's marketing.
"It isn't a coincidence that certain subpopulations are using very specific tobacco products at far higher numbers," Myers said. "It's directly correlated to where the tobacco industry has targeted its advertising."
Exposure to nicotine is dangerous to youth brain development
The study reported middle and high school students who used multiple tobacco products is "particularly concerning because it is associated with nicotine dependence, which increases the likelihood of sustained tobacco use in adulthood."
The study also cited the importance of restricting sales to underage users, banning flavored products, and prohibiting indoor use of tobacco products.
Sward said public health officials want to emphasize the importance of halting underage use of any nicotine-delivering device or product.
"We know that any exposure to nicotine by youth is dangerous for brain development, and we also know how dangerous that chemicals are to their lung health," Sward said.
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This article originally appeared on USA TODAY: Teen vaping and smoking: 1 in 6 used tobacco products in 2022