Latest Data Show More Than 2.1 Million U.S. Youth Currently Use E-Cigarettes

Cigarette smoking is an old behavior, socially acceptable among adults but prohibited among youth, and for good reasons.

Firstly, nicotine, the drug in cigarettes, has a brain-rewarding effect that triggers the feel-good hormone dopamine when inhaled and is, for that reason, addictive.（1）

Secondly, exposure to nicotine among youth has adverse effects on their brain development. Studies show that exposure to nicotine in adolescents impairs the way their brain responds to reward-related stimuli and the resulting behavior.（2）

So, how do e-cigarettes come in?

E-cigarettes are devices that use a battery to heat a nicotine-containing liquid into an inhalable aerosol or vapor. Although some brands claim their products are nicotine-free, tests on these brands show they have the drug in varied amounts, while others record more or less nicotine than what’s on the label.（3）

Unfortunately, data confirm that e-cigarettes are the most popular tobacco product consumed among youth. In fact, the mentioned survey established this fact for the 10th consecutive year. And, despite active efforts by agencies such as the FDA and CDC to curb e-cigarette and other tobacco product use, their consumption among U.S. youth is significantly high.

So, exactly how high is e-cigarette consumption among U.S. youth? The figures in the section below will leave you worried.

Data from the 2023 annual National Youth Tobacco Survey reports that 2.1 million U.S. youth currently consume e-cigarettes. That’s about 7.7% of students in middle and high schools.（4）

While there’s a silver lining in the fact that the figure dropped from 2.5 million (9.4%) in 2022, the numbers are still worrying. After all, tobacco consumption is a public health issue, and its continued use among youth pulls back the FDA’s efforts to stop it.

Additional data from the survey also reports a ray of hope among high school students but not middle school students. Among high school students, e-cigarette consumption dropped to 10% from 14.1% in 2022. Instead, the figure among middle school students went up from 3.3% in 2022 to 4.5% in 2023.（2,5）

These figures point to a more worrying situation among younger students. And the numbers are not the only ones highlighting how dire the situation actually is.

Besides, these devices should only be handled by trained professionals who know how to carry out the procedure, interpret the images, and write a signed comprehensive report.（1）

Here are a few other figures that show the current situation regarding e-cigarette use among U.S. youth:

The changes in the 2022 data reflect some of the key steps the FDA has taken to control e-cigarette brands consumed among youth. You can read more about the FDA’s efforts to stop the trend in the following section.

Following an April 14, 2022, federal law passed by Congress, the U.S. Food and Drug Administration, FDA, is authorized to regulate tobacco products with nicotine from natural or synthetic sources. That includes the non-tobacco nicotine (NTN) commonly used in e-cigarettes.

With this authority, the FDA has authorized the sale of some e-cigarette products to U.S. adults. However, the agency also uses its mandate to regulate tobacco products by consistently cracking down on the sale of e-cigarette brands with high appeal to youth sold without authorization.

For example, of the top 3 commonly used e-cigarette brands among youth in 2022, the brands responsible for selling Puff Bar, PVG2, LLC, and EVO Brands LLC received a warning letter for selling the product without authorization.

In response, the companies would have to explain how they will stop the sale of these e-cigarettes and consistently comply with the FDA directives within 15 days. Failure to comply would lead to regulatory action like product seizure and civil money penalties against the manufacturer.

In the same year, the FDA also denied marketing authorization orders to Magellan Technology Inc. for the sale of Hyde e-cigarettes. The Agency established that the flavored e-cigarettes would not add any recognizable benefits to adult users, even while posing risks to users among the youth.

As such, permitting their sale would cause an undesirable risk to public health. So, the manufacturer must remove the product from the market, failure to which it would call enforcement action upon itself.

Unfortunately, a similar trend is recorded in 2023.

The Elf Bar and Esco Bars brands, which were top on the list of the most commonly consumed e-cigarettes among U.S. youth in 2023, also received warning letters alongside other 187 retailers of e-cigarettes in June of the same year.

Later in the year, the third most popular e-cigarette brand among youth in 2023, Vuse, was also denied a marketing order by the FDA for 6 of its flavored e-cigarettes.

All this underlines that the risky and unregulated sale of e-cigarettes to U.S. youth remains a real challenge. But you should also know about the continued efforts of the FDA and what you could do to contribute to these efforts.

E-cigarette brands sold without premarket authorization are illegal, and the FDA can take enforcement action against the manufacturers and distributors of these brands.

Enforcement action on these retailers and distributors can be in the form of injunctions, seizures, or civil money penalties.

You should consistently check the FDA’s Tobacco Product Marketing Orders page to see which brands the agency has authorized.

Additionally, you should also use this online form to notify the FDA of any violations of its directives against the sale of tobacco products and e-cigarettes to youth.

The FDA will not issue marketing orders for premarket e-cigarette applications that don’t show evidence they meet the set public health standards. This is especially true if the brands promote consumption among youth.

Besides, the agency consistently monitors brand compliance with its orders.

Youth are considered the present and future of any nation. As such, the consumption of substances that can compromise their well-being counts as a threat to public health and the well-being of the entire nation.

E-cigarettes can negatively affect the mental development of adolescents. For that reason, e-cigarette brands, which appeal to youth and are sold without authorization must be removed from the market.

In the U.S. the FDA continues to crack down on these rogue brands in favor of the nation’s youth wellbeing.

You can also contribute to this noble cause by reporting non-compliance by any of these brands.

1. NIDA. Is nicotine addictive? 2021.

2. Castro EM, Lotfipour S, Leslie, FM. Nicotine on the developing brain, Pharmacological Research, 2023; 190: 106716

3. Taylor A, Dunn K, Turfus S. A review of nicotine-containing electronic cigarettes—Trends in use, effects, contents, labelling accuracy and detection methods. Drug Test Anal. 2021; 13: 242–260.

4. FDA. Results from the Annual National Youth Tobacco Survey, 2023.

5. FDA. Results from the Annual National Youth Tobacco Survey, 2022.