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Flavored tobacco product use among middle and high school students—United States, 2014–2018
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The 2009 Family Smoking Prevention and Tobacco Control Act prohibits the inclusion of characterizing flavors (e.g., candy or fruit) other than tobacco and menthol in cigarettes; however, characterizing flavors are not currently prohibited in other tobacco products at the federal level.*Flavored tobacco products can appeal to youths and young adults and influence initiation and establishment of tobacco-use patterns (1).The Food and Drug Administration (FDA) and CDC analyzed data from the 2014-2018 National Youth Tobacco Surveys (NYTS) to determine prevalence of current (past 30-day) use of flavored tobacco products, including electronic cigarettes (e-cigarettes), hookah tobacco, cigars, pipe tobacco, smokeless tobacco, bidis, and menthol cigarettes among U.S. middle school (grades 6-8) and high school (grades 9-12) students.In 2018, an estimated 3.15 million (64.1%) youth tobacco product users currently used one or more flavored tobacco products, compared with 3.26 million (70.0%) in 2014.Despite this overall decrease in use of flavored tobacco products, current use of flavored e-cigarettes increased among high school students during 2014-2018; among middle school students, current use of flavored e-cigarettes increased during 2015-2018, following a decrease during 2014-2015.During 2014-2018, current use of flavored hookah tobacco decreased among middle and high school students; current use of flavored smokeless tobacco, cigars, pipe tobacco, and menthol cigarettes decreased among high school students.Full implementation of comprehensive tobacco prevention and control strategies, coupled with regulation of tobacco products by FDA, can help prevent and reduce use of tobacco products, including flavored tobacco products, among U.S. youths (2,3).NYTS is an annual cross-sectional, school-based, selfadministered, pencil-and-paper questionnaire administered to U.S. middle and high school students.† A three-stage cluster sampling procedure was used to generate a nationally representative sample of U.S. students attending public or private schools in grades 6-12.This report uses data from five NYTS waves (2014)(2015)(2016)(2017)(2018).Sample sizes and response * Family Smoking Prevention and Tobacco Control Act [Pub.L. No. 111-31, H.R.
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“Whereas the use of tobacco cigarettes has declined in the United States within recent years, the use of electronic cigarettes (e-cigarettes) has increased exponentially (Cullen et al., 2019; Miech et al., 2019).”
From Unique, long-term effects of nicotine on adolescent brain. (2020) · cites this paper as Cullen et al., 2019
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“In absolute numbers, the National Youth Tobacco Survey shows that ~5 million students in grades 6–12 have tried e-cigarettes within the past 30 days, an increase from ~3.6 million in 2018 (Cullen et al., 2019).”
From Unique, long-term effects of nicotine on adolescent brain. (2020) · cites this paper as Cullen et al., 2019
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“Although there has been a decline in teen use of cigarettes in recent years, there has been a huge increase in nicotine vaping.”
From Unique, long-term effects of nicotine on adolescent brain. (2020) · cites this paper as Cullen et al., 2019
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“the advent of electronic cigarette products has led to a resurgence of nicotine use among adolescents [167, 168]”
From Consequences of adolescent drug use (2023) · cites this paper as [167]
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“Of these, nearly 1 million are vaping daily.”
From Unique, long-term effects of nicotine on adolescent brain. (2020) · cites this paper as Cullen et al., 2019
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Metadata
- Authors
- Cullen, K. A., Liu, S. T., Bernat, J. K., Slavit, W. I., Tynan, M. A., King, B. A., & Neff, L. J.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Cullen, Karen A.
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2019-10-04
- Volume
- 68
- Issue
- 39
- Pages
- 839-844
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC6776376
- OpenAlex
- W2978784026
- Cited by
- 181
- References
- 14
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 10 · 2023: 12 · 2022: 17 · 2021: 23 · 2020: 22 · 2019: 26
- FWCI
- 15.08
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Keywords
- flavored tobacco products, youth tobacco use, electronic cigarettes, hookah tobacco, menthol cigarettes, cigars, pipe tobacco, smokeless tobacco, bidis, tobacco product regulation, Family Smoking Prevention and Tobacco Control Act, junior high school students, high school students, National Youth Tobacco Survey
- MeSH terms
- Smoking Prevention, Adolescent, Child, Female, Flavoring Agents, Health Surveys, Humans, Male, Schools, Students, Tobacco, Smokeless, United States, United States Food and Drug Administration, Prevalence, Tobacco Products, Tobacco Use, Electronic Nicotine Delivery Systems
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