Current e-cigarette use among U.S. youth has declined considerably since 2019*; however, approximately 2.13 million youths used e-cigarettes in 2023 (1). As sales of nicotine pouches (small, dissolvable, flavored pouches containing nicotine derived from tobacco that users place in the mouth between the lip and gum)† have continued to rise nationally since 2016, their use among U.S. youths has become concerning (2,3). All pouches and most e-cigarettes contain nicotine,§ which is highly addictive and can harm the developing adolescent brain (4,5).

The Food and Drug Administration and CDC analyzed nationally representative data from the 2024 National Youth Tobacco Survey (NYTS), a cross-sectional, school-based, self-administered web-based survey of U.S. students in middle school (grades 6-8) and high school (grades 9-12), which was conducted among 29,861 students from 283 schools during January 22-May 22, 2024. Current (i.e., past-30-day) use of e-cigarettes and nicotine pouches was assessed overall, and by frequency of use, device type used for e-cigarettes, any brand and usual brand used,** and flavor types. Weighted prevalence estimates, 95% CIs, and population totals were calculated using SAS-callable SUDAAN software (version 11.0.4; RTI International). Changes in current use since 2023 were evaluated using t-tests; p-values <0.05 were considered statistically significant. The 2023 NYTS data collection methods and estimates have been published (1). This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.

In 2024, 5.9% of middle and high school students reported current e-cigarette use, including 7.8% of high school students and 3.5% of middle school students (Table). Among students who currently used e-cigarettes, 38.4% reported frequent use, and 26.3% reported daily use. The device types used most often by students reporting current e-cigarette use were disposables (55.6%), followed by prefilled or refillable pods or cartridges (15.6%) and tanks or mod systems*** (7.0%); 21.8% of students currently using e-cigarettes were unsure of the device type used. Among students who currently used e-cigarettes, 36.1% used Elf Bar, followed by Breeze (19.9%), Mr. Fog (15.8%), Vuse (13.7%), and JUUL (12.6%); 87.6% used a flavored product; fruit (62.8%), candy (33.3%), and mint (25.1%) were the flavor types most frequently reported.

In 2024, 1.8% of middle and high school students reported current nicotine pouch use, including 2.4% of high school students and 1.0% of middle school students. Among students who currently used nicotine pouches, 29.3% reported frequent use, and 22.4% reported daily use. Among students reporting current nicotine pouch use, 68.7% used ZYN, followed by on! (14.2%), Rogue (13.6%), Velo (10.7%), and Juice Head ZTN (9.8%); 85.6% used a flavored product: mint (53.3%), fruit (22.4%), and menthol (19.3%) were the flavor types most frequently reported.

From 2023 to 2024, current e-cigarette use declined among middle and high school students overall (from 7.7% to 5.9%; p<0.05) and high school students (from 10.0% to 7.8%; p<0.05). No significant changes were observed for current e-cigarette use among middle school students or for current nicotine pouch use among high school students or middle and high school students overall.