Evidence map›Paper›PMID 40557691›Full record

ArticleAddiction (Abingdon, England)2025

Changing patterns of nicotine product use and nicotine dependence among United States high-school students: The National Youth Tobacco Survey, 2014-2023.

Sarah E Jackson, Jamie Brown, Harry Tattan-Birch, Martin J Jarvis

Abstract read
In one paragraph

Article in Addiction (Abingdon, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sarah E JacksonDepartment of Behavioural Science and Health, University College London, London, UK.ORCID https://orcid.org/0000-0001-5658-6168
Jamie BrownDepartment of Behavioural Science and Health, University College London, London, UK.ORCID https://orcid.org/0000-0002-2797-5428
Harry Tattan-BirchDepartment of Behavioural Science and Health, University College London, London, UK.
Martin J JarvisDepartment of Behavioural Science and Health, University College London, London, UK.

Funding

Cancer Research UK PRCRPG-Nov21\100002
6 · The paper itself

Abstract

BACKGROUND AND

aimConcerns have been raised that e-cigarettes have created a new generation of people addicted to nicotine. This study aimed to measure changes in the proportion of US high-school students reporting symptoms of nicotine dependence over the past decade, in the context of changing patterns of nicotine product use.

designRepeat cross-sectional analyses of the 2014-2023 National Youth Tobacco Surveys.

settingUnited States of America.

participants107 968 high-school students (14-18y). MEASUREMENTS: Nicotine product use was categorised based on self-reported past-30-day use of cigarettes, other combustible tobacco, smokeless/non-combustible products and e-cigarettes. Nicotine dependence was operationalised as (a) strong past-30-day cravings to use tobacco and (b) wanting to use nicotine products within 30 minutes of waking.

findingsPast-30-day use of any nicotine product decreased from 24.5% (95% confidence interval = 22.5%-26.6%) to 19.6% (16.8%-22.4%) between 2014 and 2017, increased sharply, reaching 31.4% (29.0%-33.7%) in 2019 (driven by an increase in e-cigarette use), then fell to the lowest level at 12.5% (10.9%-14.1%) by 2023. The proportion who reported symptoms of nicotine dependence was substantially lower, but followed a similar pattern of changes over time. For example, the proportion reporting strong cravings decreased from 7.8% (6.6%-9.0%) to 5.5% (4.3%-6.7%) between 2014 and 2017, increased to 7.9% (6.8%-9.0%) between 2017 and 2018 and remained stable up to 2020, then fell to the lowest level at 2.5% (1.9%-3.1%) by 2023. While dependence symptoms were consistently highest among cigarette users, they were increasingly prevalent among those using only e-cigarettes after 2017.

conclusionsThe sharp rise in the prevalence of nicotine product use (in particular, e-cigarettes) among US high-school students in the late 2010s was short-lived and was not accompanied by a sustained increase in the overall population burden of nicotine dependence. By 2023, both nicotine product use and nicotine dependence had reached historic lows. However, dependence symptoms increased over time among those using e-cigarettes only.

Indexed as

StudentsTobacco ProductsTobacco Use DisorderVapingAdolescentCross-Sectional StudiesElectronic Nicotine Delivery SystemsFemaleHumansMaleUnited Statesadolescentsdependencee‐cigarettesnicotinesmokingtobacco products

Identifiers

PMID40557691
PMCPMC12529234

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.