ArticleLancet regional health. Americas2027
Nicotine and tobacco product use among US youth in 10th and 12th grade, 2023-2025: a repeated cross-sectional study.
Article in Lancet regional health. Americas, 2027. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Youth nicotine/tobacco use has shifted in recent decades. Updated national estimates are essential for policy and practice. We examined changes in youth nicotine/tobacco use in the United States (US) across three annual surveys (2023-2025) and assessed sociodemographic correlates and multi-product co-use patterns in 2025. Methods: Self-reported lifetime and past-30-day use of seven nicotine/tobacco products were analyzed among US 10th and 12th graders (2023-2025; n = 47,524; mean age 17.0 years [standard deviation 1.1]; 47.5% female, 48.6% male, 3.8% reported another sex or preferred not to report; 41.0% non-Hispanic White, 22.3% Hispanic, 16.5% Multiracial, 13.7% non-Hispanic Black) in Monitoring the Future's nationally representative cross-sectional survey. Changes in prevalence across the three survey years were examined using survey-weighted log-binomial regression. Findings: Lifetime nicotine pouch use increased from 3.1% in 2023 to 7.5% in 2025 (average annual prevalence ratio [PR] 1.53, 95% confidence interval [CI] 1.32-1.78, Interpretation: There was little evidence of change in US youth nicotine/tobacco use, except for rising nicotine pouch use. Combustible tobacco use remained at historically low levels. In 2025, use was concentrated in sociodemographic groups and marked by high multi-product use. Funding: National Cancer Institute, National Institute on Drug Abuse, US Food and Drug Administration, and Tobacco-Related Disease Research Program of the University of California.
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