On November 2, 2023, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) released data from the 2023 National Youth Tobacco Survey (“NYTS”), a cross-sectional, school-based, self-administered, web-based survey of U.S. middle school (grades 6-8) and high school (grades 9-12) students. The NYTS has been conducted periodically during 1999–2009 and annually since 2011, and provides national data on estimates of tobacco product use among U.S. youth.

• In 2023, data were collected from March to June 2023 from more than 22,000 students across 179 schools.
• The data show a significant drop in high school vaping — the lowest in nearly a decade. Current e-cigarette use (defined as use on one or more days during the past 30 days) declined from 14.1% in 2022 to 10% in 2023 among high school students. More than half a million fewer U.S. high school students vaped in 2023 compared to 2022.
• Among U.S. high school students, current overall tobacco product use also dropped in 2023 (16.5% in 2022 to 12.6% in 2023). In its News Release, FDA attributes this decline “primarily” to reduced e-cigarette use.
• High school students’ current use of combustible tobacco products (e.g., traditional cigarettes) also declined in 2023 to 1.9, representing an all-time low for this tobacco product category.
• Although a slight increase in the use of tobacco products generally was observed among middle school students, no statistically significant shift was observed from 2022-2023 for current use of any tobacco product type by middle school students, including e-cigarettes.
• In sum, 10% of U.S. middle and high school students, or roughly 2.8 million youth, reported current use of any tobacco product in 2023. The 2023 numbers indicate a sharp decline from the 14.1% of high school students who reported current e-cigarette use in 2022. For more details on the trends in youth vaping, see Clive Bates’ summary here.

• FDA Center for Tobacco Products (CTP) Director Brian King described the “substantial decline in e-cigarette use among high schoolers” as a “win for public health,” with a call to “continue to build on this progress.”
• The continued decline in underage use of e-cigarettes may demonstrate that appropriate youth access restrictions and adult-focused marketing efforts are having a meaningful impact. If these trends continue, the U.S. marketplace may continue to see significant reductions in underage use balanced with continued access to adult smokers in a reasonably regulated marketplace. These data also call into question whether e-cigarettes really do serve as “gateway” products that lead to regular use of other, more dangerous combustible products such as cigarettes, a point that is often raised during public health debates surrounding electronic nicotine delivery systems (ENDS). 
• While acknowledging the progress made possible, in part, by appropriate public awareness and youth access restriction measures, the Agency has also announced that it is stepping up enforcement efforts against illegal, flavored disposable products that now appear to primarily contribute to youth ENDS use. FDA’s new wave of enforcement actions include civil money penalties (CMPs) against dozens of retailers for sale of illegal e-cigarettes with youth-appeal.

Thomas J. Smith, Law Graduate, also contributed to this article.