The 2023 National Youth Tobacco Study is important for the data it reports and notable for what it leaves out. The study is produced annually by the Centers for Disease Control and Prevention (CDC). It’s straight-up statistical data on tobacco use by 6th through 12th graders. They’ve left it for others to figure out the broader insights, indications and reasons for the future of tobacco use.
The latest report, completed in November 2023, concludes that continued vigilance and enforcement to curb underage tobacco use is called for. No surprises there. The study is a self-administered, web-based survey of middle-school and high school students. They’ll become adults in a few years to influence how tobacco is presented by c-stores.
The survey uses two tobacco usage metrics for its teen smoker basis: a) “Ever Used” which means “even once or twice” in their lives, and b) “Currently Use,” defined as more than once in the past 30 days. “Currently Use” is also broken out by frequency; over-and-under 20 days or more per month. For me, this is the important metric because it shows regular usage beyond experimenting or short-term peer approval.
For example, the 2023 data shows that vape usage 20 days or more a month is 45% of the students who “currently use” e-cigarettes. But that’s only 2.6% of the CDC’s adjusted teen census of 28 million. Important, but not as alarming as the broader 11.4% number in news reports (Note: Census data shows 30 million people in the 12-18 age group — the CDC appears to cut off some 12 and 18 year-olds for school grade totals of 28 million).
There’s A Lot More To Puff, Vape And Pinch These Days
CDC’s Youth Tobacco Study covers nine different forms of tobacco, a lot more today than just cigarettes and other tobacco products (OTP). This is why the study’s data, adjusted to U.S. census totals, shows only 1.5% of 2023 middle school and high school kids smoked cigarettes and cigars more than 20 days a month.
By comparison, according to the CDC, daily or near daily cigarette use by 18-24 year-olds was 5.3% of that census segment in 2023. Collectively, older age segments (35 to 65 year-olds) are 14% to 16% daily or near daily use.
The CDC’s combined reports show that around nine times more 45 year-olds than teens smoke cigarettes. This is a significant difference, even with fake IDs.
Historically, the huge majority of smokers started during their teen years, according to the Journal of the American Medical Association (JAMA). Four times as many of today’s teen parents began smoking cigarettes in their teens. Did parents talk their own kids out of smoking? Are health alerts the reason? The survey doesn’t ask.
At the other end of the risk continuum, current 30-day teen vape use in 2023 declined to 7.6% of the middle school and high school population. This is what teen tobacco users chose instead of cigarettes. Still huge, but a big decline from the 2021 11.4% spike. If you cull it down to daily or near daily teen vape use, it’s still four times greater than teen use of cigarettes or cigars. “Dad doesn’t want to smell any cigarette smoke in the car.”
The FDA is rightly focused on future youth tobacco use. I’m more interested in what these kids will be buying as they age up into 21-25-year-olds and beyond. Elements and trends of the 2023 Tobacco Study imply that today’s middle school and high school kids are undertaking tobacco products much less than prior teen generations. Emergence from the COVID-19 pandemic, alcohol, cannabis, peer shaming, health awareness and the electronic tether of mobile devices are re-ranking tobacco’s role for teens as a personal statement or leisure activity.
So What’s Going On?
Current alcohol use by 12-20-year-olds is three times greater than tobacco. Some 6.3% of teens reported current marijuana use multiple times in the past 30 days.
Cultural attitudes, media influences, fast-paced stress and generational personal electronics are changing how they spend their time and what they think about. If you look at the smaller percentage of cigarette usage of 18-24-year-olds compared to older age groups, it’s not that they quit. It’s more likely they never ventured beyond “ever used.”
Along with the new decline in vape and combustible usage, are signs that something else is happening. Current use of “any tobacco product” declined by an estimated 540,000 kids in 2023 versus 2022. In the 2021 study, menthol or mint flavor was the vape choice of 30% of surveyed teens. By 2023, menthol vape flavor preference was less than 10% of surveyed youth e-cigarette smokers. Compared to census data, that’s less than 1% of the total 12-18-year-old population. Current menthol cigarette use by teens is 6/10th of 1%. Daily and near-daily use is half. CDC data shows that. The report doesn’t.
The dramatic fall-off in response rate to the 2023 survey is another signal that 12 to 18-year-olds have other things to do. The 2021 and 2022 survey responses were 45% and 44%. The 2023 survey barely achieved a 31% response rate. Did playing Candy Crush and Dead by Daylight on cell phones replace smoking as a leisure habit?
The tobacco rite of passage for many of their parents may not be such a big a deal anymore. You can’t smoke and play video games at the same time.
Meanwhile, cigarettes and cigars are where the FDA has proposed flavor bans. C-stores are waiting to adjust their tobacco backbars to FDA menthol and flavor bans that may not show up until early 2026.
And after the bans are enforced, the current crop high-schoolers will age up into 18-24 and 25-35-year-old c-store shoppers. Fewer of them than their parents will be smokers, vape use is declining and 12% of senior smokers are projected to quit as the flavor ban is enforced.
Teens Shop The Whole Store
The Youth Tobacco study doesn’t go past tobacco data. It doesn’t address teen food trends, snacks, recharging their electronics or c-store visits. There are two chain-franchised c-stores a short walk from my granddaughter’s high school. At 2:45 p.m., and again after sports practice, 100 or so hungry teenagers buy and eat at outside tables or in their cars on the way home. 7-Eleven is adjusting its corporate strategy because it figured out what’s coming. Others are already there.
According to NACS, prepared foods grew 12% last year to $51,000 per store to become the leading category. Teens eat food. Food and beverage sales were 27% of total store revenue, returning 35% profit. Teens drink hot and cold beverages.
Caffeine is still legal. In-store sales totaled $327 billion. Teens spend money.
Tobacco unit sales declined 4.5%. Fewer teens are smoking. “We’re stopping for gas and road food on the way to the concert. I promised mom nobody would smoke in the car.”
Afterthought
Last year, teen tobacco use declined more than twice as fast as the decrease in use by more mature age groups. Beyond tobacco, there will be nicotine-free, non-tobacco menthol filtered smokes, and alternative products using CBD, cannabis and other botanicals coming to market. They all fall outside of the FDA’s deeming authority for rulemaking.
Congress only gave the FDA tobacco, and the White House wants to cap nicotine. The c-store industry is preparing for a smaller tobacco section, but if the CDC is right, the advice they’re getting regarding trends to alternative nicotine and non-combustibles may be optimistic.
