Tobacco Use Among Middle and High School Students: 2025 National Youth Tobacco Survey.

BACKGROUND AND

OBJECTIVES

This paper summarizes 2025 findings of the National Youth Tobacco Survey (NYTS) regarding middle and high school students' use of tobacco and compares these findings with historical information on the 2 most common products used by youth, e-cigarettes and nicotine pouches.

METHODS

Prevalence estimates from the NYTS public use dataset, accounting for complex survey design, are presented.

RESULTS

Tobacco use continued declining through 2025, when 7.2% of youth used tobacco. Only nicotine pouches increased, doubling from 0.8% in 2021 to 1.7% in 2025. Pouches were the second-most-used tobacco product, after e-cigarettes (5.2%). Most youth used flavored tobacco products. E-cigarette use intensity increased over time, with daily use growing from 9.4% in 2014 to 35.4% in 2025. Dual and poly use is common among e-cigarette and pouch users.

CONCLUSION

Although progress continued in reducing overall youth tobacco use, nicotine pouch use doubled. The changing market, elimination of the Centers for Disease Control and Prevention Office on Smoking and Health, and protobacco Food and Drug Administration regulatory decisions threaten progress in youth tobacco control, increasing the importance of state and local tobacco control policies, including comprehensive flavor bans, smokefree laws, and consistently higher taxes across all tobacco products.