{
  "abstract": "Background\n\nYouth 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\n\nSelf-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\n\nLifetime 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, p < 0.0001), and past-30-day use rose from 1.2% to 2.9% (PR 1.45, 95% CI 1.19-1.75, p = 0.0012). Prevalences were largely unchanged for past-30-day cigar/cigarillo, combustible cigarette, e-cigarette, hookah, nicotine candy, and smokeless tobacco use and lifetime cigarette, e-cigarette, and smokeless tobacco use. In 2025, e-cigarettes were the most used product, followed by nicotine pouches. Use of several products was higher among male, rural, non-Hispanic White, and Multiracial youth, and those with lower parental education. Among users, co-use of multiple products was prevalent, with the strongest associations observed for combustible cigarette-e-cigarette co-use and nicotine pouch-smokeless tobacco co-use.Interpretation\n\nThere 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\n\nNational Cancer Institute, National Institute on Drug Abuse, US Food and Drug Administration, and Tobacco-Related Disease Research Program of the University of California.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.",
    "Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.",
    "USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA.",
    "Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.",
    "Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.",
    "Campaign for Tobacco-Free Kids, Washington, DC, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Dayoung Bae"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Junhan Cho",
      "orcid": "0000-0002-6617-1625"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Alyssa F Harlow"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yi-Chun Chang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Louisiana M Sanchez"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Steve Y Sussman",
      "orcid": "0000-0002-6778-9718"
    },
    {
      "affs": [
        3
      ],
      "name": "Hongying D Dai"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Leah Meza"
    },
    {
      "affs": [
        4
      ],
      "name": "Megan E Patrick"
    },
    {
      "affs": [
        5
      ],
      "name": "Brian A King"
    },
    {
      "affs": [
        4
      ],
      "name": "Richard A Miech"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Adam M Leventhal"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/33ksvhfrp14xv.bib",
  "cited_by": 0,
  "doi": "10.1016/j.lana.2026.101673",
  "fulltext_url": "https://europepmc.org/articles/PMC13683872",
  "id": "33ksvhfrp14xv",
  "issns": [
    "2667-193X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909247",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2737|Smoking Behavior and Cessation"
    ]
  ],
  "openalex": "W7221823611",
  "pdf_url": "https://europepmc.org/articles/PMC13683872?pdf=render",
  "pmcid": "PMC13683872",
  "pmid": "42909247",
  "published": "2026-10-14",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/33ksvhfrp14xv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42909247",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909247"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Smoking Behavior and Cessation",
      "subfield": "physiology"
    }
  ],
  "title": "Nicotine and tobacco product use among US youth in 10th and 12th grade, 2023-2025: a repeated cross-sectional study.",
  "title_text": "Nicotine and tobacco product use among US youth in 10th and 12th grade, 2023-2025: a repeated cross-sectional study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/33ksvhfrp14xv",
  "venue": "Lancet regional health. Americas",
  "versions": []
}