Trends in exclusive and dual cigarette and electronic cigarette use among United States middle and high school students from 2017 to 2024: A cross-sectional analysis.
4 affiliations
- 1Department of Population Health SciencesBritish Columbia Cancer Research InstituteVancouverCanada.
- 2Department of EpidemiologyUniversity of MichiganAnn ArborUnited States.
- 3School of Population and Public Health, University of British ColumbiaVancouverCanada.
- 4Rutgers Cancer Institute, Rutgers UniversityNew BrunswickUnited States.
Abstract
The increase in electronic cigarette (e-cigarette) use among United States (US) middle and high school students raises public health concerns. Understanding cigarette and e-cigarette use patterns is crucial for targeted tobacco control policies. This study aimed to identify and characterize changes in trends of exclusive and dual use of cigarettes and e-cigarettes among US middle and high school students from 2017 to 2024, by grade and sex. We conducted a secondary analysis of the Monitoring the Future (MTF) survey, an annual, nationally representative cross-sectional survey of US students in Grades 8, 10, and 12 (2017-2024; N=227966). Students self-reported past 30-day cigarette and e-cigarette use via school-administered questionnaires. The survey's complex sampling design incorporated clustering, stratification, and weighting. We conducted joinpoint regression analyses by grade (8, 10, or 12) and sex (boys or girls). The prevalence of daily cigarette use in the past 30 days between 2017 and 2024 decreased with annual percent changes (APCs) of -23.3% among Grade 12 boys (95% confidence interval [CI]: -31.7 - -13.9) and -29.5% among girls (95% CI: -35.6 - -22.9). Exclusive cigarette use declined significantly among Grade 12 boys from 2017 to 2024 (APC= -23.0%; 95% CI: -32.8 - -11.6) and girls from 2017 to 2020 (APC= -49.3%; 95% CI: -63.6 - -29.5). E-cigarette use increased sharply until 2019-2020, particularly among girls, then declined significantly mainly among boys; girls' use remained above 2017 levels (e.g. regular use among Grade 12 girls: average annual percent change [AAPC]=19.7%; 95% CI: 9.6-30.7). From 2017 to 2024, any dual use fell, especially among Grade 10 boys (APC= -16.2%; 95% CI: -22.1 - -9.9) and girls (APC= -14.3%; 95% CI: -18.4 - -9.9). Cigarette and dual use of cigarettes and e-cigarettes among US middle and high school students declined significantly from 2017 to 2024, suggesting positive shifts in tobacco use behavior, but stable e-cigarette use highlights an ongoing challenge in nicotine control among youth.
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BibTeX
@article{chen2026trends,
title = {{Trends in exclusive and dual cigarette and electronic cigarette use among United States middle and high school students from 2017 to 2024: A cross-sectional analysis.}},
author = {Yixian Chen and Evelyn Jimenez-Mendoza and Jihyoun Jeon and Rafael Meza},
journal = {Tobacco induced diseases},
year = {2026},
month = oct,
doi = {10.18332/tid/231124},
url = {https://europepmc.org/article/MED/42996486},
note = {CC BY},
}
RIS
TY - JOUR
TI - Trends in exclusive and dual cigarette and electronic cigarette use among United States middle and high school students from 2017 to 2024: A cross-sectional analysis.
AU - Yixian Chen
AU - Evelyn Jimenez-Mendoza
AU - Jihyoun Jeon
AU - Rafael Meza
PY - 2026
DA - 2026/10/29
JO - Tobacco induced diseases
DO - 10.18332/tid/231124
UR - https://europepmc.org/article/MED/42996486
AB - The increase in electronic cigarette (e-cigarette) use among United States (US) middle and high school students raises public health concerns. Understanding cigarette and e-cigarette use patterns is crucial for targeted tobacco control policies. This study aimed to identify and characterize changes in trends of exclusive and dual use of cigarettes and e-cigarettes among US middle and high school students from 2017 to 2024, by grade and sex. We conducted a secondary analysis of the Monitoring the Future (MTF) survey, an annual, nationally representative cross-sectional survey of US students in Grades 8, 10, and 12 (2017-2024; N=227966). Students self-reported past 30-day cigarette and e-cigarette use via school-administered questionnaires. The survey's complex sampling design incorporated clustering, stratification, and weighting. We conducted joinpoint regression analyses by grade (8, 10, or 12) and sex (boys or girls). The prevalence of daily cigarette use in the past 30 days between 2017 and 2024 decreased with annual percent changes (APCs) of -23.3% among Grade 12 boys (95% confidence interval [CI]: -31.7 - -13.9) and -29.5% among girls (95% CI: -35.6 - -22.9). Exclusive cigarette use declined significantly among Grade 12 boys from 2017 to 2024 (APC= -23.0%; 95% CI: -32.8 - -11.6) and girls from 2017 to 2020 (APC= -49.3%; 95% CI: -63.6 - -29.5). E-cigarette use increased sharply until 2019-2020, particularly among girls, then declined significantly mainly among boys; girls' use remained above 2017 levels (e.g. regular use among Grade 12 girls: average annual percent change [AAPC]=19.7%; 95% CI: 9.6-30.7). From 2017 to 2024, any dual use fell, especially among Grade 10 boys (APC= -16.2%; 95% CI: -22.1 - -9.9) and girls (APC= -14.3%; 95% CI: -18.4 - -9.9). Cigarette and dual use of cigarettes and e-cigarettes among US middle and high school students declined significantly from 2017 to 2024, suggesting positive shifts in tobacco use behavior, but stable e-cigarette use highlights an ongoing challenge in nicotine control among youth.
SN - 2070-7266
SN - 1617-9625
ER -