The Montana Office of Public Instruction (MOPI) has published the 2023 results for the Youth Risk Behavior Survey (YRBS) among Montana high school students. For those concerned about youth smoking and tobacco use, the results are both encouraging and alarming. While vaping has decreased overall, youth combustible cigarette use is on the rise, suggesting that the overemphasis on vaping may have inadvertently exposed youth to more harmful tobacco products.

Since 1993, Montana high school students have participated in the biennial YRBS, a collaboration between the Montana Office of Public Instruction and the Centers for Disease Control and Prevention. The survey examines various youth behaviors and attitudes, ranging from dietary habits and social behaviors to substance use.

In 2023, 45.3% of Montana high school students reported having ever tried an e-cigarette, 29.5% were currently using them (defined as having used the product at least once in the last 30 days), and 9.4% used them daily. Vaping seems to have peaked in 2019 when 58.3% of students had tried e-cigarettes, 30.2% were actively vaping, and 8.7% used them daily. Between 2019 and 2023, ever-use of e-cigarettes decreased by 22.3%, and current use declined by 2.3%. However, daily use increased by 8% over the same period, and overall e-cigarette use fell by 4.4%.

Montana is one of the few states offering insights into why youth use e-cigarettes. In 2023, 58% of students had never used one; 11.3% cited curiosity; 11.1% mentioned anxiety, depression, and/or stress; 7% wanted a nicotine buzz; 6.5% used them because friends or family members did; and 4.8% had other reasons. Only 0.9% cited flavors, indicating that recent efforts to restrict e-cigarette flavors in Montana may not address the primary motivations for youth vaping.

In the campaign to reduce youth vaping, public health authorities may have overlooked the rising number of youths turning to combustible cigarettes, the most harmful form of tobacco. In 2023, 29.3% of Montana youth had tried a cigarette, 9.3% were actively smoking, and 1.3% smoked daily. Between 2019 and 2023, ever-use of cigarettes fell slightly by 5.5%, but current use increased by 20.8%, and daily use by 8.3%. Overall, combustible cigarette use among Montana teens has increased by 9.3%. While current levels remain lower than a decade ago, this increase is troubling.

The results of the 2023 Youth Risk Behavior Survey underscore a complex landscape of tobacco use among Montana high school students. Although vaping has seen a decline since its peak in 2019, the rise in combustible cigarette use among youth reveals the unintended consequences of the overemphasis on vaping. Despite well-intentioned public health campaigns focused on e-cigarettes, the increasing trend in traditional cigarette smoking demands urgent attention, while efforts to reduce youth vaping must understand why youth vape. 

Lindsey Stroud is a Visiting Fellow at Independent Womens Forum, a Senior Fellow at the Taxpayers Protection Alliance, and a board member with the American Vapor Manufacturers Association.