The Maryland Department of Health has released the results of the state’s 2022-2023 Youth Risk Behavior Survey (YRBS). This biennial survey, conducted in coordination with federal agencies, monitors student behaviors ranging from dietary habits and physical activity to mental well-being and substance use. The latest findings provide encouraging news for policymakers in Maryland: Youth use of traditional tobacco products is at an all-time low, and e-cigarette use has significantly decreased in recent years.
Among middle schoolers in Maryland for the 2022-23 period, 1.2% reported current use of combustible cigarettes, defined as using the product at least once in the 30 days prior to the survey. Additionally, 1.4% reported current smokeless tobacco use, and 1.7% were smoking cigars. Only 10.4% of middle school students had ever tried an e-cigarette, marking a 45% decline from 2019 when 18.9% had experimented with them. Furthermore, 5.9% reported current use of vapor products, unchanged from 2019.
For high school students during the same period, 3.2% were currently smoking combustible cigarettes, 2.6% used smokeless tobacco products, and 5.5% were smoking cigars. Current cigarette use has dropped by 36% since 2019, when 5% of students smoked. Vapor product use has also decreased. In 2022-23, 25.4% of high school students had ever tried an e-cigarette, while 14.3% were currently vaping, representing a decrease of 36% and 37.8% in ever-use and current use, respectively, since 2019.
Maryland’s YRBS is among the few state surveys providing insights into why youth use e-cigarettes, revealing that only a small fraction cite flavors as a reason. In 2022-23, 8.1% of high school students who had ever used e-cigarettes did so because of flavors, while 43.7% cited “other” reasons, and 38.9% used them due to influence from friends or family. Similarly, among middle school students, only 7.3% used e-cigarettes because of flavors, whereas 48.8% cited “other” reasons, and 41.7% were influenced by friends or family.
These results are particularly relevant as Maryland lawmakers have recently considered banning the sale of flavored tobacco and vapor products. While such measures aim to prevent youth access to age-restricted products, they may also inadvertently restrict adult access to safer alternatives to smoking. In 2022, over 220,000 adults aged 18 and over were vaping in Maryland, with nearly half (48.9%) of current adult e-cigarette users formerly smoking.
The 2022-2023 YRBS results highlight significant progress in reducing tobacco and e-cigarette use among Maryland’s youth, with traditional tobacco use reaching historic lows and a notable decline in e-cigarette usage. While it is essential for policymakers to address youth access to these products, they must also consider the implications of restrictive measures that could affect adults who rely on these products as safer alternatives to smoking.
Lindsey Stroud is a Visiting Fellow at Independent Women’s Forum, a Senior Fellow at the Taxpayers Protection Alliance, and a board member with the American Vapor Manufacturers Association.