November 21 marks the 48th anniversary of the American Cancer Society’s Great American Smokeout, first observed in 1976. This annual event, held every third Thursday in November, provides “an opportunity for individuals, community groups, businesses, health care providers, and others to encourage people to make a plan to quit” smoking. For years, the event has also addressed youth use of deadly combustible cigarettes. 

Public health groups and policymakers should celebrate this year: youth use of combustible cigarettes is at record lows, while the use of less harmful tobacco harm reduction products, including e-cigarettes, continues to decline.

In 1996, the ACS was “involving more schools and youths in [that] year’s Smokeout than ever before.” Such campaigns were warranted. According to the Centers for Disease Control and Prevention’s biennial Youth Risk Behavior Survey (YRBS), in 1995, nearly three-fourths (71.3%) of U.S. high school students reported ever-trying a combustible cigarette, while more than one-third (34.8%) were currently smoking, defined as having used the product on at least one occasion in the 30 days prior. Alarmingly, more than one in ten (12.2%) reported smoking cigarettes daily.

By 2023, only 14.4% of U.S. high schoolers had ever used a combustible cigarette, 3.5% were currently smoking, and a minuscule 0.5% reported daily use. Between 1995 and 2023, ever-use of cigarettes declined by 79.8%, current use by 89.9% and daily use decreased by a whopping 95.9%. It seems that combustible cigarette use among American high school students has been smoked out.

Contrary to what tobacco control activists anticipated, the introduction of newer products has not led to increases in youth use of traditional tobacco products. E-cigarettes, which entered the U.S. market in 2007, saw a 190% increase in products on the market from 2012 to 2016. In 2017, an estimated 28.9% of high school students had tried a cigarette, 8.8% were currently smoking, and 2% were daily users. Between 2017 and 2023, ever-use of cigarettes declined by 50.2%, current use was down by 60.2%, and daily use had decreased by 75%.

In recent years, public health organizations have used the Smokeout to launch campaigns against e-cigarettes and other tobacco harm reduction products, including heated tobacco and oral nicotine products. While addressing youth use of these products is commendable, alarmist campaigns could inadvertently confuse adults about the reduced risks these products offer. 

Moreover, youth use of e-cigarettes has declined in recent years. According to the YRBS, in 2023, 33.8% of U.S. high school students had ever tried a vapor product, 16.8% were currently using e-cigarettes, and 5% were daily users. Vaping seems to have peaked in 2019 when more than half (50.1%) of students had tried an e-cigarette, nearly one-third (32.7%) were current users, and 7.2% were daily users. Between 2019 and 2023, ever-use of e-cigarettes declined by 32.5%, current use by 48.6%, and daily use was down by 30.6%.

Policymakers and public health groups should recognize and appreciate the historic lows in youth combustible cigarette use this Smokeout and throughout the year. Rather than advancing draconian measures like banning flavored tobacco and vapor products or imposing excessive taxation, they should focus on additional education efforts to push youth combustible cigarette use to zero.

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.