Youth tobacco control has made significant strides over the past two decades in addressing the risks of tobacco use for youth and young adults.
Combustible cigarette use among teens has reached an all-time low, with only 1.4% currently smoking—down from 34.5% of high school students in 2000. Similarly, youth e-cigarette use has dropped from a 2019 peak of 27.5% to just 7.8% in 2024.
These milestones reflect major public health victories, driven by coordinated efforts across sectors including healthcare, education, research, and community advocacy.
However, the battle is far from over.
Newer devices pose ongoing challenges with youth nicotine use
E-cigarettes still expose young users to harmful substances and health risks like asthma flare-ups, bronchitis, and respiratory tract irritation. can also affect memory, mental health, and the potential for addiction to other substances later in life.
Importantly, many young people report feeling trapped by nicotine addiction and worry about how vaping is affecting their physical and mental health, social relationships and self-image.
And yet, in 2024, over 1.6 million middle and high school students reported recent e-cigarette use, with alarming signs of dependence, including increased daily use.
These troubling signals of dependence are perhaps not surprising given the availability of newer, cheaper e-cigarette devices that contain more liquid and higher concentrations of nicotine.
Young adults unaware of available cessation resources
Young adults, age 18-24, also show concerning trends.
Although smoking rates have declined overall, more young adults are starting to smoke or transition to daily use in their young adult years.
From 2002 to 2018, young adult cigarette initiation more than doubled, and daily smoking among this group has risen significantly. E-cigarette use among this group also jumped from 2.7% in 2017 to 10.3% in 2023. It appears that young adults have fallen through the cracks.
This population is not typically the target of prevention efforts aimed at youth or cessation efforts aimed at middle aged adults. As a result, many young adults are unaware of available cessation resources.
In fact, young adults have the highest rates of quit attempts each year but the lowest rates of cessation treatment utilization.
Addressing the risks of tobacco use for youth and young adults requires targeted strategies that bridge the gap between early prevention and accessible cessation support.
Digital solutions and campaigns that inspire change
Encouragingly, many young people are motivated to quit, and science-backed tools exist to help them.
Digital interventions—especially those using tailored messaging and proven behavior change techniques—are highly effective and scalable.
Truth Initiative’s EX Program, a text-based cessation tool for teens and young adults, has enrolled over 830,000 users since its 2019 launch and is the only program to be evaluated in two published vaping cessation clinical trials.
To raise awareness and close the cessation gap, Truth Initiative launched “Outsmart Nicotine,” a national campaign targeting young adults, in December 2024. The campaign leverages digital media, influencers, and relatable messaging to encourage quitting and highlight the support available. So far, it has driven about 12,000 new monthly enrollees into EX Program.
Young adulthood is a pivotal stage for shaping long-term health risks. By focusing on both prevention and cessation for this age group, public health efforts can not only improve individual outcomes but also shift cultural norms around nicotine use.
Your continued investment in youth and young adult tobacco control is essential, now more than ever, to build on the progress already made and move closer to a tobacco-free future.
See how EX Program effectively engages youth and young adults in quitting here. Or connect with one of our experts to schedule a demo tailored to your needs.
