US teens are smoking and vaping less than their peers abroad

Smoking and vaping continued to decline among middle school and high school students in 2025, according to the U.S. Food and Drug Administration’s 2025 National Youth Tobacco Survey, released in July 2026. This annual, school-based survey has been tracking smoking and other nicotine product use in American youth ages 11 to 18 since 1999.

Perhaps most excitingly, the survey found that smoking – the leading cause of preventable death and disease in the U.S. and worldwide – is at a historic low among U.S. youth, at just 1.4%. By contrast, in 1997 – when smoking rates in U.S. youth were the highest ever recorded, 36% of U.S. high school students reported currently smoking, and 70% reported having tried smoking at least once.

Meanwhile, the use of nicotine vapes, or e-cigarettes, fell to 5.2% in 2025, the lowest it’s been since its peak in 2019.

On the other hand, young people’s use of nicotine pouches – small pouches that are placed between the lip and gum and are available in different flavors and strengths – has risen over the past five years. The new survey shows that this rate is now stable compared with the previous year and remains relatively low at 1.7%.

We are public health researchers who study the use of tobacco products. We delved into this survey to see what it tells us about tobacco use in the U.S. more broadly and how use among young people in the U.S. stacks up against their peers in other countries.

New products on the market

With the introduction of nicotine vapes in the early 2010s and, more recently, nicotine pouches in the mid-2010s, the tobacco and nicotine market has been in flux. This is particularly true for the youth market, where smoking has fallen so substantially.

Some researchers estimate that vaping has significantly reduced the numbers of people who smoke from ages 16 and up, with e-cigarettes acting as a substitute for cigarettes.

The harm from smoking comes from a deadly mix of chemicals released when tobacco leaf is burned. Regulated nicotine vapes and pouches do not contain tobacco leaf and do not involve burning. Therefore, they pose substantially fewer risks than smoking. But these new ways of consuming nicotine are not risk-free.

The risks from e-cigarettes vary from product to product, depending largely on what substances are in e-liquids. E-cigarettes on the FDA’s authorized list of vaping products have been extensively tested and designated as “appropriate for the protection of public health,” meaning they have the potential to prevent and
reduce tobacco-related disease and other health harms. But the U.S. e-cigarette market is largely dominated by unauthorized products.

Depending on what’s in them, e-cigarettes can pose risks to heart, circulatory, lung and oral health. The FDA continues to approve new vaping products, and recently – and somewhat controversially – the list expanded to include flavored vapes.

High on the list of public health concerns is young people’s use of these products, because early use of nicotine is one of the biggest risk factors for lifelong addiction.

While smoking in 11- to 18-year-olds has continued to decrease, adult smoking in the U.S. has remained relatively stable. Older people continue to smoke at higher levels than young people, so they are most at risk of smoking-related harms.

The global picture

It’s difficult to get a complete picture of tobacco and nicotine use around the world. Many countries have no recent data on their population’s e-cigarette use, and countries that have conducted surveys may not have data from the same years. The questions and product definitions used in these surveys can also be inconsistent.

For this reason, it makes sense to compare the U.S. only with other countries such as Canada, Germany, the Netherlands and the U.K. that have similar populations, data coverage and policies.

In 2024, the World Health Organization looked at available data from different countries in order to better understand the global picture of tobacco and nicotine product use.

The biggest difference between the U.S. and comparable countries is in people 18 and under, although this data is the hardest to compare accurately due to survey differences. In the latest reported data considered by the WHO, the U.S. has a notably lower rate of e-cigarette use in this age group.

Though the numbers are hard to compare directly, Canada, Germany, the U.K. and the Netherlands all had relatively higher rates of vaping in young people compared with the United States. We do not yet know the cause of this phenomenon, though it aligns with the FDA’s findings on decreasing smoking and relatively low level of nicotine pouch use in people ages 11 to 18.

The WHO report also shows that in 2000, almost 50% of U.S. adults reported current smoking, a higher proportion than in comparable countries like Canada and Germany, but similar to smoking in the U.K. Current reported smoking among U.S. adults has dropped rapidly over the past two decades, falling below an estimated 10% in 2024. It has also dropped rapidly in the U.K.

Much of that decline is likely caused by public health policies and public messaging about the harms of smoking. Adult smoking rates also declined in Canada, the Netherlands and Germany over the same period, but less dramatically.

Drawing again from WHO data, reported use of e-cigarettes among U.S. adults was higher than in some comparable countries such as the Netherlands or Germany. The U.S. policy approach to e-cigarettes is more similar to that of the U.K., intentionally nudging people toward vaping instead of smoking to reduce health risks. Both countries have similar rates of adult e-cigarette use.

Looking ahead

Just because tobacco and nicotine use is declining among young people in the U.S. and in some other populations, it doesn’t mean that these substances are no longer a public health problem. Adult usage is holding steady, and there’s no guarantee that young people will continue abstaining.

The past year has seen a growing number of influencers, many of whom are aligned with the Make America Healthy Again movement, promoting nicotine as a health product. Recent years have also seen the rise of “cigfluencers” – celebrities and influencers who openly promote smoking.

One study even found that many people wrongly believe that vaping and pouch use are as harmful or even more harmful than smoking.

It would be a public health catastrophe if smoking rates were to go up again, so we will be watching for next year’s numbers to see how these smoking and nicotine use trends among young people continue to evolve.