Tobacco Use - Youth in Wisconsin

Wisconsin

People who smoke cigarettes are at greater risk of heart disease, cancer and stroke. According to a report from the surgeon general, cigarette smoking remains a leading cause of preventable death in the United States. Furthermore, smoking is costly: In 2018, cigarette smoking among people of all ages cost the U.S. more than $600 billion in health care expenditures and lost productivity.

The use of cigarettes, cigars and smokeless tobacco has decreased among adolescents in recent years. Cigarette smoking among youth has reached its lowest level ever recorded, with only 1.4% of students citing current use. Electronic cigarettes, also known as e-cigs or vape pens, are now the most commonly used tobacco product among youth, surpassing cigarettes in 2014. In 2025, 5.2% of middle and high school students in the U.S. reported using e-cigarettes. Nicotine pouches, which contain flavored nicotine that dissolves in the mouth, have also become more popular among youth. According to a 2023 study, 35.5% of students have heard of nicotine pouches, and in 2025 1.7% of students reported using them.

Tobacco industry marketing strategies are associated with increased addiction risk among adolescents. For example, adding flavorings to tobacco products has made them more appealing to children and led to increased usage. A 2024 study also shows associations between youth social media use, engagement with tobacco brands on these platforms and an increased risk of initiating tobacco use.

Nearly 9 in 10 people who smoke cigarettes have their first cigarette by age 18. The 2014 Surgeon General’s Report estimated that 5.6 million young people younger than age 18 today will die prematurely from diseases caused by long-term tobacco use.

Populations with higher rates of tobacco use include:

• American Indian/Alaska Native youth compared with Asian youth.
• Lesbian, gay and bisexual (LGB) youth compared with heterosexual youth. Transgender youth have a similarly high prevalence.
• Students experiencing psychological distress.

Many resources are available for youth looking for support around smoking or quitting. The Centers for Disease Control and Prevention emphasizes that interventions are most effective when implemented together. Interventions that have been found to reduce and prevent youth tobacco use include:

• Raising costs for tobacco products.
• Prohibiting smoking in indoor and public places.
• Countering tobacco product advertisements with media messages.
• Implementing community programs and school policies encouraging tobacco-free environments and lifestyles.

In 2019, the Tobacco 21 law increased the federal minimum age to purchase tobacco products (including cigarettes, cigars and e-cigarettes) from 18 to 21. A one-year assessment of the policy found that the percentage of teenagers surveyed who felt it was easy to purchase tobacco products from a store had decreased. However, there was no discernible change in how easy it felt to buy tobacco products online.

Healthy People 2030 has several tobacco use objectives for adolescents, including:

• Reducing current use of tobacco products among adolescents.
• Reducing the proportion of adolescents exposed to tobacco marketing.
• Eliminating cigarette smoking initiation in adolescents and young adults.

Agaku, Israel T., Lungile Nkosi, Queen D. Agaku, Joy Gwar, and Tina Tsafa. “A Rapid Evaluation of the US Federal Tobacco 21 (T21) Law and Lessons From Statewide T21 Policies: Findings From Population-Level Surveys.” Preventing Chronic Disease 19 (June 2, 2022): 210430. https://doi.org/10.5888/pcd19.210430.

Gentzke, Andrea S., Teresa W. Wang, Monica Cornelius, Eunice Park-Lee, Chunfeng Ren, Michael D. Sawdey, Karen A. Cullen, Caitlin Loretan, Ahmed Jamal, and David M. Homa. “Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021.” MMWR. Surveillance Summaries 71, no. 5 (March 11, 2022): 1–29. https://doi.org/10.15585/mmwr.ss7105a1.Kramer, Renee D., Eunice Park-Lee, Kristy L. Marynak, Jamal T. Jones, Michael D. Sawdey, and Karen A. Cullen. “Nicotine Pouch Awareness and Use Among Youth, National Youth Tobacco Survey, 2021.” Nicotine & Tobacco Research 25, no. 9 (September 1, 2023): 1610–13. https://doi.org/10.1093/ntr/ntad080.

Park-Lee, Eunice, Lauren M. Dutra, Hannah Cowan, Burton Levine, Michael D. Sawdey, Maria Cooper, Brittany Merson, et al. “Tobacco Product Use among Middle and High School Students in the United States: National Youth Tobacco Survey, 2025.” Nicotine & Tobacco Research, June 23, 2026. https://doi.org/10.1093/ntr/ntag116.

Park-Lee, Eunice, Chunfeng Ren, Maria Cooper, Monica Cornelius, Ahmed Jamal, and Karen A. Cullen. “Tobacco Product Use Among Middle and High School Students — United States, 2022.” MMWR. Morbidity and Mortality Weekly Report 71, no. 45 (November 11, 2022): 1429–35. https://doi.org/10.15585/mmwr.mm7145a1.

Ranker, Lynsie R., Jiaxi Wu, Traci Hong, Derry Wijaya, Emelia J. Benjamin, Aruni Bhatnagar, Rose M. Robertson, Jessica L. Fetterman, and Ziming Xuan. “Social Media Use, Brand Engagement, and Tobacco Product Initiation among Youth: Evidence from a Prospective Cohort Study.” Addictive Behaviors 154 (July 2024): 108000. https://doi.org/10.1016/j.addbeh.2024.108000.

U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. https://www.ncbi.nlm.nih.gov/books/NBK179276/.