In 2019, the popularity of self-reported e-cigarette use was high among high school and middle school students, with many current e-cigarette users reporting frequent use and most of the exclusive users reporting use of flavored e-cigarettes.

The objective of the study was to estimate the prevalence of e-cigarette use among US high school and middle school students in 2019, including frequency of use, brands used, and use of flavored products.

From February 15, 2019 to May 24, 2019, 19,018 US students in grades 6 to 12 participated in the 2019 National Youth Tobacco Survey. A cross-sectional analysis was done nationally.

Out of the 10,097 high school students who were involved in the study, an estimated 27.5% reported current e-cigarette use. 34.2% of these users reported frequent use, and 63.6% reported exclusive use of e-cigarettes.

Meanwhile, out of the 8,837 middle school students who participated in the study, 10.5% reported current e-cigarette use. Among these users, 18.0% reported frequent use and 65.4% reported exclusive use of e-cigarettes.

An estimated 59.1% of high school students and 54.1% of middle school students prefer the brand JUUL for e-cigarettes. However, among current e-cigarette users, 13.8% of high school students and 16.8% of middle school students reported not having a usual e-cigarette brand.

The results of this survey and the high exposure to nicotine at youth waves a red flag to the study authors. “For young people, this is of particular concern because it could promote the development of nicotine dependence, making it easier to initiate and proceed to regular e-cigarette use or transition to cigarette or other combustible tobacco product use.”


Cullen KA, Gentzke AS, Sawdey MD, et al. e-cigarette use among youth in the United States, 2019. JAMA. doi: