After years of sharp increases in teen vaping, new federal data shows a glimmer of progress. According to the 2024 National Youth Tobacco Survey, the number of U.S. middle and high school students using e-cigarettes dropped from 2.13 million (7.7%) in 2023 to 1.63 million (5.9%) in 2024.
Health experts welcome the decline but caution that vaping remains one of the most significant pediatric health threats today.
Who’s Still Vaping
In 2024, about 3.5% of middle school students—roughly 410,000 children—and 7.8% of high school students, or about 1.21 million teens, reported current e-cigarette use. Among them:
- Nearly 4 in 10 vaped on 20 or more days in the past month.
- More than 1 in 4 vaped every single day.
- Almost 88% used flavored products.
Disposable vapes were the most popular device type, followed by pods and cartridges. Top brands among teens included Elf Bar, Breeze, Mr. Fog, Vuse, and JUUL.
A Changing Tobacco Landscape
Overall, 8.1% of middle and high school students—about 2.25 million youth—used some form of tobacco product in 2024. E-cigarettes dominated the market, far outpacing nicotine pouches and combustible cigarettes. Traditional cigarette smoking hit an all-time low, with just 1.7% of high school students reporting use.
Why Doctors Are Still Concerned
Flavored vapes remain a powerful draw, with nearly 90% of youth choosing them. Most e-cigarettes contain nicotine, which can interfere with brain development, affecting memory, attention, learning, and impulse control. Nicotine use during adolescence can also raise the risk of mood disorders and long-term dependence.
The vapor inhaled from these devices often contains harmful substances, including ultrafine particles, lung-damaging chemicals like diacetyl, volatile organic compounds, and heavy metals such as nickel, tin, and lead.
“As pediatric pulmonologists, we’re seeing the real-world effects,” said Dr. Inderpal Randhawa. “Young patients are coming in with persistent cough, asthma flare-ups, and in rare but serious cases, vaping-related lung injuries. The concern is not just what’s happening now, but what this means for their long-term lung health.”
Preventing the Next Wave
Experts say parents, caregivers, and pediatricians all have a role to play:
- Start the conversation early—and keep it open and judgment-free.
- Share accurate facts about nicotine addiction and the risks of flavored products.
- Encourage quitting—programs like This Is Quitting have helped many teens stop vaping.
- Support strong policies—including age restrictions, marketing limits, and public health campaigns.
The Bottom Line
Youth vaping rates may be down, but with more than 1.6 million teens still using e-cigarettes—many daily—the problem is far from solved. Sustained education, strict regulation, and compassionate intervention remain critical to protecting the next generation’s lungs, brains, and futures.
About Dr. Inderpal Randhawa:
Dr. Randhawa is the medical director of the Children’s Pulmonary Institute at Miller Children’s & Women’s. He has served at Miller Children’s & Women’s in various leadership positions for more than a decade. Dr. Randhawa also is the Program Director of the Pediatric Pulmonology Fellowship at UCI and Miller Children's & Women’s. He has led several initiatives at Miller Children’s & Women’s resulting in regional and national acclaim including the Sickle Cell Pulmonary Center, Disease Specific Certification in Pediatric Asthma from The Joint Commission, and the Primary Ciliary Dyskinesia Center.
Dr. Randhawa is a leading specialist in internal medicine, pediatrics, immunology, allergy medicine, and pulmonology with fifteen years of experience. Dr. Randhawa focuses on the research and treatment of ‘orphan’ diseases—areas of medicine that have stalled in development and progress. He is the president and chief medical officer of the Translational Pulmonary & Immunology Research Center (TPIRC), a nonprofit corporation located in Long Beach, California, which uses a specialized ‘collaborative’ approach to treating patients suffering from these orphan diseases. Dr. Randhawa is also the founder of TPIRC's Southern California Food Allergy Institute, a nonprofit dedicated to providing innovative and safe treatment for the six million children in the U.S. who suffer from food allergies. In 2021 and 2022, he was recognized as a Top Los Angeles Doctor by the Los Angeles Business Journal.
