Youth Cigarette and Vape Use Down in Indiana, While Adult E-Cigarette Use Has Increased

The Indiana Department of Health has released the 2023 Youth Risk Behavior Survey results, which biennially track high school students’ behaviors, spanning dietary and physical activity habits to mental health and substance use.

Notably, there’s encouraging news for policymakers focused on youth tobacco and vapor product usage, with combustible cigarette use reaching historic lows and vapor product use continuing a downward trend. However, there has been a slight increase in combustible cigarette use which may require monitoring to prevent a return to the higher levels observed in previous years.

In 2023, 6.1% of Indiana high school students reported current use of combustible cigarettes, defined as using the product at least once in the 30 days prior. This marks a 45.2% increase from 2021, where 4.2% of students smoked, but still represents a significant decrease of 45.5% from 2015 and 66.3% from 2011.

Daily usage of combustible cigarettes among these students shows a consistent decline. Only 0.6% reported smoking cigarettes daily throughout the 30 days before the survey in 2023—a 14.3% drop from 2021 and a steep 90.5% decline from 2011.

As e-cigarettes are a newer technology, they have recently become a focal point for policymakers. The survey data from 2015, 2021, and 2023 reveal a general decrease in e-cigarette use among students. In 2023, 17.9% of students reported using e-cigarettes currently, down 6.3% from 2021 and 25.1% from 2015. Although there’s a decrease in general use, daily usage has increased by 19% from 4.2% in 2021 to 5% in 2023.

Regrettably, the 2023 survey lacks data on the use of other tobacco products such as cigars and smokeless tobacco. The National Youth Tobacco Survey in 2024 noted that among all U.S. middle and high school students, only 1.8% reported current use of nicotine pouches, a slight increase from 1.5% in 2023. While monitoring all age-restricted products is essential, public health efforts should be cautious to avoid inadvertently promoting youth use of these products.

Further, policymakers should be aware that many adults in the Hoosier State use e-cigarettes as a smoking cessation tool. In 2023, 8.5% of adults aged 18 years or older were using e-cigarettes either occasionally or daily, up from 8.1% in 2022 and a significant increase of 80.9% from 2016. During the same period, the percentage of adults who smoked in Indiana fell by 31.3%, from 21.1% to 14.5%.

It’s crucial for policymakers to acknowledge the significant declines in youth tobacco and vapor product use and to avoid restrictive measures that could hinder adult access to safer smoking alternatives. In 2022, more than half (51.2%) of Indiana adults aged 25 or older who were vaping had formerly smoked. Stringent policies, such as bans or excessive taxation, could potentially drive these individuals back to combustible cigarettes, which are the most harmful tobacco products.

Lindsey Stroud is a Visiting Fellow at Independent Women’s Forum, a Senior Fellow at the Taxpayers Protection Alliance, and a board member with the American Vapor Manufacturers Association.