While cigarette use among teens in the St. Louis region is low, rates of e-cigarette use have increased, according to data from state surveys.
The Missouri Department of Health and Senior Services' 2024 Missouri Student Survey found that 13% of teens surveyed in St. Louis had used e-cigarettes in the past 30 days. That’s up from a little more than 2% in 2022.
In St. Louis County, the rate of e-cigarette use among students in sixth to 12th grade rose from 3.5% to 4.3% between 2022 and 2024.
Cigarette use among teens has been falling, said Rachel Sanford, health promotions manager for the American Lung Association in Missouri. In 2024, only 2.2% of those surveyed reported smoking cigarettes.
But the rise in popularity of vapes, e-cigarettes and smokeless products risks wiping out progress anti-smoking advocates have made, she said.
“The fact that these tobacco companies are continuing to reinvent the wheel indicates that this is still an issue that we're going to continue to fight,” Sanford said.
Sanford takes the risk survey data with a grain of salt, she said. Because it’s self-reported, she knows not all teens are going to honestly participate. Other years have had low response rates, which makes reporting trends over time difficult.
Still, she thinks that the rate of tobacco use is much higher than reported based on what she’s hearing from teens in the region. High schoolers are using Zyn and other smokeless products, she said.
Nicotine pouches resemble small tea bags. They’re filled with nicotine and are placed between a person’s gums and lips. Unlike with chewing tobacco, people don’t spit anything out when they use the products.
“I feel like everything old is always kind of made new again,” she said. “The tobacco industry is always revamping certain products and figuring out how to continue to make them fun and exciting for younger generations.”
While nicotine pouches are sometimes marketed as a safer alternative to vaping and cigarettes, officials from the federal Centers for Disease Control and Prevention warn that nicotine is highly addictive and that “there are no safe tobacco products, including nicotine pouches. This is particularly true for youth, young adults, and people who are pregnant.”
According to the latest data available from the American Lung Association, Missouri ranks 11th in the nation for smoking rates among high school teens.
Missouri and other Midwestern and Southern states have some of the highest smoking rates in the country.
Sanford points to Missouri’s low cigarette taxes and high density of tobacco retailers as factors behind residents’ high tobacco use.
