CDC Data: Rhode Island Teen Smoking and Vaping Down, But Substance Use Patterns Shift

Lindsey Stroud

The Centers for Disease Control and Prevention has released the 2023 results of the Youth Risk Behavior Survey (YRBS), which tracks various behaviors among Rhode Island high school students, including diet, physical activity, mental health, and substance use. The latest findings offer encouraging news for policymakers concerned about youth nicotine use: both e-cigarette and traditional cigarette use have declined significantly, reaching record lows. However, there is growing concern about increased youth use of other substances, particularly marijuana.

According to the 2023 YRBS, 11.9 percent of Rhode Island high school students had ever tried a combustible cigarette, and just 3.1 percent reported current cigarette use—defined as using a cigarette at least once in the past 30 days. Only 0.6 percent reported frequent use (20 or more days), and 0.6 percent were daily smokers.

These figures represent historic lows and dramatic declines over the past two decades. In 2003, nearly half (49.7 percent) of Rhode Island high schoolers had ever tried a cigarette, and 19.3 percent were current smokers. Since then, ever-use has declined by 76.1 percent, and current use by 83.9 percent.

E-cigarette use, which has faced increasing scrutiny, also shows a sharp decline since its peak in 2019. That year, 48.9 percent of students had ever tried vaping, 30.1 percent were current users, 10.2 percent were frequent users, and 7.3 percent vaped daily. By 2023, those figures had dropped to 32.4 percent (ever-use), 16.5 percent (current use), 5.8 percent (frequent use), and 3.9 percent (daily use). Between 2019 and 2023, e-cigarette ever-use dropped 33.7 percent, current use 45.2 percent, frequent use 43.1 percent, and daily use 46.6 percent.

Meanwhile, the use of other substances remains prevalent. In 2023, 18.3 percent of students reported current alcohol use, and 9.3 percent reported binge drinking—more than twice the rate of daily vaping. Marijuana use has also remained relatively stable: 29.9 percent had ever tried marijuana, and 19.8 percent were current users—18.2 percent higher than the number currently vaping.

Despite these trends, Rhode Island lawmakers responded to vaping concerns by banning flavored e-cigarettes in 2020, a measure codified in 2024. Recent proposals would allow flavored products to be sold in age-restricted stores.

However, this policy overlooked critical data about why youth vape. In 2023, among students who had ever tried an e-cigarette, only 4 percent cited flavors as the reason. The most common reasons were curiosity (32.9 percent) and self-medicating for anxiety, depression, or stress (20.4 percent). Even in 2019, when youth vaping was highest, just 7.3 percent cited flavors, while 43.2 percent selected "other," and 34 percent said they used vapes because a friend or family member did.

E-cigarettes and other alternatives to combustible tobacco are valuable harm reduction tools and should not be restricted based on outdated narratives. These products have clearly contributed to sharp declines in youth—and adult—smoking. In 2023, just 9.5 percent of Rhode Island adults aged 18 and older were current smokers, a 19.5 percent drop from 2022 and an all-time low.

Policymakers should support access to safer alternatives while remaining vigilant about youth use and unintended consequences. Prohibition has not curbed demand—it has merely driven it underground.