{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:51:21Z","timestamp":1791557481827,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["PRCRPG\u2010Nov21\\100002"],"award-info":[{"award-number":["PRCRPG\u2010Nov21\\100002"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aim<\/jats:title><jats:p>Concerns have been raised that e\u2010cigarettes have created a new generation of people addicted to nicotine. This study aimed to measure changes in the proportion of US high\u2010school students reporting symptoms of nicotine dependence over the past decade, in the context of changing patterns of nicotine product use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Repeat cross\u2010sectional analyses of the 2014\u20132023 National Youth Tobacco Surveys.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>United States of America.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>107\u2009968 high\u2010school students (14\u201318y).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Nicotine product use was categorised based on self\u2010reported past\u201030\u2010day use of cigarettes, other combustible tobacco, smokeless\/non\u2010combustible products and e\u2010cigarettes. Nicotine dependence was operationalised as (a) strong past\u201030\u2010day cravings to use tobacco and (b) wanting to use nicotine products within 30\u2009minutes of waking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Past\u201030\u2010day use of any nicotine product decreased from 24.5% (95% confidence interval\u2009=\u200922.5%\u201326.6%) to 19.6% (16.8%\u201322.4%) between 2014 and 2017, increased sharply, reaching 31.4% (29.0%\u201333.7%) in 2019 (driven by an increase in e\u2010cigarette use), then fell to the lowest level at 12.5% (10.9%\u201314.1%) by 2023. The proportion who reported symptoms of nicotine dependence was substantially lower, but followed a similar pattern of changes over time. For example, the proportion reporting strong cravings decreased from 7.8% (6.6%\u20139.0%) to 5.5% (4.3%\u20136.7%) between 2014 and 2017, increased to 7.9% (6.8%\u20139.0%) between 2017 and 2018 and remained stable up to 2020, then fell to the lowest level at 2.5% (1.9%\u20133.1%) by 2023. While dependence symptoms were consistently highest among cigarette users, they were increasingly prevalent among those using only e\u2010cigarettes after 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The sharp rise in the prevalence of nicotine product use (in particular, e\u2010cigarettes) among US high\u2010school students in the late 2010s was short\u2010lived and was not accompanied by a sustained increase in the overall population burden of nicotine dependence. By 2023, both nicotine product use and nicotine dependence had reached historic lows. However, dependence symptoms increased over time among those using e\u2010cigarettes only.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70120","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T05:46:35Z","timestamp":1750830395000},"page":"2215-2222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Changing patterns of nicotine product use and nicotine dependence among United States high\u2010school students: The National Youth Tobacco Survey, 2014\u20132023"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-6168","authenticated-orcid":false,"given":"Sarah E.","family":"Jackson","sequence":"first","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"},{"name":"SPECTRUM Consortium  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2797-5428","authenticated-orcid":false,"given":"Jamie","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"},{"name":"SPECTRUM Consortium  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Tattan\u2010Birch","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"},{"name":"SPECTRUM Consortium  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Centers for Disease Control and Prevention.Youth and tobacco use. 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