Trends in cigarette, cigar, and smokeless tobacco use among New York City public high school youth smokers, 2001–2013

• Overall, youth cigarette smoking in NYC has declined since 2001.
• Since 2007, NYC youth who smoke are smoking fewer cigarettes per day.
• Cigar use among youth smokers in NYC doubled between 2001 and 2013.
• Smokeless tobacco use among smokers increased 400% from 2001 to 2013.

ObjectiveThis study aimed to describe the recent trends in youth smoking behaviors, and examine cigar and smokeless tobacco use patterns among youth smokers in New York City.MethodsData, analyzed in 2014, were from the New York City Youth Risk Behavior Survey, a cross-sectional survey conducted bi-annually since 1997 in a representative sample of New York City public high school students (2001–2013), n = 59,122.ResultsCigarette smoking declined 53%, from 17.6% in 2001 to 8.2% in 2013 (p < 0.001). The proportion of cigar use among smokers doubled, from 22.2% in 2001 to 45.9% in 2013 (p < 0.001), while the proportion of smokeless tobacco use among smokers increased by 400% between 2001 and 2013 (4.2% vs. 21.2%, p < 0.001).ConclusionsYouth cigarette smoking rates in New York City decreased, while cigar smoking and smokeless tobacco use among smokers increased considerably. These data highlight trends in youth smoking behaviors within the context of New York City's comprehensive tobacco control program and stress the need for additional activity to spur further declines in cigarette smoking and reverse the trends in cigar and smokeless tobacco use among New York City youth. Results demonstrate the need for continuous surveillance and action by the public health community to counteract tobacco industry promotion of other products.