Cigarette smoking among high school students dropped to the lowest levels since the National Youth Risk Behavior Survey (YRBS) began in 1991, but the use of electronic vapor products, including e-cigarettes, among students poses new challenges according to the 2015 survey results released today by the Centers for Disease Control and Prevention.

Although current cigarette use decreased significantly from 28 percent in 1991 to 11 percent in 2015, new data from the 2015 survey found that 24 percent of high school students reported using e-cigarettes during the past 30 days.

“Current cigarette smoking is at an all-time low, which is great news. However, it’s troubling to see that students are engaging in new risk behaviors, such as using e-cigarettes,” said CDC Director Tom Frieden, M.D., M.P.H., in a news release. “We must continue to invest in programs that help reduce all forms of tobacco use, including e-cigarettes, among youth.”

The 2015 survey findings included questions on prescription drug use. One key finding was that prescription drug use among youth decreased from 20 percent in 2009 to 17 percent in 2015. In addition, nationwide, 17 percent of students had taken prescription drugs (e.g., Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor’s prescription one or more times during their life.

“Health risk behaviors among youth vary over time and across the nation, making the YRBS an important tool to better understand youth. The YRBS helps us identify newly emerging behaviors and monitor long-standing youth risk behaviors over time,” said Laura Kann, Ph.D., chief of CDC’s School-Based Surveillance Branch. “While overall trends for the 2015 report are positive, the results highlight the continued need for improvements in reducing risks among teens.”