North Dakota Saw Rise in Teen Smokeless Tobacco Use
High school smokeless tobacco usage rates more than doubled in two years as teen e-cigarette use declined.
Updated on Oct. 2, 2026 in Substance Abuse
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Recent findings show that smokeless tobacco use among North Dakota high school students rose to 7% in 2025, up from 3% in 2023. Meanwhile, data from the Youth Risk Behavior Survey indicates that e-cigarette use among middle and high school students is trending downward.
Why it matters
Health officials believe the increase in smokeless tobacco usage is driven by the rising popularity of nicotine pouches, which are often marketed with tobacco-free labeling. This labeling may lead young people to mistakenly assume these products carry fewer health risks.
Smokeless tobacco use among high schoolers reached 7% in 2025 compared to 3% in 2023. These findings were presented to the State Board of Health following the latest biennial survey.
The players
State Board of Health
This government entity oversees public health initiatives and reviews vital health data for North Dakota.
Fargo Cass Public Health
This local agency is responsible for public health research and conducts the biennial Youth Risk Behavior Survey.
Food and Drug Administration
This federal agency regulates tobacco products and previously recommended child-resistant packaging for nicotine pouches.
The details
The Youth Risk Behavior Survey, conducted by Fargo Cass Public Health, suggests a shifting landscape in youth nicotine consumption. While traditional vaping has seen a decrease, the adoption of nicotine pouches—which faced federal safety scrutiny regarding child-resistant packaging in 2025—has emerged as a significant health concern.
Timeline
High school smokeless tobacco use was measured at 3% in 2023.
Usage rates rose to 7% among high school students by 2025.
The FDA recommended child-resistant packaging for pouches in 2025.
Survey results were presented to the State Board of Health on October 2, 2026.
The next round of the youth health survey is expected in 2027.
Health Landscape
The report highlights the limitations of the FDA's 2025 child-resistant packaging recommendations for nicotine pouches in curbing total youth uptake. This trend reflects an ongoing struggle to regulate emerging nicotine delivery systems that bypass traditional tobacco classifications.
Parents and educators should be aware that products marketed as tobacco-free may still contain high concentrations of nicotine. Health officials advise discussing these products with teenagers to clarify misconceptions regarding their safety profile.
The takeaway
The transition from vaping to other nicotine products illustrates how quickly youth consumption habits evolve. Families should remain vigilant about new nicotine delivery systems that avoid traditional tobacco labeling.
What happens next
The next round of the Youth Risk Behavior Survey is scheduled to take place in 2027.
Further reading
For more information on trends in the state, visit the /health/substance-abuse/ section.
Source note: This article includes information reported by INFORUM.
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