Preventing school failure for middle school students: motivation and mindset for variation in math achievement among middle school students with and without LD
U.S. student progress in mathematics is assessed throughout the K-12 experience, from elementary to high school (NECS, 2015). Before students enter high school to learn and understand more complex concepts, they need a strong knowledge of basic mathematics. Middle school is a critical transitional period between elementary and high school. It is an opportune time to address foundational mathematics understandings, prior to the more rigorous demands of high school. Among the students who may need additional mathematical foundations instructions to support their math achievement are students with learning disabilities (LD) (Gebhardt, Zehnera, & Hessels, 2014). However, beyond standard mathematics instruction, there are other constructs that can be addressed through targeted intervention to enhance LD student’s achievement. This study aims to explore the relationships between emotional constructs (motivation and mindset) and math achievement for middle school students with and without learning disabilities. It offers descriptive insights for educators about the self-perceptions of these two groups of students.
- Research Article
16
- 10.1016/j.lanwpc.2022.100549
- Jul 28, 2022
- The Lancet Regional Health: Western Pacific
Prevalence, frequency, intensity, and location of cigarette use among adolescents in China from 2013–14 to 2019: Findings from two repeated cross-sectional studies
- Research Article
- 10.18438/b80w2g
- Dec 11, 2006
- Evidence Based Library and Information Practice
Elementary, Middle, and High School Students Vary in Frequency and Purpose When Using Online Digital References
- Research Article
- 10.15384/kjhp.2025.00031
- Mar 31, 2025
- Korean Journal of Health Promotion
Background: This study aim to compare between middle and high school students on the relationship of high-caffeine drinks and mental health.Methods: This national cross-sectional secondary study used data from the 20th Korea Youth Risk Behavior Survey (2024). The respondents of this study were 54,653 middle and high school students. Descriptive statistics, chi-square analysis, and complex sample logistic regression analysis were performed using IBM SPSS Statistics 25.0. Results: Respondents of ‘much’ perceived stress consumed 1.493 times (P<0.001) more high-caffeine drinks in middle school and 1.699 times (P<0.001) in high school than those of ‘little.’ Respondents of ‘yes’ sadness & despair consumed 1.189 times (P<0.001) more high-caffeine drinks in middle school and consumed 1.142 times (P<0.001) in high school than those of ‘no.’ Suicidal ideation and loneliness variables were statistically significant in middle school, but not in high school. Conclusions: It was concluded that middle and high school students who were more stressed and experienced sadness & despair consumed more high-caffeine drinks. However, only middle school students who experienced suicidal ideation and loneliness consumed more high-caffeine drinks. Recognizing each characteristic of middle and high school students, tailored intervention program should be developed based on the community and school.
- Research Article
5
- 10.1044/leader.ftr1.14062009.10
- May 1, 2009
- The ASHA Leader
Response-to-Intervention: SLPs as Linchpins in Secondary Schools
- Research Article
9
- 10.2307/1593590
- May 1, 2003
- Learning Disability Quarterly
We know that students who do not possess basic early reading skills by the end of third grade will likely continue to struggle with reading throughout their school career and into adulthood. We also know that approximately 80% of students identified with learning disabilities (LD) have reading problems (National Research Council, 1998). Findings from the National Assessment of Education Progress (NAEP, 1998) may lend support to this prediction of persistent reading problems. For instance, at the eighth-grade level, 32% of boys and 19% of girls could not read at the basic level while 30% of boys and 17% of girls in twelfth grade scored below the basic level. Additionally, at the eighth-grade level, 47% Black, 46% Hispanic, and 39% American Indian students scored below the basic level in reading. The NAEP data also indicated deficits in inferential comprehension skills and writing abilities. Thus, the long-term ramification of literacy problems is a significant issue for middle and high school students and their teachers. Moreover, contributing to the profile of struggling middle and high school (secondary level) students, data from the National Longitudinal Transition Study (Wagner, Blackorby, & Hebbeler, 1993) indicated that compared to the general population, a disproportionate percentage of students with LD drop out of school. In sum, these data present a disturbing profile of our secondary struggling students. For those struggling, secondary-level students who remain in school, the performance gap may continue to widen as the expectations for proficient literacy skills in textbook-driven content-area curriculum become the norm for secondary instruction. As schools increasingly focus on standards- and outcome-based educational programming across grade levels and as students with LD attend mostly general education classes for instruction, students with reading disabilities will continue to need intervention that is responsive to the range of literacy difficulties they present at an intensity of instruction that will be necessary to promote their successful learning of the general education curriculum (Deshler et al., 2001). It is well known that phonemic awareness, phonics, fluency, comprehension, vocabulary, and writing are important components of reading instruction at the elementary level. For middle and high school struggling readers, some or all of these components may be necessary as well. Students may need not only basic reading skills but also instruction in strategies that will help them to better understand and think critically about the text they encounter in their daily classes. Based on students' abilities, the focus of the interventions, the intensity of instruction, and the individuals responsible for instruction must be considered in purposefully planning for effective instruction. The purpose of this special issue is to provide information about ways to promote effective reading and writing instruction for students with learning disabilities who continue to struggle at the secondary level because of literacy problems. The articles are presented in a way that first reflects the basic reading instruction that some struggling students may require even at the secondary level. The remaining articles focus on those skills, including higher-order critical thinking skills, that are critical for secondary students to be able to tackle the demands of content-area reading. The articles were solicited from researchers who have spent a great deal of time working with students at the secondary level who have been left behind. I thank them for their participation in this project and thank the LDQ editor, Dave Edyburn, who helped to make this issue a reality. The following is an overview of the papers. In their article on phonological awareness (PA) training with middle school students with LD and deficits in PA, Bhat, Griffin, and Sindelar present findings from a study on the effects of PA training on students' PA and word identification skills as measured by the Comprehensive Test of Phonological Processing (CTOPP). …
- Research Article
3
- 10.3389/fpsyg.2023.1061027
- Apr 6, 2023
- Frontiers in Psychology
Research has shown that mindfulness can reduce students' negative emotions associated with high-stakes tests and thereby improve test performance. This study explored the association between mindfulness-based intervention (MBI) and high-risk math test scores of middle school students, which is noticeably slim in the domain of mathematics education, through a mediating process involving math-specific test anxiety and math self-efficacy. Using data from a sample of 45 students, age 12-13, we found empirical support for a significant positive correlation between mindfulness and middle school students' math achievement. Participants listened to a mindfulness audio every other week before a mathematics test. Weekly mathematics test scores, student group discussion data, and in-depth interview data were analyzed to explore how mindfulness affected students' mathematics test performance, which showed a statistically significant improvement after mindfulness compared to mathematics achievement without the intervention. Our results indicate that mindfulness can relieve mathematics anxiety symptoms, including physiological manifestations, test-unrelated thinking and worries, and problem-solving obstacles caused by mathematics anxiety. Also, mindfulness, especially its non-judgmental attitude, positively affects students' mathematical self-efficacy. The current research provides evidence of the mindfulness intervention's efficacy for improving middle school mathematics test performance but also identifies the complexities of implementing it with large numbers of students.
- Dissertation
- 10.17918/00001340
- Nov 17, 2022
The purpose of this mixed method nested case study is to: (a) provide indicators and experiences math educators have recognizing math anxiety in students; (b) identify ways in which middle and high school math educators implement creative teaching strategies to reduce math anxiety in middle and high school students; and (c) look at the veracity and truthfulness of educator recognition of student math anxiety. Four data collection methods were implemented to complete this study: (1) survey, (2) one-on-one interviews, (3) classroom observations, and (4) Reisman Diagnostic Creativity Assessment (RDCA). The sample population for the survey was comprised of 35 middle and high school math educators: 20 middle school and 15 high school. Seven participants were selected to participate in the one-on-one interviews: four middle school and three high school math educators. Four participants were selected to participate in classroom observations: two middle school and two high school math educators. Finally, 13 educators participated in the RDCA: 11 middle school and 2 high school math educators. The researcher aimed to answer the following three research questions: (1) What are the similarities and differences of how middle and high school math educators recognize math anxiety in their students? (2) What creative teaching strategies do middle and high school math educators implement to decrease math anxiety among their students? (3) Do middle and high school mathematics educators have similar or different risk taking, tolerance of ambiguity, and originality when identifying their own creative strengths? The conceptual framework of this study involves experience teaching middle and high school mathematics, working/collaborating directly with middle and high school math educators, and implementing interventions and creative teaching strategies to reduce math anxiety in middle and high school students. The findings of this study may be used to: (1) help middle and high school math educators to understand how to identify math anxiety in their students, (2) understand creative teaching strategies and its implementation to reduce math anxiety in middle and high school students, and (3) help middle and high school math educators identify their own creativity factors. Keywords: Math anxiety, creative teaching strategies, middle school, high school, teaching mathematics, identifying creativity, reduce math anxiety
- Research Article
113
- 10.1086/447369
- May 1, 1996
- Comparative Education Review
Differentes recherches ont etabli l'influence des enseignants sur la qualite de l'apprentissage des enfants. La question est de savoir ce qui rend un enseignant plus performant qu'un autre. Quatre indicateurs, etudies par les AA., peuvent etre utilises dans ce but : les acquisitions pedagogiques des enseignants, leurs participations dans les programmes d'etudes, leurs connaissances des matieres enseignees et leurs strategies pedagogiques
- Research Article
1
- 10.22251/jlcci.2022.22.17.341
- Sep 15, 2022
- Korean Association For Learner-Centered Curriculum And Instruction
Objectives The purpose of this study is to classify the latent groups according to the learning motivation of Korean language and mathematics of middle and high school students, and to analyze the differences in academic achievement, distance learning experiences and satisfaction in 2020 by learning motive groups.
 Methods The subject of analysis is the data of 10,653 middle school students and 10,528 high school students responding to the 「2020 National Assessment of Educational Achievement」 of Korea Institute for Curriculum and Evaluation. For data processing, frequency analysis, factor analysis, and reliability analysis were performed using SPSS and Jamovi programs, the latent groups according to the Korean language and math learning motivation were extracted using the Mplus program, and the characteristics of each latent group were analyzed.
 Results The learning motivation groups of middle and high school students were identified as upper, middle, and lower 3 groups in Korean, and upper, middle-high, middle-low, and lower 4 groups in mathematics. As a result of examining the characteristics of each group, the group with high motivation for Korean and math had good Korean and math achievement. Looking at the changes in school level, Korean learning motivation gradually increased, but Korean language achievement decreased, and math learning motivation gradually decreased, but achievement tended to increase. As a result of examining the environmental differences in distance learning experienced in 2020 by the learning motivation group, the group with high Korean and math learning motivation was found to have the least negative influence of distance learning, suggesting the possibility of a learning gap. In addition, there was a difference in satisfaction with distance learning according to the level of motivation, and lower satisfaction with feedback and communication was shown compared to other items.
 Conclusions Middle and high school students' motivation for Korean and mathematics and academic achievement are closely related, suggesting the development of convergence classes between subjects. In addition, the group with high learning motivation appears to be the group that minimizes the unfavorable influence of distance learning, requiring the establishment of strategies to improve learners' learning motivation for each subject.
- Research Article
9
- 10.1001/jamanetworkopen.2022.26886
- Aug 16, 2022
- JAMA network open
Screening and brief intervention (SBI) programs in schools have the potential to provide substance use prevention messages to large numbers of adolescents. This study evaluated the association between exposure to a school-based SBI program and reductions in substance use among youths after enactment of a law that required Massachusetts schools to provide SBI to all students. To estimate the association between exposure to a school-based SBI program and changes in substance use among youths. In this mixed-method quality improvement study using an effectiveness-implementation hybrid design, stakeholder interviews were conducted to describe the operations, timing, and impressions of SBI implementation at 14 intervention schools in Massachusetts. Repeated cross-sectional surveys of youths in intervention and comparison groups were administered between December 19, 2017, and May 22, 2019, to assess substance use and associated measures of perceived risk, knowledge, and adult support before and approximately 3 months after SBI implementation among exposed groups. A difference-in-differences framework was used to estimate substance use outcomes associated with SBI exposure among students in middle school (grades 7 and 8) and high school (grades 9 and 10) using adjusted overlap-weighted generalized models to account for covariate imbalance between exposed and unexposed school grades. In addition, 14 school staff members were interviewed about implementation. Exposure vs nonexposure to a school-based SBI program. Frequency of alcohol, cannabis, and e-cigarette use (measured in days) and any binge drinking in the past 3 months. Between December 2017 and May 2019, 8771 survey responses were collected from 4587 students in grades 7 through 10 who were attending one of 23 participating school districts. The median (IQR) age was 13 (13-14) years (range, 12-17 years); 2226 students self-identified as female (48.5%), 2206 (48.1%) as male, and 155 (3.4%) as transgender or preferred not to answer. Overall, 163 students (3.6%) identified their race as Asian, 146 (3.2%) as Black or African American, 2952 (64.4%) as White, and 910 (19.8%) as mixed or other race (including American Indian or Alaska Native and Native Hawaiian or Pacific Islander); 416 students (9.1%) preferred not to answer or were missing data on race. A total of 625 students (13.6%) identified their ethnicity as Hispanic and 3962 (86.4%) as non-Hispanic. Cannabis use increased over time in both the SBI group (middle school: marginal estimated probability, 0.73 [95% CI, 0.21-2.51] at baseline vs 2.01 [95% CI, 0.60-6.70] at follow-up; high school: marginal estimated probability, 2.86 [95% CI, 0.56-14.56] at baseline vs 3.10 [95% CI, 0.57-16.96] at follow-up) and the control group (middle school: marginal estimated probability, 0.24 [95% CI, 0.05-1.03] at baseline vs 3.38 [95% CI, 0.81-14.18] at follow-up; high school: marginal estimated probability, 1.30 [95% CI, 0.27-6.29] at baseline vs 1.72 [95% CI, 0.34-8.66] at follow-up). e-cigarette use also increased over time in both the SBI group (middle school: marginal estimated probability, 0.81 [95% CI, 0.22-3.01] at baseline vs 1.94 [95% CI, 0.53-7.02] at follow-up; high school: marginal estimated probability, 3.82 [95% CI, 0.72-20.42] at baseline vs 3.51 [95% CI, 0.55-22.59] at follow-up) and the control group (middle school: marginal estimated probability, 0.51 [95% CI, 0.12-2.30] at baseline vs 3.40 [95% CI, 0.72-16.08] at follow-up; high school: marginal estimated probability, 2.29 [95% CI, 0.41-12.65] at baseline vs 3.53 [95% CI, 0.62-20.16] at follow-up). Exposure to SBI was associated with a significantly smaller increase in the rate of cannabis use among middle school students (adjusted rate ratio [aRR], 0.19; 95% CI, 0.04-0.86) and significantly smaller increases in the rates of cannabis and e-cigarette use among all female students (cannabis use: aRR, 0.17 [95% CI, 0.03-0.96]; e-cigarette use: aRR, 0.16 [95% CI, 0.03-0.82]) compared with nonexposure. No other significant differences were observed among students in grades 7 and 8, and no differences were found in any comparison between groups in grades 9 and 10. In this quality improvement study, exposure to a school-based SBI program was associated with a significantly smaller increase in the rate of cannabis use among middle school students and significantly smaller increases in the rates of cannabis and e-cigarette use among all female students. These findings suggest that implementation of SBI programs in schools may help to reduce substance use among middle school and female students, and further study of these programs is warranted.
- Research Article
284
- 10.15585/mmwr.mm6950a1
- Dec 18, 2020
- Morbidity and Mortality Weekly Report
Tobacco use is the leading cause of preventable disease and death in the United States; nearly all tobacco product use begins during youth and young adulthood (1,2). CDC and the Food and Drug Administration (FDA) analyzed data from the 2019 and 2020 National Youth Tobacco Surveys (NYTS) to determine changes in the current (past 30-day) use of seven tobacco products among U.S. middle (grades 6-8) and high (grades 9-12) school students. In 2020, current use of any tobacco product was reported by 16.2% (4.47 million) of all students, including 23.6% (3.65 million) of high school and 6.7% (800,000) of middle school students. Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among high school (19.6%; 3.02 million) and middle school (4.7%; 550,000) students. From 2019 to 2020, decreases in current use of any tobacco product, any combustible tobacco product, multiple tobacco products, e-cigarettes, cigars, and smokeless tobacco occurred among high school and middle school students; these declines resulted in an estimated 1.73 million fewer current youth tobacco product users in 2020 than in 2019 (6.20 million) (3). From 2019 to 2020, no significant change occurred in the use of cigarettes, hookahs, pipe tobacco, or heated tobacco products. The comprehensive and sustained implementation of evidence-based tobacco control strategies at the national, state, and local levels, combined with tobacco product regulation by FDA, is warranted to help sustain this progress and to prevent and reduce all forms of tobacco product use among U.S. youths (1,2).
- Research Article
- 10.35510/jer.2023.46.1.169
- Feb 28, 2024
- The Institute of Educational Research Chonnam National University
This study analyzed the latent profile and latent profile transition of middle and high school students during and before the COVID-19 pandemic. The aim was to identify and characterize the latent profile of emotional problems among middle and high school students and to examine the transfer between latent groups. To do so, we utilized data from the third and fourth years of the Child and Adolescent Panel 2018 (Middle 1 Panel) and the sixth and seventh years of the Child and Adolescent Panel 2010 (Elementary 4 Panel). As a result of the analysis, first, during COVID-19, the profiles of emotional problem were categorized into five groups for middle school students and four groups for high school students. Second, the pre-COVID-19 emotional problem profiles were equally categorized into four groups of middle school and high school students. Third, the classification of potential profiles is noteworthy for the “Attention Deficit-Aggression Hyperactivity” group during the corona period. In 2020, due to the pandemic, middle school students did not attend school for the majority of the regular school days, creating a group that was not present at any other point in time, as they were unable to learn the daily routine of school and were unable to be sanctioned for attention. Fourth, before the COVID-19 pandemic, the transition type of the emotional problem profile showed a transition to a stable emotional group as students entered high school, but during the pandemic, there was a notable shift, with transitions in emotions, including transitions from the 'emotional risk group' to the 'emotional stability group' and vice versa.
- Research Article
- 10.35510/jer.2024.46.1.169
- Feb 28, 2024
- The Institute of Educational Research Chonnam National University
This study analyzed the latent profile and latent profile transition of middle and high school students during and before the COVID-19 pandemic. The aim was to identify and characterize the latent profile of emotional problems among middle and high school students and to examine the transfer between latent groups. To do so, we utilized data from the third and fourth years of the Child and Adolescent Panel 2018 (Middle 1 Panel) and the sixth and seventh years of the Child and Adolescent Panel 2010 (Elementary 4 Panel). As a result of the analysis, first, during COVID-19, the profiles of emotional problem were categorized into five groups for middle school students and four groups for high school students. Second, the pre-COVID-19 emotional problem profiles were equally categorized into four groups of middle school and high school students. Third, the classification of potential profiles is noteworthy for the “Attention Deficit-Aggression Hyperactivity” group during the corona period. In 2020, due to the pandemic, middle school students did not attend school for the majority of the regular school days, creating a group that was not present at any other point in time, as they were unable to learn the daily routine of school and were unable to be sanctioned for attention. Fourth, before the COVID-19 pandemic, the transition type of the emotional problem profile showed a transition to a stable emotional group as students entered high school, but during the pandemic, there was a notable shift, with transitions in emotions, including transitions from the 'emotional risk group' to the 'emotional stability group' and vice versa.
- Research Article
5
- 10.1097/01.cot.0000436598.08572.f7
- Oct 1, 2013
- Oncology Times
FigureElectronic cigarettes, or e-cigarettes, are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. Depending on the brand, e-cigarette cartridges typically contain nicotine, a component to produce the aerosol (e.g., propylene glycol or glycerol), and flavorings (e.g., fruit, mint, or chocolate).1 Potentially harmful constituents also have been documented in some e-cigarette cartridges, including irritants, genotoxins, and animal carcinogens.1 E-cigarettes that are not marketed for therapeutic purposes are currently unregulated by the Food and Drug Administration, and in most states there are no restrictions on the sale of e-cigarettes to minors. Use of e-cigarettes has increased among U.S. adult current and former smokers in recent years,2 but the extent of use among youths is uncertain. Data from the 2011 and 2012 National Youth Tobacco Survey (NYTS), a school-based, pencil-and-paper questionnaire given to U.S. middle school (grades 6–8) and high school (grades 9–12) students, were used to estimate the prevalence of ever and current (one or more per day in the past 30 days) use of e-cigarettes, ever and current (one or more per day in the past 30 days) use of conventional cigarettes, and use of both. The survey consists of a cross-sectional, nationally representative sample of students in grades 6–12 from all 50 states and the District of Columbia.3 During 2011–2012, among all students in grades 6–12, “ever” e-cigarette use increased from 3.3 to 6.8 percent (p<0.05); current e-cigarette use increased from 1.1 to 2.1 percent (p<0.05); and current use of both e-cigarettes and conventional cigarettes increased from 0.8 to 1.6 percent (p<0.05). In 2012, among ever e-cigarette users, 9.3 percent reported never smoking conventional cigarettes; among current e-cigarette users, 76.3 percent reported current conventional cigarette smoking.Figure: Ever electronic cigarette (e-cigarette) use among middle and high school students, by year, in the United States during 2011–2012. During that time, among all students in grades 6–12, ever e-cigarette use increased from 3.3% to 6.8%; current e-cigarette use increased from 1.1% to 2.1%, and current use of both e-cigarettes and conventional cigarettes increased from 0.8% to 1.6%.Among middle school students, ever e-cigarette use increased from 1.4 to 2.7 percent during 2011–2012 (p<0.05); current e-cigarette use increased from 0.6 to 1.1 percent (p<0.05); and current use of both e-cigarettes and conventional cigarettes increased from 0.3 to 0.7 percent (p<0.05). In 2012, among middle school ever e-cigarette users, 20.3 percent reported never smoking conventional cigarettes; among middle school current e-cigarette users, 61.1 percent reported current conventional cigarette smoking. Among high school students, ever e-cigarette use increased from 4.7 to 10.0 percent during 2011–2012 (p<0.05); current e-cigarette use increased from 1.5 to 2.8 percent (p<0.05); and current use of both e-cigarettes and conventional cigarettes increased from 1.2 to 2.2 percent (p<0.05). In 2012, among high school ever e-cigarette users, 7.2 percent reported never smoking conventional cigarettes; among high school current e-cigarette users, 80.5 percent reported current conventional cigarette smoking. Use Doubled E-cigarette experimentation and recent use doubled among U.S. middle and high school students during 2011–2012, resulting in an estimated 1.78 million students having ever used e-cigarettes as of 2012. Moreover, in 2012, an estimated 160,000 students who reported ever using e-cigarettes had never used conventional cigarettes. This is a serious concern because the overall impact of e-cigarette use on public health remains uncertain. In youths, concerns include the potential negative impact of nicotine on adolescent brain development,4 as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products. CDC and the Food and Drug Administration will continue to explore ways to increase surveillance and research on e-cigarettes. Given the rapid increase in use and youths' susceptibility to social and environmental influences to use tobacco, developing strategies to prevent marketing, sales, and use of e-cigarettes among youths is critical. Reprinted (slightly edited) from Morbidity and Mortality Weekly Report 2013; 62:729–730
- Research Article
617
- 10.15585/mmwr.mm6514a1
- Apr 15, 2016
- MMWR. Morbidity and Mortality Weekly Report
Tobacco use is the leading cause of preventable disease and death in the United States; if current smoking rates continue, 5.6 million Americans aged <18 years who are alive today are projected to die prematurely from smoking-related disease. Tobacco use and addiction mostly begin during youth and young adulthood. CDC and the Food and Drug Administration (FDA) analyzed data from the 2011-2015 National Youth Tobacco Surveys (NYTS) to determine the prevalence and trends of current (past 30-day) use of seven tobacco product types (cigarettes, cigars, smokeless tobacco, electronic cigarettes [e-cigarettes], hookahs [water pipes used to smoke tobacco], pipe tobacco, and bidis [small imported cigarettes wrapped in a tendu leaf]) among U.S. middle (grades 6-8) and high (grades 9-12) school students. In 2015, e-cigarettes were the most commonly used tobacco product among middle (5.3%) and high (16.0%) school students. During 2011-2015, significant increases in current use of e-cigarettes and hookahs occurred among middle and high school students, whereas current use of conventional tobacco products, such as cigarettes and cigars decreased, resulting in no change in overall tobacco product use. During 2014-2015, current use of e-cigarettes increased among middle school students, whereas current use of hookahs decreased among high school students; in contrast, no change was observed in use of hookahs among middle school students, use of e-cigarettes among high school students, or use of cigarettes, cigars, smokeless tobacco, pipe tobacco, or bidis among middle and high school students. In 2015, an estimated 4.7 million middle and high school students were current tobacco product users, and, therefore, continue to be exposed to harmful tobacco product constituents, including nicotine. Nicotine exposure during adolescence, a critical period for brain development, can cause addiction, might harm brain development, and could lead to sustained tobacco product use among youths. Comprehensive and sustained strategies are warranted to prevent and reduce the use of all tobacco products among U.S. youths.
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