Knox and Waldo County teens report rise in smokeless tobacco use and underestimate alcohol risks
The 2025 Maine Integrated Youth Health Survey (MIYHS) provides insight into the health behaviors of Maine students. Conducted every two years by the Maine Department of Health and Human Services (DHHS), the Maine Center for Disease Control (CDC), and the Maine Department of Education (DOE), the survey helps guide youth prevention and intervention programs.
Overall, survey results show that teen participation in cigarette smoking and vaping is declining. However, smokeless tobacco use—including nicotine pouches—has increased significantly statewide. In 2023, 3.1% of Maine high school students reported recent use of nicotine pouches (2023 MIYHS, page 329); by 2025, the statewide high school average rose to 5.2% (2025 MIYHS, page 296).
Smokeless nicotine options, such as nicotine pouches (e.g., Zyn), are not a safer alternative to smoking or vaping for teens. Nicotine pouches deliver high levels of nicotine, which can impact the developing brain and lead to addiction. Smokeless tobacco also introduces nicotine and other carcinogens into the mouth which can lead to gum disease, tooth loss and increased risk for cancer.
The survey also highlights risk perceptions among middle school students regarding alcohol. In Knox and Waldo counties, over 30% of youth surveyed believe there is “slight or no risk” in drinking one or two alcoholic beverages every day (2025 MIYHS, page 297). Between 13% and 23% of students in Knox and Waldo counties reported “slight or no risk” from consuming five or more alcoholic drinks in a single sitting, a level considered binge drinking. This highlights that some youth may underestimate the dangers of heavy drinking, which can lead to accidents, alcohol poisoning, and long- term health consequences.
In Waldo County, nearly 31% of middle school students reported living—or having lived—with an adult who had a problem with alcohol or drugs (2025 MIYHS, page 583). “This data highlights the importance of providing opportunities for middle and high school students to have open, supportive, and informative conversations about substance use and local resources for treatment or recovery. A compassionate approach to these discussions can reduce stigma and increase the likelihood that they will reach out for support when needed,” said Jamie Lovley, Director of the Community Health Promotion at the Penobscot Bay YMCA (PBCHP). PBCHP delivers free substance use programming and education to youth and adults in Knox and Waldo.
Maine schools should prioritize participation in the Maine Integrated Youth Health Survey (MIYHS) in order to assist in identifying emerging and changing youth health needs. The data gathered from these surveys is also used to guide youth-serving programs and overall better equip professionals to support young people with emerging mental health and substance use challenges.
For more information about substance use prevention education and stigma reduction programming in Knox and Waldo counties, contact Penobscot Bay Community Health Partnerships at jlovley@penbayymca.org or pbchp.org .

