Each day in the United States, approximately 4,400 youths aged 12-17 years try their first cigarette. An estimated one third of these young smokers are expected to die from a smoking-related disease. The National Youth Tobacco Survey (NYTS), conducted by the American Legacy Foundation, provides estimates of usage among U.S. middle and high school students for various tobacco products (i.e., cigarettes, cigars, smokeless tobacco, pipes, bidis [leaf-wrapped, flavored cigarettes from India], and kreteks [clove cigarettes]). This report summarizes tobacco use prevalence estimates from the 2002 NYTS and describes changes in prevalence since 2000. Both tobacco use and cigarette smoking among students in high school (i.e., grades 9-12) decreased by approximately 18% during 2000-2002; however, a decrease among students in middle school (i.e., grades 6-8) was not statistically significant. The lack of progress among middle school students suggests that health officials should improve implementation of proven antismoking strategies and develop new strategies to promote continued declines in youth smoking.