The only national survey of middle and high school students focusing exclusively on tobacco use demonstrates that cigarette smoking among kids is down but use of other tobacco produces is way up. According to Benjamin J. Apelberg, Ph.D., branch chief of epidemiology at FDA’s Center for Tobacco Products, “Middle and high school kids are using novel products like e-cigarettes and hookahs in unprecedented numbers, and many are using more than one kind of tobacco product.” What is the impact of these survey results for clinicians? Patient intake questionnaires should ask about use of tobacco products not just smoking.