Two of the national health objectives for 2010 are to reduce the prevalence of any tobacco use during the preceding month to < or =21% and the prevalence of current cigarette use to < or =16% among high school students (objectives 27-2a and 27-2b). The National Youth Tobacco Survey (NYTS), conducted by CDC in 2004, provided estimates of current use of tobacco products and selected indicators related to tobacco use, including youth exposure to tobacco-related media and access to cigarettes. This report summarizes data from the 2004 NYTS and describes changes in tobacco use and indicators related to tobacco use since 2002. During 2002-2004, middle school students reported decreases in pipe use, seeing actors using tobacco on television or in movies, and seeing advertisements for tobacco products on the Internet. Among high school students, no changes were observed in the use of tobacco or in access to tobacco products; however, seeing actors using tobacco on television or in movies declined slightly, and seeing advertisements for tobacco products on the Internet increased. The lack of substantial decreases in the use of almost all tobacco products among middle and high school students underscores the need to fully implement evidence-based strategies (e.g., increasing the retail price of tobacco products, implementing smoking-prevention media campaigns, and decreasing minors' access as part of comprehensive tobacco-control programs) that are effective in preventing youth tobacco use.