Child and Teen Tobacco Use

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Child and Teen Tobacco Use

The good news: The number of younger Americans who smoke cigarettes has been going down since the late 1990s.

The bad news: Each day, nearly 4,000 kids under the age of 18 try their first cigarette and another 1,000 become regular, daily smokers. About one third of these smokers will die prematurely from a smoking-related disease.

More bad news: As of 2012, more than 23% of all high school students (grades 9-12) had used some kind of tobacco product in the past month. Now, there are many more forms of tobacco to choose from, and more teens are choosing flavored cigars, smokeless tobacco, hookahs, pipes, and even electronic cigarettes. Some still smoke cigarettes.

Whatever they choose, kids are getting hooked in high school – by 12th grade, about half the smokers had tried to quit at least once in the past year.

Children and teens are easy targets for the tobacco industry. They’re often influenced by TV, movies, the Internet, advertising, and by what their friends do and say. They don’t realize what a struggle it can be to quit. And having cancer, emphysema, blindness, or impotence may not seem like real concerns – kids and teens don’t think much about future health outcomes.

Here we talk about tobacco use among children and teens. We also give some tips for parents, teachers, and other adults who want to keep their kids tobacco-free.

Facts about kids and tobacco

Almost all smokers start while they’re young

In 2012, 18% of high school girls and 23% of high school boys used some form of tobacco at least one day in the month before the survey. Studies have found that nearly all first use of tobacco takes place before high school graduation.

According to the 2012 Surgeon General’s Report, very few people start smoking after age 25: 99% of adult smokers first smoked by age 26. Nearly 9 out of 10 adult smokers had their first smoke by age 18.

The younger a person is when they start using tobacco, the more likely they are to use it as an adult. And people who start regularly using tobacco when they are younger are more likely to have trouble quitting than people who start later in life.

This means if we can keep kids tobacco free until age 18, most will never start using it.

Kids who smoke have smoking-related health problems

Cigarette smoking causes serious health problems in children and teens. Children and teens who smoke regularly have problems such as:

  • Coughing spells
  • Shortness of breath, even when not exercising
  • Wheezing or gasping
  • More frequent headaches
  • Increased phlegm (mucus)
  • Respiratory illnesses that are worse and happen more often
  • Worse cold and flu symptoms
  • Reduced physical fitness
  • Poor lung growth and function
  • Worse overall health
  • Addiction to nicotine

As they get older, teens who continue to smoke can expect problems like:

  • Gum disease and tooth loss
  • Infertility and impotence
  • Chronic lung diseases, like emphysema and bronchitis, which limit exercise and activity
  • Hearing loss
  • Vision problems, such as macular degeneration, which can lead to blindness
  • Blood vessel disease, which can lead to heart attacks or strokes at a young age

Most young smokers are addicted and find it hard to quit

Most young people who smoke regularly are already addicted to nicotine. In fact, they have the same kind of addiction as adult smokers. According to the 2012 Surgeon General’s Report:

    “Of every three young smokers, only one will quit, and one of those remaining smokers will die from tobacco-related causes. Most of these young people never considered the long-term health consequences associated with tobacco use when they started smoking; and nicotine, a highly addictive drug, causes many to continue smoking well into adulthood, often with deadly consequences.”

Most teen smokers say that they would like to quit and many have tried to do so without success. Those who try to quit smoking report withdrawal symptoms much like those reported by adults.

Tobacco use is linked to other harmful behaviors

Research has shown that teen tobacco users are more likely to use alcohol and illegal drugs than are non-users. Cigarette smokers are also more likely to get into fights, carry weapons, attempt suicide, suffer from mental health problems such as depression, and engage in high-risk sexual behaviors.

Look at the numbers

Tobacco use in middle school students

The most recent numbers on tobacco use among US middle school students come from a 2012 survey by the CDC. (Middle school includes children in grades 6, 7, and 8.)

  • Nearly 7% of middle school students reported using some form of tobacco − cigarettes, spit or other oral tobacco, cigars, hookahs, pipes, electronic cigarettes (e-cigarettes), and flavored cigarettes like bidis or kreteks – at least once in the past 30 days.
  • 3.5% of the students had smoked cigarettes, and 2.8% had smoked cigars. Nearly 2% had smoked pipes, 1.3% had smoked hookahs, and 1.1% had used e-cigarettes. Around 0.5% had used kreteks and about the same number had smoked bidis (0.6%).
  • 1.7% used spit or other smokeless tobacco. Nearly 1% had used snus (a newer form of snuff). Half a percent (0.5%) had used dissolvable tobacco.
  • Boys (about 8%) were more likely than girls (about 6%) to use some form of tobacco.

Tobacco use in high school students

The most recent tobacco numbers for high school students come from the 2012 CDC Youth Tobacco Survey and other CDC surveys. Keep in mind that these studies are done with students who are still in school. Those who drop out have higher rates of smoking and tobacco use, and are not included in these numbers.

  • Nationwide, more than 23% of high school students reported using some type of tobacco (cigarette, cigar, pipe, bidi, kretek, hookah, e-cigarette, or some form of smokeless tobacco) on at least 1 of the 30 days before the survey.
  • On average, about 1 out of 7 students (14%) smoked cigarettes. Girls (12%) were less likely to smoke cigarettes than boys (16%). White students (15%) were more likely to smoke cigarettes than black (10%), or Hispanic/Latino (14%) students.
  • About 13% of high school students had smoked cigars in the last 30 days. Male students (17%) were more likely to smoke cigars than female students (8%).
  • About 6% of high school students reported using spit or other smokeless tobacco at least once in the 30 days before the survey. About 11% of all the boys and about 2% of all the girls surveyed had used smokeless tobacco.
  • About half of all the school students who reported that they still smoked had tried to quit at least once during the year before.
  • Other tobacco use among high school students included pipes (over 4%), bidis (about 1%), and kreteks (about 1%).

Last Medical Review: 11/15/2013
Last Revised: 11/15/2013