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Youth Tobacco

Preventing tobacco use among youth is critical to ending the tobacco epidemic in the United States.

If smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans younger than 18 will die early from a smoking-related illness. That’s about 1 of every 13 Americans aged 17 years or younger alive today.

  • Tobacco use is started and established primarily during adolescence.
    • Nearly 9 out of 10 cigarette smokers first tried smoking by age 18, and 98% first tried smoking by age 26.
    • Each day in the United States, more than 3,200 youth aged 18 years or younger smoke their first cigarette, and an additional 2,100 youth and young adults become daily cigarette smokers.
  • Flavorings in tobacco products can make them more appealing to youth.
    • In 2014, 73% of high school students and 56% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time.
  • Current use of electronic cigarettes increased among middle and high school students from 2011 to 2018.
    • Nearly 5 of every 100 middle school students (4.9%) reported in 2018 that they used electronic cigarettes in the past 30 days—an increase from 0.6% in 2011.
    • Nearly 21 of every 100 high school students (20.8%) reported in 2018 that they used electronic cigarettes in the past 30 days—an increase from 1.5% in 2011.
  • In 2018, about 7 of every 100 middle school students (7.2%) and about 27 of every 100 high school students (27.1%) reported current use of some type of tobacco product.
  • In 2013, nearly 18 of every 100 middle school students (17.7%) and nearly half (46.0%) of high school students said they had ever tried a tobacco product.
  • In 2016, 5.1 % of Lincoln County youth between sixth and 12th grade reported smoking tobacco products.

Factors associated with youth tobacco use include the following

  • Social and physical environments
    • The way mass media show tobacco use as a normal activity can promote smoking among young people.
    • Youth are more likely to use tobacco if they see that tobacco use is acceptable or normal among their peers.
    • High school athletes are more likely to use smokeless tobacco than their peers who are non-athletes.
    • Parental smoking may promote smoking among young people.
  • Biological and genetic factors
    • There is evidence that youth may be sensitive to nicotine and that teens can feel dependent on nicotine sooner than adults.
    • Genetic factors may make quitting smoking more difficult for young people.
    • A mother’s smoking during pregnancy may increase the likelihood that her offspring will become regular smokers.
  • Mental health: There is a strong relationship between youth smoking and depression, anxiety, and stress.
  • Personal perceptions: Expectations of positive outcomes from smoking, such as coping with stress and controlling weight, are related to youth tobacco use.
  • Other influences that affect youth tobacco use include:
    • Lower socioeconomic status, including lower income or education
    • Lack of skills to resist influences to tobacco use
    • Lack of support or involvement from parents
    • Accessibility, availability, and price of tobacco products
    • Low levels of academic achievement
    • Low self-image or self-esteem
    • Exposure to tobacco advertising

Reducing Youth Tobacco Use

National, state, and local program activities have been shown to reduce and prevent youth tobacco use when implemented together. They include the following:

  • Higher costs for tobacco products (for example, through increased taxes)
  • Prohibiting smoking in indoor areas of worksites and public places
  • Raising the minimum age of sale for tobacco products to 21 years, which has recently emerged as a potential strategy for reducing youth tobacco use
  • TV and radio commercials, posters, and other media messages targeted toward youth to counter tobacco product advertisements
  • Community programs and school and college policies and interventions that encourage tobacco-free environments and lifestyles
  • Community programs that reduce tobacco advertising, promotions, and availability of tobacco products

Some social and environmental factors have been found to be related to lower smoking levels among youth. Among these are:

  • Religious participation
  • Racial/ethnic pride and strong racial identity
  • Higher academic achievement and aspirations

Continued efforts are needed to prevent and reduce the use of all forms of tobacco use among youth.


Teen Link

Youth Prevention: You Can

Washington Recovery Helpline

Center for Disease Control and Prevention (CDC)

The Real Cost


Parent Resources

What you need to know about Tobacco (CDC)

Know the Risks: E-cigarettes & Young People