Cigarette smoking during childhood and adolescence causes significant health problems among young people, including an increase in the number and severity of respiratory illnesses, decreased physical fitness and potential effects on lung growth and function. 1
Most importantly, this is when an addiction to smoking takes hold, often lasting into and sometimes throughout adulthood. Among adults who have ever smoked daily, 87% had tried their first cigarette by the time they were 18 years of age, and 95% had by age 21. 2
Key Facts about Tobacco Use among Children and Teenagers
- Every day, almost 2,500 children under 18 years of age try their first cigarette, and more than 400 of them will become new, regular daily smokers. 3 Half of them will ultimately die from their habit. 4
- People who start smoking at an early age are more likely to develop a severe addiction to nicotine than those who start at a later age. Of adolescents who have smoked at least 100 cigarettes in their lifetime, most of them report that they would like to quit, but are not able to do so. 5
- If current tobacco use patterns persist, an estimated 5.6 million of today’s youth under age 18 eventually will die prematurely from a smoking-related disease. 6
Prevalence of Tobacco Use among Children and Teenagers
- In 2015, 9.3% of high school students reported smoking cigarettes in the last 30 days, down 74% from 36.4% in 1997 when rates peaked after increasing throughout the first half of the 1990s. 7
- In 2015, 2.3% of middle school students smoked cigarettes in the last 30 days.7
- Rates of overall tobacco use remain high, however. In 2015, 25.3% of high school students and 7.4% of middle school students used a tobacco product. 7
- Among high school students in 2015, the most prevalent forms of tobacco used were electronic cigarettes (16%), cigarettes (9.3%), cigars (8.6%) and hookah (7.2%). 7
- In 2015, about half of middle and high school students reported using two or more tobacco products in the past 30 days.7
- Since 1990, teenagers and young adults have had the highest rates of maternal smoking during pregnancy. In 2014, 10.2% of female teens aged 15 to 19 and 13% of women aged 20 to 24 smoked during pregnancy.8
- In 2014, around 62% of current smokers in both middle and high school seriously thought about quitting. Seventy percent of middle school and 59% of high school current smokers had tried to quit smoking for one day or more.9
Additional Facts about Tobacco Use among Children and Teenagers
- Menthol cigarette use is more common among younger and newer teen smokers. 10 This is due to young smokers perceiving menthol cigarettes as less harsh and easier to smoke. 11
- One study found that teens exposed to the greatest amount of smoking in movies were 2.6 times more likely to start smoking themselves compared with teens who watched the least amount of smoking in movies. 12
- The good news is that help is available for teen smokers who want to quit. The American Lung Association’s Not-On-Tobacco (N-O-T) program is designed for 14- to 19-year-old smokers who want to quit. Contact your local American Lung Association office to find out if N-O-T is available in your area.
Learn about the American Lung Association’s programs to help you or a loved one quit smoking, and join our advocacy efforts to reduce tobacco use and exposure to secondhand smoke. Visit Lung.org or call the Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872).
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General, 1994
Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health, 2014. Analysis by the American Lung Association Epidemiology and Statistics Unit Using SPSS Software.
Substance Abuse and Mental Health Services Administration. 2015 National Survey on Drug Use and Health: Detailed Tables. 2016.
Centers for Disease Control and Prevention. Office on Smoking and Health. Sustaining State Programs for Tobacco Control: State Data Highlights, 2006. Accessed on June 9, 2008.
American Legacy Foundation. 2000. National Youth Tobacco Survey. 2001.
U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014.
Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students — United States, 2011–2015. Morbidity and Mortality Weekly Report. April 15, 2016; 65(14):361-7.
Centers for Disease Control and Prevention. National Center for Health Statistics. CDC WONDER On-line Database, Natality public-use data 2007-2014, 2016.
Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2014. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.
Hersey JC, Nonnemaker JM, Homsi G. Menthol Cigarettes Contribute to the Appeal and Addiction Potential of Smoking for Youth. Nicotine & Tobacco Research. 2010; 12(Suppl 2):S136–S146.
Klausner K. Menthol Cigarettes and Smoking Initiation: A Tobacco Industry Perspective. Tobacco Control. 2011; 20(Supp 2):ii12–ii19.
Lee YO, Glantz SA. Putting the Pieces Together. Tobacco Control. 2011; 20(Suppl 2):ii1–ii7.
Sargent JD et al. Exposure to Movie Smoking: Its Relations to Smoking Initiation Among US Adolescents. Pediatrics. November 5, 2005; 116(5):1183-91.
Page last updated: March 13, 2020