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Tobacco Use in Adolescence

Preventing and Reducing Teen Tobacco Use

More deaths are caused each year by tobacco use than by human immunodeficiency virus (HIV), illegal drug use, alcohol, motor vehicle injuries, suicides, and murders combined.1,2,5 However, tobacco use by adolescents and young adults has declined substantially over the past 40 years. In 2017, only one in 25 high school seniors identified as a daily smoker, and fewer than one in 10 had smoked within the past 30 days.3 Furthermore, adolescents’ use of smoking products is evolving. In 2014 and for the first time in history, more teenagers used electronic cigarettes (or e-cigarettes) than smoked tobacco cigarettes. This trend continued in 2017, as more high school students used e-cigarettes or similar devices to vape (i.e., inhale vapors that include nicotine) than smoked tobacco cigarettes.3 These products pose a set of new challenges, as they are known to be harmful but their health impact is not yet fully understood.6

Tobacco use remains the number one cause of preventable deaths in the United States. It is critical that efforts to prevent and reduce teen smoking continue, as the stakes could not be higher. On average, smokers die at least 10 years earlier than non-smokers and, every day, more than 1,200 people in the United States die from smoking-related causes. Almost 90 percent of those who die from smoking-related causes began using tobacco products at or prior to age 18. 4 The Surgeon General estimates that if all the evidence-based youth anti-tobacco strategies were implemented, smoking among high school students would decline by more than 50 percent by 2020. 4

Ways to Reduce Adolescent Tobacco Use

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The Surgeon General’s report Preventing Tobacco Use among Youth and Young Adults summarizes the causes, the solutions, and the latest findings about the epidemic of tobacco use among these groups.

The U.S. Preventive Services Task Force recommends that primary care clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use among school-aged children and adolescents (ages 10-17).

The Community Preventive Services Task Force offers guidance and recommendations on evidence-based approaches to prevent and reduce tobacco use by adolescents. These include:

  • Reducing the initiation of tobacco use (such as by increasing the price of tobacco products)
  • Increasing tobacco use cessation for smokers and users of other tobacco products (through mass media campaigns and other interventions)
  • Restricting minors’ access to tobacco products (through community mobilization and enforcement)
  • Reducing exposure to second hand smoke (primarily through smoking bans)


1 U.S. Department of Health and Human Services. (2014). The health consequences of smoking—50 Years of Progress: A report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.
2 Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States. Journal of the American Medical Association, 291(10), 1238-1245. doi:10.1001/jama.291.10.1238.
3 Johnston, L. D., Miech, R. A., O'Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Patrick, M.E. (2018). Monitoring the Future national survey results on drug use, 1975-2017: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. Retrieved from http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2017.pdf
4 Centers for Disease Control and Prevention. (2015). Smoking & tobacco use: Tobacco industry marketing.  Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/marketing/.
5 U.S. Department of Health and Human Services. (2012). Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved from http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/.
6 Singh, T., Arrazola, R. A., Corey, C. G., Husten, C. G., Neff, L.J., Homa, D.M., & King, B.A. (2016). Tobacco use among middle and high school students — United States, 2011–2015. Morbidity and Mortality Weekly Report, 65(14), 361–367. Retrieved from http://www.cdc.gov/mmwr/volumes/65/wr/mm6514a1.htm.
Content created by Office of Adolescent Health
Content last reviewed on July 26, 2016