Smoking cigarettes has many health risks for everyone. However, the younger you are when you start smoking, the more problems it can cause. People who start smoking before the age of 21 have the hardest time quitting. Teens who smoke are also more likely to use alcohol and illegal drugs.

The problem is not just cigarettes. Spit tobacco, e-cigarettes, and cigars are not safe alternatives to cigarettes. Low-tar and additive-free tobacco products are not safe either.

Young people who do not start using tobacco by age 18 will most likely never start.

Tobacco and Athletic Performance

• Don’t get trapped. Nicotine in cigarettes, cigars, and spit tobacco is addictive.
• Nicotine narrows your blood vessels and puts added strain on your heart.
• Smoking can wreck lungs and reduce oxygen available for muscles used during sports.
• Smokers suffer shortness of breath (gasp!) almost 3 times more often than nonsmokers.
• Smokers run slower and can’t run as far, affecting overall athletic performance.
• Cigars and spit tobacco are NOT safe alternatives.

Tobacco and Personal Appearance

• Yuck! Tobacco smoke can make hair and clothes stink.
• Tobacco stains teeth and causes bad breath.
• Short-term use of spit tobacco can cause cracked lips, white spots, sores, and bleeding in the mouth.
• Surgery to remove oral cancers caused by tobacco use can lead to serious changes in the face. Sean Marcee, a high school star athlete who used spit tobacco, died of oral cancer when he was 19 years old.

S0. . .

• Know the truth. Despite all the tobacco use on TV and in movies, music videos, billboards and magazines–most teens, adults, and athletes DON’T use tobacco.
• Make friends, develop athletic skills, control weight, be independent, be cool … play sports.
• Don’t waste (burn) money on tobacco. Spend it on CDs, clothes, computer games, and movies.
• Get involved: make your team, school, and home tobacco-free; teach others; join community efforts to prevent tobacco use.

What Parents Should Know

Parents—Help Keep Your Kids Tobacco-Free

• Kids who use tobacco may
  • Cough and have asthma attacks more often and develop respiratory problems, leading to more sick days, more doctor bills, and poorer athletic performance.
  • Be more likely to use alcohol and other drugs such as cocaine and marijuana.
  • Become addicted to tobacco and find it extremely hard to quit.
  • Spit tobacco and cigars are not safe alternatives to cigarettes; low-tar and additive-free cigarettes are not safe either.
  • Tobacco use is the single most preventable cause of death in the United States, causing heart disease, cancers, and strokes.

Take a Stand at Home—Early and Often

• Despite the impact of movies, music, and TV, parents can be the GREATEST INFLUENCE in their kids’ lives.
• Talk directly to children about the risks of tobacco use; if friends or relatives died from tobacco-related illnesses, let your kids know.
• If you use tobacco, you can still make a difference. Your best move, of course, is to try to quit. Meanwhile, don’t use tobacco in your children’s presence, don’t offer it to them, and don’t leave it where they can easily get it.
• Start the dialog about tobacco use at age 5 or 6 and continue through their high school years. Many kids start using tobacco by age 11, and many are addicted by age 14.
• Know if your kids’ friends use tobacco. Talk about ways to refuse tobacco.
• Discuss with kids the false glamorization of tobacco on billboards and in other media, such as movies, TV, and magazines.

Make a Difference in Your Community

• Vote with your pocketbook. Support businesses that don’t sell tobacco to kids. Frequent restaurants and other places that are tobacco-free.
• Be sure your schools and all school events (i.e., parties, sporting events, etc.) are tobacco-free.
• Partner with your local tobacco prevention programs. Call your local health department or your cancer, heart, or lung association to learn how you can get involved.

What Coaches Should Know

Coaches—You Can Influence Youth

• Smoking slows lung growth, decreases lung function, and reduces the oxygen available for muscles used in sports.
• Smokers suffer from shortness of breath almost 3 times more often than nonsmokers.
• Nicotine is addictive in ways like heroin and cocaine.
• Young people who do not start using tobacco by age 18 will most likely never start.
• Young people who use tobacco may be more likely to use alcohol and other drugs such as cocaine and marijuana.
• Spit tobacco and cigars are NOT safe alternatives to cigarettes; low-tar and additive-free tobacco products are not safe either.
• Tobacco use is the single most preventable cause of death in the United States, causing heart and lung diseases, cancers, and strokes.

Take a Stand—Early and Often

• Recognize your influence with young people. Don’t use tobacco around players. Remind them of the importance of being tobacco-free.
• When talking to players, remember they relate more to messages about the immediate effects of tobacco use (such as poorer athletic performance) than to its long-term health threats.
• Adopt and enforce a tobacco-free policy for players, coaches, and referees.
• Send a copy of the tobacco-free policy home for parents to review.
• Make all practices, games, and competitions tobacco-free—on the field and sidelines and in the stands.
• Announce and display tobacco-free messages at games.
• Consider partnering with your local tobacco prevention programs. Voice your support for tobacco-free schools, sports, and other community events.

If cigarette 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 who are alive today.

Background

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

• Tobacco product use is started and established primarily during adolescence.
• Nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18, and 99% first try smoking by age 26.
  • Each day in the U.S., about 1,600 youth smoke their first cigarette and nearly 200 youth start smoking every day.
• Flavorings in tobacco products can make them more appealing to youth.
  • In 2020, 85% of high school students and 74% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time.

Estimates of Current Tobacco Use Among Youth

Tobacco Product Use Among High School Students – 2019

Electronic cigarettes (E-cigarettes)

• E-cigarettes have been the most commonly used tobacco product among youth since 2014.
• After increasing between 2017 and 2019, current (past 30 day) use of e-cigarettes went down among middle and high school students from 2019 to 2020.
  • About 1 of every 20 middle school students (4.7%) reported in 2020 that they used e-cigarettes in the past 30 days—a decrease from 10.5% in 2019.
  • About 1 of every 5 high school students (19.6%) reported in 2020 that they used electronic cigarettes in the past 30 days—a decrease from 27.5% in 2019.

Cigarettes

• From 2011 to 2019, current (past 30 day) cigarette smoking went down among middle and high school students.
  • About 2 of every 100 middle school students (2.3%) reported in 2019 that they smoked cigarettes in the past 30 days—a decrease from 4.3% in 2011.
  • About 6 of every 100 high school students (5.8%) reported in 2019 that they smoked cigarettes in the past 30 days—a decrease from 15.8% in 2011.

Cigars

• From 2011 to 2019, current use of cigars went down among middle school students and high school students.
  • About 2 of every 100 middle school students (2.3%) reported in 2019 that they had used cigars in the past 30 days—a decrease from 3.5% in 2011
  • Nearly 8 of every 100 high school students (7.6%) reported in 2019 that they had used cigars in the past 30 days—a decrease from 11.6% in 2011.

Smokeless Tobacco

• From 2011 to 2019, current use of smokeless tobacco went down among middle and high school students:
  • Nearly 2 of every 100 middle school students (1.8%) reported in 2019 that they had used smokeless tobacco in the past 30 days—a decrease from 2.2% in 2011.
  • Nearly 5 of every 100 high school students (4.8%) reported in 2019 that they had used smokeless tobacco in the past 30 days—a decrease from 7.9% in 2011.

Hookah

• From 2011 to 2019, current use of hookahs did not change in a meaningful way among middle school students and high school students.
  • Nearly 2 of every 100 middle school students (1.6%) reported in 2019 that they had smoked hookah in the past 30 days. The prevalence was 1.0% in 2011.
  • About 3 of every 100 high school students (3.4%) reported in 2019 that they had smoked hookah in the past 30 days. The prevalence was 4.1% in 2011.

All Tobacco Product Use

• In 2019, about 12 of every 100 middle school students (12.5%) and about 31 of every 100 high school students (31.2%) reported current use of a tobacco product.
• In 2019, nearly 1 of every 4 middle school students (24.3%) and over half (53.3%) of high school students said they had ever tried a tobacco product.

Many young people use two or more tobacco products.

• In 2019, 4 of every 100 middle school students (4.0%) and nearly 11 of every 100 high school students (10.8%) reported current use of two or more tobacco products in the past 30 days.
• In 2019, about 12 of every 100 middle school students (11.5%) and about 30 of every 100 high school students (29.9%) said they had ever tried two or more tobacco products.

Youth who use multiple tobacco products are at higher risk for developing nicotine dependence and might be more likely to continue using tobacco into adulthood.

Factors Associated With Youth Tobacco Product Use

Factors associated with youth tobacco product use include the following:

• Social and physical environments
  • The way mass media show tobacco product use as a normal activity can make young people want to try these products.
  • Youth are more likely to use tobacco products if they see people their age using these products.
  • High school athletes are more likely to use smokeless tobacco than those of the same age who are not athletes.
  • Young people may be more likely to use tobacco products if a parent uses these products.
• 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 harder for young people.
  • Smoking during pregnancy may increase the likelihood that the child will smoke cigarettes regularly in the future.
• Mental health: There is a strong relationship between youth smoking and depression, anxiety, and stress.
• Personal views: When young people expect positive things from smoking, such as coping with stress better or losing weight, they are more likely to smoke.

• Other influences that affect youth tobacco use include:
  • Lower socioeconomic status, including lower income or education
  • Not knowing how to say “no” to tobacco product use
  • Lack of support or involvement from parents
  • Accessibility, availability, and price of tobacco products
  • Doing poorly in school
  • Low self-image or self-esteem
  • Seeing tobacco product advertising in stores, on television, the Internet, in movies, or in magazines and newspapers

Reducing Youth Tobacco Product Use

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

• Higher costs for tobacco products (for example, through increased taxes)
• Prohibiting smoking in indoor areas of workplaces and public places
• Raising the minimum age of sale for tobacco products to 21 years
• TV and radio commercials, posters, and other media messages aimed at kids and teens in order to counter tobacco product ads
• Community programs and school and college policies that encourage tobacco-free places and lifestyles
• Community programs that lower tobacco advertising, promotions, and help make tobacco products less easily available

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

• Being part of a religious group or tradition
• Racial/ethnic pride and strong racial identity
• Higher academic achievement

It is important to keep working to prevent and reduce the use of all forms of tobacco product use among youth.

It’s well known that smoking is bad for your health and causes many serious diseases later in life. In fact, one out of three adolescents who continue to smoke regularly will die prematurely from cigarette smoking. But did you know that smoking can also harm young smokers’ health right away?

Early smoking can cause early heart disease

New research shows that smoking during adolescence and young adulthood causes early damage to the abdominal aorta, the large artery that carries oxygen-rich blood from the heart through the abdomen to major organs. Even young adults who have only been smoking for a few years can show signs of narrowing of this large artery. When a person breathes tobacco smoke, it causes immediate damage to blood vessels throughout the body. Repeatedly breathing tobacco smoke can cause a mixture of scar tissue and fats to build up inside blood vessels. This plaque makes blood vessels narrow and limits blood flow.

Early smoking can harm lungs now

Young people are still growing. Their lungs don’t reach full size until late teens for girls and after age 20 for boys. Adults who smoked during adolescence can have lungs that never grow to their potential size and never perform at full capacity.

The lungs of young smokers don’t perform as well as those of nonsmokers. Because their lungs don’t work as well, they are short of breath and may have more trouble participating in sports and other physical activities. Even though people who stop smoking will improve their health dramatically, early lung damage doesn’t go away completely in most cases.

Smoking can lead to cancer

Tobacco smoke contains about 70 chemicals that can cause cancer. It’s no surprise, then, that smoking causes about one in three of all cancer deaths in the United States. And it can cause cancer almost anywhere in the body by damaging DNA.

Youth—a Great Time to Quit

The good news: Smokers who quit before age 30 will undo much of the health damage caused by tobacco use.

Why Is It So Hard to Quit?

Tobacco users often get hooked on nicotine—the drug in cigarettes, cigars, and smokeless tobacco (snuff and chewing tobacco). Many teens and young adults plan to quit using tobacco after a few years but find out too late how powerfully addictive nicotine can be. Like heroin and cocaine, nicotine acts on the brain and creates feelings of pleasure or satisfaction. Young brains are still developing. That may be one reason many teens feel dependent on tobacco after using it for only a short time. Quitting isn’t easy, but it can be done. Better yet—don’t start! Not starting is even better than quitting. Their health depends on it!

Working together, we can end the tobacco epidemic.

If we choose to, we can end the tobacco epidemic in this country. But it’s going to take all of us—parents, teachers, health care providers, communities, states, schools, and policymakers—supporting policies, programs, and media campaigns that prevent tobacco use by youth and young adults.

Policies and Programs? Which Works Best?

There are effective policies and programs that prevent young people from using tobacco. Policies and programs that contain several parts working together to make tobacco use more difficult and less accepted are the ones that work best.

Policies

Policies are very effective because they can change the environment so that choosing a tobacco-free life is encouraged and supported. Government and private entities have implemented a number of policies that are effective in preventing youth tobacco use.

Here are some policies proven to work best:

• Make tobacco products less affordable.
• Restrict tobacco marketing.
• Ban smoking in public places—such as workplaces, schools, day care centers, hospitals, restaurants, hotels, and parks.
• Require tobacco companies to label tobacco packages with large, graphic health warnings.

Programs

Many states and communities have programs to prevent tobacco use by young people. The most effective ones combine several elements; include evidence-based curricula in secondary schools; work with policies; and influence people at work, at home, in school, in health care settings, and in public places.

Mass Media Campaigns

Mass media campaigns against tobacco use—most often TV ads—have proven very effective at helping prevent tobacco use by young people. Studies show that teens respond most to ads that trigger strong negative feelings, such as ads about how smoking and secondhand smoke harm health and ads that expose the tobacco industry’s marketing strategies that target young people.

Even ads that are designed for adult audiences help reduce tobacco use among young people. Every 3 or 4 years, new groups of children and teens reach the age where they are vulnerable to influences encouraging them to smoke. To be effective, mass media campaigns must be repeated so they will reach new vulnerable populations.

Parents - How You Can Help

You can help your children make healthy choices about tobacco use. Try these tips.

Tell them:

• Key facts about tobacco
• You don’t want anyone—including them—to use tobacco in your house or car.
• You expect they will never use tobacco, or will stop using it.

Help them:

• Cope with their problems.
• Refuse tobacco.
• Quit if they’re current users.

Make sure you:

• Know what they’re doing and who their friends are.
• Network with other parents who can help you encourage children and teens to refuse tobacco.
• Encourage your children’s schools to enforce tobacco-free policies for students, faculty, staff, and visitors both on campus and at all school-sponsored events off campus.
• Enforce movie age restrictions—and discourage teens from playing video games or using other media that feature smoking.
• Never give tobacco to children or teens.
• Set a good example by not using tobacco yourself.