Youth and Tobacco Use

Overview

Smoking and smokeless tobacco use are usually initiated during adolescence. More than 80% of adult smokers begin smoking before 18 years of age. Additionally, adolescent smokeless tobacco users are more likely than nonusers to become adult cigarette smokers.^1,2,3

Youth cigarette use declined sharply during 1997–2003; however, rates have remained relatively stable in recent years.⁴

Youth smokeless tobacco use also declined in the late 1990s and early 2000s, but an increasing number of U.S. high school students have reported using smokeless tobacco products in recent years.⁵

Current Estimates of Youth Tobacco Use

Cigarettes

Each day in the United States, approximately 3,450 young people between 12 and 17 years of age smoke their first cigarette, and an estimated 850 youth become daily cigarette smokers.⁶

Percentage of high school students who were current cigarette smokers in 2009:³

• 17.2% of high school students

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• 14.8% of female high school students
• 19.6% of male high school students

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•   7.4% of African-American high school students
•   9.7% of Asian-American high school students
• 19.2% of Hispanic high school students
• 19.4% of white high school students

Percentage of middle school students who were current cigarette smokers in 2009:³

• 5.2% of middle school students

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• 4.7% of female middle school students
• 5.6% of male middle school students

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• 5.2% of African-American middle school students
• 2.5% of Asian-American middle school students
• 6.7% of Hispanic middle school students
• 4.3% of white middle school students

Cigars

Percentage of high school students who were current cigar smokers in 2009:³

• 10.9% of high school students

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•   6.7% of female high school students
• 15.0% of male high school students

Percentage of middle school students who were current cigar smokers in 2009:³

• 3.9% of middle school students

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• 3.2% of female middle school students
• 4.6% of male middle school students

Bidis

Percentage of high school students who were current bidi smokers in 2009:³

• 2.4% of high school students

Percentage of middle school students who were current bidi smokers in 2009:³

• 1.6% of middle school students

(In 2009, the U.S. Food and Drug Administration banned the sale of flavored cigarettes—with the exception of menthol; consequently, the use of bidis is likely to decline even further.⁵)

Smokeless Tobacco

Percentage of high school students who were current smokeless tobacco users in 2009:³

• 6.7%   of high school students

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•   1.8% of female high school students
• 11.6% of male high school students

Percentage of middle school students who were current smokeless tobacco users in 2009:³

• 2.6% of middle school students

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• 1.4% of female middle school students
• 3.7% of male middle school students

Factors Associated with Youth Tobacco Use

Some factors associated with youth tobacco use include:^1,7

• Low socioeconomic status
• Use and approval of tobacco use by peers or siblings
• Lack of skills to resist influences to tobacco use
• Smoking by parents or guardians and/or lack of parental support or involvement
• Accessibility, availability, and price of tobacco products
• A perception that tobacco use is the norm
• Low levels of academic achievement
• Low self-image or self-esteem
• Aggressive behavior (e.g., fighting, carrying weapons)

Tobacco use during adolescence is associated with the following health risk behaviors:^1,8

• High-risk sexual behavior
• Use of alcohol
• Use of other drugs

Reducing Youth Tobacco Use

National, state, and local program activities that have reduced and prevented youth tobacco use in the past have included combinations of the following:^4,9

• Counteradvertising mass-media campaigns (i.e., TV and radio commercials, posters, and other media messages targeted toward youth to counter pro-tobacco marketing)
• Comprehensive school-based tobacco-use prevention policies and programs (e.g., tobacco-free campuses)
• Community interventions that reduce tobacco advertising, promotions, and commercial availability of tobacco products
• Higher costs for tobacco products through increased excise taxes

NOTES:

• High school student is defined as students in grades 9 through 12.
• Middle school student is defined as students in grades 6 through 8.
• Bidis are small, thin, hand-rolled cigarettes imported to the United States primarily from India and other Southeast Asian countries; refer to the bidis fact sheet for more information.
• Daily smoking is defined as ever smoking every day for at least 30 days.
• Current smoking is defined as using on 1 or more of the 30
     days preceding the survey.

References

1. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994 [accessed 2011 Mar 11].
2. Campaign for Tobacco-Free Kids. The Path to Smoking Addiction Starts at Very Young Ages (PDF–49.65 KB). Washington: Campaign for Tobacco-Free Kids, 2009 [accessed 2011 Mar 11].
3. Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students—United States, 2000–2009. Morbidity and Mortality Weekly Report 2010;59(33):1063–8 [accessed 2011 Mar 11].
4. Centers for Disease Control and Prevention. Cigarette Use Among High School Students—United States, 1991–2009. Morbidity and Mortality Weekly Report 2010;59(26):797–801 [accessed 2011 Mar 11].
5. Johnston LD, O’Malley PM, Bachman PM, Schulenberg JE. Monitoring the Future—National Results on Adolescent Drug Use: Overview of Key Findings, 2010 (PDF–1.66 MB). Ann Arbor (MI): University of Michigan, Institute for Social Research, 2011 [accessed 2011 Mar 11].
6. Substance Abuse and Mental Health Services Administration. Results from the 2009 National Survey on Drug Use and Health: Detailed Tables (PDF–36.30 KB). [accessed 2010 2011 Mar 11].
7. U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000 [accessed 2011 Mar 11].
8. Campaign for Tobacco-Free Kids. How Parents Can Protect Their Kids from Becoming Addicted Smokers (PDF–259.13 KB). Washington: Campaign for Tobacco-Free Kids, 2009 [accessed 2011 Mar 11].
9. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2007. 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, 2007 [accessed 2011 Mar 11].

For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO

Media Inquiries: Contact CDC's Office on Smoking and Health press line at 770-488-5493.