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Preventing
Tobacco Use
Among Young People
A Report of the Surgeon General
AT-A-GLANCE (1994)
More than 400,000 premature deaths occur each year in the
United States from tobacco-related causes. This epidemic is totally preventable—and the
key opportunities for prevention are childhood and adolescence.
"Most people who are going to smoke are hooked
by the time they are 20 years old."
M. Joycelyn Elders, M.D., former Surgeon
General
Tobacco use usually begins in early adolescence,
typically by age 16. Almost all first use occurs before young people graduate from high
school. If adolescents can be kept tobacco-free, most will remain tobacco-free for the
rest of their lives.
- At
least 3.1 million adolescents are current smokers. Smoking is most common among 17- and
18-year-olds; about 25 percent of these young people smoke.
- By
age 18, about two-thirds of young people in the United States have tried smoking.
- Nicotine is generally the first drug used by young people who use alcohol, marijuana, and
harder drugs.
- Adolescent tobacco use is associated with being in fights, carrying weapons, and engaging
in higher-risk sexual behavior.
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- Nearly all first use of tobacco occurs before high school
graduation.
- Most young people who smoke are addicted to nicotine and
report that they want to quit but are unable to do so.
- Tobacco is often the first drug used by young people who
use alcohol and illegal drugs.
- Among young people, those with poorer grades and lower
self-images are most likely to begin using tobacco.
- Cigarette advertising appears to increase young
peoples risk of smoking by conveying that smoking has social benefits and that it is
far more common than it really is.
- The most effective preventive programs are communitywide
ones that combine education and public policy approaches.
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The younger a person begins smoking, the greater the risk
for developing the numerous illnesses associated with smoking. And even teens experience
adverse health effects:
- General decrease in physical fitness.
- Increased coughing and phlegm.
- Greater susceptibility to and severity of respiratory illnesses.
- Early development of artery disease, a possible precursor of heart disease.
- Slower rate of lung growth—and, by adulthood, possible reduced level of normal lung
function.
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Nicotine addiction makes quitting smoking as hard as
quitting heroin, cocaine, or alcohol. For most smokers, nicotine addiction begins during
childhood or adolescence.
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Most young people who have smoked as few as 100 cigarettes in their lifetime report that
they would like to quit – but cant.
- Young people develop tolerance for, and become dependent on, nicotine as quickly as adults
do, and young people have just as hard a time quitting.
- A
long-term national study found that 70 percent of high school seniors who smoked as few as
one to five cigarettes a day were still smoking five years later, and most of these were
smoking more cigarettes a day.
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Smokeless tobacco is definitely not a safe
alternative to smoking. Many young people, however, do not know that even in the short
term, smokeless tobacco is a dangerous alternative to cigarettes. Adolescent users of
smokeless tobacco
- Have early signs of gum disease.
- Develop lesions in their oral soft tissue – a possible warning sign of cancer.
- Are much more likely than nonusers to become cigarette smokers.
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Almost all adolescents will at some time feel pressured
to try tobacco.
- Peers, siblings, and friends are powerful influences. The most common situation for first
trying a cigarette is with a friend who already smokes.
- Young people are sensitive to perceived signals that smoking is the norm. These signals
include visible public smoking, the availability of cigarettes to minors, and the
widespread promotion and advertising of tobacco products.
- A
1992 national sample found that 87 percent of the adolescents surveyed could recall
recently seeing one or more advertisements for tobacco products.
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The tobacco industry loses – and therefore must replace – some two million consumers each year, either because they quit smoking or
because they die. Studies show that the vast majority of new consumers will come from the
ranks of young people. Intentionally or not, then, successful tobacco marketing influences
adolescents.
- Print
media remain an important source of tobacco advertising. After automobiles, cigarettes
are the most heavily advertised retail product.
- Especially in inner-city neighborhoods, young people may be repeatedly exposed to outdoor
billboards portraying apparent benefits of tobacco use.
- Increasingly, tobacco companies market their products through promotional activities
that reach youth. These activities include sponsoring sporting and musical events,
distributing specialty items that bear brand names, and encouraging stores to carry
point-of-sale displays.
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"Clearly, young people are being indoctrinated
with tobacco
promotion at a susceptible time in their lives."
M. Joycelyn Elders, M.D., former Surgeon
General
Pictures of Health? Misleading Images in Tobacco
Advertising
Ads for tobacco products have become short on words and
facts—and long on visual images that suggest positive associations.
- Cigarette ads visually associate smoking with independence, healthfulness,
adventure-seeking, and physical attractiveness – themes that appeal to young people.
- These attractive pictures suggest that smoking is a powerful tool for improving
self-image. Young people with low self-esteem are particularly receptive to this message.
- The pervasiveness of cigarette advertising may suggest that smoking is more common than it
really is. Young people are far more likely than adults to greatly overestimate the
prevalence of smoking.
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Promising results have been seen in school-based programs
that teach young people how to resist social influences to smoke. Such programs are even
more successful when they are supported in the adolescents home and community.
Other measures that appear to discourage youth from
trying tobacco include
- Taxes that raise the price of cigarettes.
- Strongly enforced laws that prohibit the sale of tobacco to young people.
- Policies in the school, workplace, and community that restrict smoking.
Most Americans strongly favor policies that might prevent
tobacco use among youth.
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- Male and female adolescents are equally likely to smoke cigarettes. Males are much more
likely than females to use smokeless tobacco.
- White adolescents are more likely to use tobacco than are black and Hispanic adolescents;
whites are much more likely to be heavy or frequent smokers.
- Over the past decade, there has been virtually no decline in smoking rates among all
teens. Among black adolescents, however, the prevalence of smoking has declined
dramatically.
- A
1992 survey found that 32 percent of high school students had tried smokeless tobacco.
Most of these were males.
- Young people who come from a low-income family and have fewer than two adults living in
their household are especially at risk for becoming smokers.
- In
various studies of minors access to tobacco products, from 32 to 87 percent of
underage youths were able to purchase cigarettes over the counter. When the minors tried
to purchase cigarettes through vending machines, they were almost always successful.
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Source: Monitoring the Future Project, University of Michigan, Institute for Social
Research.
*Current smoking is defined as any cigarette smoking during the 30 days preceding the
survey.
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