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Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon
General.
of tobacco use among young people. Those are precisely the issues examined in
this report, which aims to support the application of this robust science base.
Nearly all tobacco use begins in childhood and adolescence (U.S. Department
of Health and Human Services [USDHHS] 1994). This is a time in life of great
vulnerability to social influences (Steinberg 2004), such as those offered through
the marketing of tobacco products and the modeling of smoking by attractive role
models, as in movies (Dalton et al. 2009), which have especially strong effects on
the young. This is also a time in life of heightened sensitivity to normative
influences: as tobacco use is less tolerated in public areas and there are fewer
social or regular users of tobacco, use decreases among youth (Alesci et al. 2003).
And so, as we adults quit, we help protect our children.
Cigarettes are the only legal consumer products in the world that cause onehalf of their long-term users to die prematurely (Fagerstrm 2002; Doll et al. 2004).
As this epidemic continues to take its toll in the United States, it is also increasing in
low- and middle-income countries that are least able to afford the resulting health
and economic consequences (Peto and Lopez 2001; Reddy et al. 2006). It is past
time to end this epidemic. To do so, primary prevention is required, for which our
focus must be on youth and young adults. As noted in this report, we now have a
set of proven tools and policies that can drastically lower youth initiation and use of
tobacco products. Fully committing to using these tools and executing these policies
consistently and aggressively is the most straight forward and effective to making
future generations tobacco-free.
This is the 31st tobacco-related Surgeon Generals report issued since 1964.
It describes the epidemic of tobacco use among youth ages 12 through 17 and
young adults ages 18 through 25, including the epidemiology, causes, and health
effects of this tobacco use and interventions proven to prevent it. Scientific
evidence contained in this report supports the following facts:
We have made progress in reducing tobacco use among youth; however, far too
many young people are still using tobacco. Today, more than 600,000 middle school
students and 3 million high school students smoke cigarettes. Rates of decline for
cigarette smoking have slowed in the last decade and rates of decline for smokeless
tobacco use have stalled completely.
Every day, more than 1,200 people in this country die due to smoking. For
each of those deaths, at least two youth or young adults become regular
smokers each day. Almost 90% of those replacement smokers smoke their
first cigarette by age 18.
Rates of smokeless tobacco use are no longer declining, and they appear to
be increasing among some groups.
Cigars, especially cigarette-sized cigars, are popular with youth. One out of
five high school males smokes cigars, and cigar use appears to be increasing
among other groups.
Prevention efforts must focus on young adults ages 18 through 25, too.
Almost no one starts smoking after age 25. Nearly 9 out of 10 smokers
started smoking by age 18, and 99% started by age 26. Progression from
occasional to daily smoking almost always occurs by age 26.
References
Alesci NL, Forster JL, Blaine T. (2003). Smoking visibility, perceived acceptability,
and frequency
Medicine. ;36(3):27281.
Dalton MA, Beach ML, Adachi-Mejia AM, Longacre MR, Matzkin AL, Sargent JD,
Heatherton TF,
Peto R, Lopez AD. Future worldwide health effects of current smoking patterns. In:
Koop CE,
Pearson CE, Schwarz MR, editors. Critical Issues in Global Health. San
Francisco: Wiley
(Jossey-Bass); (2001).
Reddy KS, Perry CL, Stigler MH, Arora M. (2006). Differences in tobacco use among
young people in urban India by sex, socioeconomic status, age, and school grade:
assessment of baseline survey data. Lancet. ;367(9510):58994.
Steinberg L. (2004). Risk taking in adolescence: what changes, and why? Annals of
the New
Human
Centers for Disease Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Office on Smoking
and Health.
https://www.surgeongeneral.gov/library/reports/preventing-youth-tobaccouse/factsheet.html