Surgeon General warns of youth smoking epidemic


More than a million Americans under the age of 26 are taking up smoking every year as tobacco companies step up their marketing efforts to attract a new generation of smokers, according to the Surgeon General’s latest report on tobacco use. 

Surgeon General Dr. Regina Benjamin appearing in an anti-smoking PSA. SOURCE:

The statics presented in the report – “Preventing Tobacco Use Among Youth and Young Adults” – are alarming:

  • Although 1,200 Americans die each day from tobacco use, each death is being replaced by 2 new smokers who are mostly under the age of 18.
  • Nearly 1 in 3 Americans between 18 and 26 smoke or use other types of tobacco products.
  • Nearly 1 in 4 – or 3.6 million – American middle and high school students smoke.
  • 80% of all teenage smokers will become lifelong tobacco users due to nicotine addiction, which has a more powerful effect on developing adolescents.

The numbers also forecast a growing burden on the health care system because tobacco is known to cause heart disease, lung cancer, emphysema, and other chronic health problems that are very costly to treat. The U.S. spends $260 million per day for medical care directly related to tobacco use, according to the Department of Health and Human Services.

“The burden of tobacco puts a heavy burden on society,” said Dr. Rebecca Benjamin, Surgeon General of the United States. “The report challenges us to end the epidemic of smoking among young people.”

Tobacco industry targets young consumers 

Although cigarette use declined rapidly in the late 1990s, tobacco use among youth and young adults has been growing since 2007. Assistant Secretary of Health Henry Koh said the uptick is “not an accident,” pointing out that tobacco companies spend $27 million a day in marketing directed at young Americans.

“The tobacco industry says that their intent is only to promote brand choices among adult smokers. But there is a difference between stated intent and documented impact. Because regardless of intent, the impact of tobacco marketing is to encourage underage use. And in fact, nearly 90% of smokers start by age 18 and more than 80% of underaged smokers choose brands from among the top 3 most heavily advertised,” said Koh.

In addition to youth-oriented marketing, tobacco companies have added features to cigarettes and other tobacco products to attract younger users.

For example, many cigarettes now contain sugar and moisture enhancers to improve the taste and reduce the harshness of smoking. Some cigarettes contain ammonia, a chemical ingredient that makes nicotine even more addictive. Improved filters allow smokers to take deeper drags for a faster nicotine high.

“All these design features work together to enhance the addictive kick and the pleasure that smokers feel,” said Benjamin.

Tobacco companies have also added fruit or candy flavors to smokeless tobacco product to attract a younger market. And some have even developed smokeless tobacco products that are “spitless” and can dissolve like mints, making it easier for teenagers to use tobacco in front of their parents and teachers without getting in trouble. The Surgeon General’s report estimates more than 1.6 million young Americans use smokeless tobacco products.

Prevention strategy focuses on Americans under age 26

Since 99% of adult smokers start before the age of 26, the Surgeon General’s prevention efforts will focus on curbing tobacco use among youth and young adults. Her recommendations include:

  • Stepping up anti-tobacco media campaigns.
  • Boosting smoking prevention programs in schools.
  • Expanding smoke-free zones in public and work places. (Currently, only 28 states and Washington, D.C. have passed smoke-free laws.)
  • Increasing state and local taxes to raise the price of tobacco to reduce youth smoking rates. Because teens and young adults generally have less disposable income, they won’t be able to buy as many cigarettes if the tobacco prices go up.
  • Restricting tobacco advertising to youth.

“We know it works,” said Benjamin. “If we can just get them to remain smoke free ’til they’re 26, then less than 1% of them will ever start…It’s time for us to really end the single most preventable cause of death in this nation.”


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