Smoking has serious long-term consequences, including the risk of smoking-related diseases and premature death, as well as the increased health care costs of treating associated illnesses.42 More than 480,000 annual deaths are attributable to tobacco use, making tobacco more lethal than all other illicit substances. Nearly 90% of smokers start smoking before age 18. Each day, more than 1,500 youth, ages 12–17, smoke their first cigarette, and another nearly 1,000 youth and young adults who are occasional smokers become daily smokers.43 The high rate of incidence and the consequences of cigarette smoking underscore the importance of studying patterns of smoking among adolescents. However, the rates represented here do not reflect data on vaping among youth.
NOTE: Daily cigarette smoking is defined as the use of one or more cigarettes per day in the past 30 days. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.
SOURCE: National Institute on Drug Abuse, Monitoring the Future Survey.
42 U.S. Department of Health and Human Services. (2014). The health consequences of smoking—50 years of progress. A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK179276/pdf/Bookshelf_NBK179276.pdf
43 Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068). Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, Populations Survey Branch. Retrieved from https://store.samhsa.gov/product/key-substance-use-and-mental-health-indicators-in-the-united-states-results-from-the-2018-national-survey-on-Drug-Use-and-Health/PEP19-5068