Recent data has revealed disturbing facts regarding a dramatic increase in tobacco use among youth. The Centers for Disease Control and Prevention (CDC) released a report on December 5, 2019 saying that 1 in 3 high school students and 1 in 8 middle school students are current or former users of tobacco products. This data was collected from a large-scale survey and indicates that over 6 million adolescents are currently using some form of tobacco-based product. In order of frequency of use, commonly used tobacco products include ecigarettes, cigars, cigarettes, smokeless tobacco, hookahs, and pipe tobacco. Specifically, ecigarettes are used most commonly, accounting for nearly 30% of adolescent tobacco product use. Notably, about one-third of the surveyed population used more than one type of tobacco-based product.
Complications due to cigarette smoking are the leading cause of preventable deaths in the United States, accounting for more than 400,000 preventable deaths per year. The rates of chronic smoking related morbidity far exceed this and are difficult to estimate accurately. Adolescents are particularly sensitive to the impacts of nicotine associated with tobacco exposure. They may suffer long-term cognitive and behavioral impairment resulting from impacts on brain development. A full and in-depth discussion of smoking-related complications is outside the scope of this post but includes cancer, vascular disease, and infant-related pregnancy complications. A table with an overview of the relative risk for many complications for current smokers according to age group can be found here. The increased use of ecigarettes has led to a vast array of complications. The CDC has reported e-cigarette, or vaping, product use-associated lung injury (EVALI) cases from across the country, with 2,409 cases having been reported to the CDC due to harmful chemicals in the ecigarette mixture. Fifty-two deaths have been reported. The CDC recommends completely refraining from using ecigarettes as the chemicals in the ecigarette mixtures are not tested or approved by the FDA. Adolescents should be warned about this and also aware that the long-term effects of ecigarettes are not known.
It is exceedingly important to educate youth regarding the deleterious impacts of smoking. Data indicates that 90% smokers begin before the age of 18 and 99% begin before the age of 26. Unfortunately, adolescents are very susceptible to various influences and pressures to begin using tobacco. Adolescents are at particularly high risk if they come from low economic backgrounds, have parents who use tobacco, and have peers that use tobacco.
Centers for Disease Control and Prevention: CDC Newsroom Releases
Centers for Disease Control and Prevention: Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products
Fishman's Pulmonary Diseases and Disorders, 5e: Chapter 41: Cigarette Smoking and Smoking Cessation
Harrison's Principles of Internal Medicine, 20e: Chapter 448: Nicotine Addiction