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Pennsylvania Value:
Percentage of children ages 12-17 who reported using a tobacco product (cigarettes, smokeless tobacco, cigars or pipe tobacco) in the past month
Pennsylvania Rank:
Percentage of children ages 12-17 who reported using a tobacco product (cigarettes, smokeless tobacco, cigars or pipe tobacco) in the past month
0.9% - 1.7%
1.8% - 1.9%
2.0% - 2.0%
2.1% - 2.3%
2.4% - 3.0%
US Value: 1.9 %
Top State(s): Utah: 0.9 %
Bottom State(s): West Virginia: 3.0 %
Definition: Percentage of children ages 12-17 who reported using a tobacco product (cigarettes, smokeless tobacco, cigars or pipe tobacco) in the past month
Data Source and Years(s): U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health State Estimates of Substance Use and Mental Disorders, 2022-2023
Suggested Citation: America's Health Rankings analysis of U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health State Estimates of Substance Use and Mental Disorders, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
Tobacco use has well-known and wide-ranging adverse impacts on health. People who smoke cigarettes are at greater risk of heart disease, cancer and stroke. According to a report from the surgeon general, cigarette smoking remains a leading cause of preventable death in the United States. Furthermore, smoking is costly: In 2018, cigarette smoking cost the U.S. more than $600 billion in health care expenditures and lost productivity.
The use of cigarettes, cigars and smokeless tobacco has declined among adolescents in recent years. Electronic cigarettes, also known as e-cigs or vape pens, are now the most commonly used tobacco product among youth, surpassing cigarettes in 2014.
Young people are particularly vulnerable to peer pressure, and tobacco companies use strategies to get tobacco users addicted early. For example, adding flavorings to tobacco products has made them more appealing to children and led to increased usage. A recent study shows associations between youth social media use, engagement with tobacco brands on these platforms and an increased risk of initiating tobacco use.
Nearly 9 in 10 cigarette smokers have their first cigarette by age 18. An estimated 5.6 million young people under age 18 today will die prematurely from diseases caused by long-term tobacco use.
Tobacco use is heavily influenced by an individual’s family, friends, community and social environment. Family and friends can be especially important: Adolescents are, in general, more likely to start smoking if their best friend smokes, but a positive parenting style can decrease this risk. Populations that have higher rates of tobacco use include:
The Centers for Disease Control and Prevention emphasizes that interventions are most effective when implemented together. Interventions that have been found to reduce and prevent youth tobacco use include:
In 2019, the Tobacco 21 (T21) law increased the federal minimum age to purchase tobacco products (including cigarettes, cigars and e-cigarettes) from 18 to 21. A one-year assessment of the policy found that the percentage of teenagers surveyed who feel it is easy to purchase tobacco products from a store had decreased. However, there was no discernible change in the perception of how easy it is to buy tobacco products online.
Healthy People 2030 has several tobacco use objectives for adolescents, including:
Agaku, Israel T., Lungile Nkosi, Queen D. Agaku, Joy Gwar, and Tina Tsafa. “A Rapid Evaluation of the US Federal Tobacco 21 (T21) Law and Lessons From Statewide T21 Policies: Findings From Population-Level Surveys.” Preventing Chronic Disease 19 (June 2, 2022): 210430. https://doi.org/10.5888/pcd19.210430.
Gentzke, Andrea S., Teresa W. Wang, Monica Cornelius, Eunice Park-Lee, Chunfeng Ren, Michael D. Sawdey, Karen A. Cullen, Caitlin Loretan, Ahmed Jamal, and David M. Homa. “Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021.” MMWR. Surveillance Summaries 71, no. 5 (March 11, 2022): 1–29. https://doi.org/10.15585/mmwr.ss7105a1.
Haas, Steven A., and David R. Schaefer. “With a Little Help from My Friends? Asymmetrical Social Influence on Adolescent Smoking Initiation and Cessation.” Journal of Health and Social Behavior 55, no. 2 (May 12, 2014): 126–43. https://doi.org/10.1177/0022146514532817.
Jamal, Ahmed, Eunice Park-Lee, Jan Birdsey, Andrenita West, Monica Cornelius, Maria R. Cooper, Hannah Cowan, et al. “Tobacco Product Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2024.” MMWR. Morbidity and Mortality Weekly Report 73, no. 41 (October 17, 2024): 917–24. https://doi.org/10.15585/mmwr.mm7341a2.
Park-Lee, Eunice, Chunfeng Ren, Maria Cooper, Monica Cornelius, Ahmed Jamal, and Karen A. Cullen. “Tobacco Product Use Among Middle and High School Students — United States, 2022.” MMWR. Morbidity and Mortality Weekly Report 71, no. 45 (November 11, 2022): 1429–35. https://doi.org/10.15585/mmwr.mm7145a1.
Ranker, Lynsie R., Jiaxi Wu, Traci Hong, Derry Wijaya, Emelia J. Benjamin, Aruni Bhatnagar, Rose M. Robertson, Jessica L. Fetterman, and Ziming Xuan. “Social Media Use, Brand Engagement, and Tobacco Product Initiation among Youth: Evidence from a Prospective Cohort Study.” Addictive Behaviors 154 (July 2024): 108000. https://doi.org/10.1016/j.addbeh.2024.108000.
U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. https://www.ncbi.nlm.nih.gov/books/NBK179276/.
Williams, Ozge C., Sakshi Prasad, Ahmed Ali Khan, Oghenetega Esther Ayisire, Hafsa Naseer, Muhammad Abdullah, Mahrukh Nadeem, Nauman Ashraf, and Muhammad Zeeshan. “Tailoring Parenting Styles and Family-Based Interventions Cross-Culturally as an Effective Prevention Strategy for Youth Substance Use: A Scoping Review.” Annals of Medicine & Surgery 86, no. 1 (January 2024): 257–70. https://doi.org/10.1097/MS9.0000000000001387.
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