Tobacco Use - Youth in Vermont

Vermont

Tobacco use has well-known and wide-ranging adverse impacts on health. People who use tobacco 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. 

The use of cigarettes, cigars and smokeless tobacco has declined among youth in recent years. Electronic cigarettes, commonly known as e-cigs or vape pens, are now the most commonly used tobacco product among youth, surpassing cigarettes in 2014.

Youth are particularly vulnerable to peer pressure, and tobacco companies use strategies to get tobacco users addicted early. Nearly 9 in 10 cigarette smokers have their first cigarette by age 18. Each day in the U.S., about 1,600 youths smoke their first cigarette. An estimated 5.6 million young people under age 18 today will die prematurely from diseases caused by long-term tobacco use. Further, cigarette smoking is responsible for approximately $225 billion in health care expenditures and an additional $156 billion in lost productivity annually in the U.S.

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. Among youth, populations that have higher rates of tobacco use include:

• American Indian/Alaska Native high school students compared with Hispanic non-Hispanic Asian and Hispanic students.
• Lesbian, gay and bisexual youth compared with heterosexual youth. Transgender youth have a similarly high prevalence.
• Students experiencing psychological distress compared with those who are not; the prevalence was significantly higher with each increase in the level of psychological distress.

The Centers for Disease Control and Prevention outlines efforts that, when implemented together, have been found to reduce and prevent youth tobacco use, including:

• Raising costs for tobacco products.
• Prohibiting smoking in indoor and public places.
• Media messages countering tobacco product advertisements.
• Community programs and school policies encouraging tobacco-free environments and lifestyles.

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. After a year of implementation, the policy was assessed and found the percentage of adolescents who believed that purchasing tobacco products from a store was easy 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:

• Reducing current use of tobacco products among adolescents.
• Reducing the proportion of adolescents exposed to tobacco marketing.
• Eliminating cigarette smoking initiation in adolescents and young adults.

Agaku, Israel T., Lungile Nkosi, Queen D. Agaku, Joy Gwar, and Tina Tsafa. 2022. “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): 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. 2022. “Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021.” MMWR. Surveillance Summaries 71 (5): 1–29. https://doi.org/10.15585/mmwr.ss7105a1.

O’Byrne, Kristin Koetting, C. Keith Haddock, and Walker S. C. Poston. 2002. “Parenting Style and Adolescent Smoking.” Journal of Adolescent Health 30 (6): 418–25. https://doi.org/10.1016/S1054-139X(02)00370-1.

Park-Lee, Eunice, Chunfeng Ren, Maria Cooper, Monica Cornelius, Ahmed Jamal, and Karen A. Cullen. 2022. “Tobacco Product Use Among Middle and High School Students — United States, 2022.” MMWR. Morbidity and Mortality Weekly Report 71 (45): 1429–35. https://doi.org/10.15585/mmwr.mm7145a1.

Substance Abuse and Mental Health Services Administration. 2022. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health.” HHS Publication No. PEP22-07-01-005, NSDUH Series H-57. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report.

U.S. Department of Health and Human Services. 2014. “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. https://www.cdc.gov/tobacco/sgr/50th-anniversary/index.htm.

Xu, Xin, Sundar S. Shrestha, Katrina F. Trivers, Linda Neff, Brian S. Armour, and Brian A. King. 2021. “U.S. Healthcare Spending Attributable to Cigarette Smoking in 2014.” Preventive Medicine 150 (September): 106529. https://doi.org/10.1016/j.ypmed.2021.106529.