Approximately 3,800 children smoke their first cigarette every day and the rates of tobacco initiation are no longer declining, according to the Surgeon General’s report, "Preventing Tobacco Use Among Youth and Young Adults."
"Every day, 1,200 Americans die from smoking and each of those people are replaced by two young smokers," Surgeon General Regina Benjamin said at a press conference. "We know that prevention is the key ... If we can just get [young people] to remain smoke free until they’re 26, then less than 1% of them will ever start."
Dr. Regina Benjamin
Among adults who smoke daily, 88% smoked their first cigarette before their 18th birthday; nearly all (99%) did so before their 26th.
According to the report, nearly 25% of high school seniors are current smokers, compared with about 33% of young adults, and about 20% of adults. And it’s not all cigarettes: About 1 in 10 male high school seniors currently uses smokeless tobacco and about 1 in 5 smokes cigars, according to the report.
The report, which updates the 1994 Surgeon General report on tobacco use in youth, highlights the immediate and long-term health consequences to which children and young adults are most vulnerable. These include cardiovascular damage, reduced lung function and growth, and risk of chronic obstructive pulmonary disease.
Because they’re impressionable, young adults and children also are vulnerable to tobacco advertising and targeted products. Even though the landmark 1998 Master Settlement Agreement drastically restricted the way tobacco can be marketed, one-third of the top grossing children’s movies in 2010 contained images of smoking, according to the report.
"Far too many kids still see smoking images and messages every day that normalize this dependence," said Dr. Howard Koh, assistant secretary for health in the Health and Human Services department. "Kids see smoking in the movies they watch, the video games they play, the websites they visit, and in the communities where they live."
Physician organizations voiced support of the report and recommended that it be used to help protect young people from using tobacco products.
"As pediatricians, and parents, we need to send a clear message to the studios that this must stop now," Dr. Robert W. Block, AAP president, said in a statement. Dr. Block added that the Surgeon General’s report should be used to help overturn a recent federal court decision that called graphic cigarette warning labels unconstitutional.
"Warning labels play a critical role in educating children, teens, and parents about the negative health impacts of tobacco. By ignoring health harms from tobacco, we are not only sustaining incredible costs in health care, but we are also risking the lives of youth and young adults. This is simply irresponsible," he said.
"If we can just get [young people] to remain smoke free until they’re 26, then less than 1% of them will ever start."
In a statement, Dr. Jack Lewin, chief executive officer of the American College of Cardiology said, "the Surgeon General’s decision to reinvigorate efforts to keep children and young adults from smoking and to encourage smoking cessation will help us continue downward the trend of mortality due to heart disease and save millions in spending on health care."
The American Medical Association called for better funding of smoking cessation programs. The AMA "is concerned that these smokers will not get the support and assistance needed to combat their addiction," Dr. Peter Carmel, the association’s president, said in a statement. "Increasing the price of tobacco and adopting comprehensive smoke-free laws throughout the entire nation would also help reduce the health, social, and economic consequences associated with tobacco use among our youth."
The American Heart Association called the report a wake-up call. "This insightful new report makes it clear that we cannot let our guard down for a minute when it comes to tobacco addiction," CEO Nancy Brown said in a statement. While many Americans may think tobacco use is fading away, the evidence in this report tells a dramatically different story."