Introduction

Tobacco use is the leading cause of preventable death in the United States today (1). It is a significant risk factor for many cancers, lung diseases, and cardiovascular disorders, and a contributing factor to a range of other chronic, debilitating diseases such as diabetes. It is estimated that five million young people alive today will die prematurely to tobacco related diseases if current trends continue (2).

Typically use of tobacco products begins in early adolescence, most often by age 16. Eighty-two percent of American adults who have ever been daily smokers tried their first cigarette before the age of 18 (3). In spite of policies prohibiting the sale of tobacco products to people under the age of 18, 72 percent of eighth graders and 88 percent of 10 th graders indicate that they can get cigarettes “fairly easily” or “very easily” when they want them (4).

It is currently estimated that in the United States more than 3,000 children and adolescents become regular users of tobacco each day (5), and that more than 4 million adolescents are now smoking cigarettes (6).

Young people who have smoked as few as 100 cigarettes in their lifetime frequently report that they would like to quit, but are unable to do so (7). The Surgeon General reported in 1994 that 44 percent of high school seniors between 1976 and 1986 who were daily smokers believed that they would no longer be smoking five years later; however, follow-up studies indicated that between five and six years later, 73 percent remained daily smokers (8). Data from 1997 surveys indicate that less than 14 percent of youth who had ever been daily smokers had abstained from using tobacco in the previous 30 days; when the time period examined is one year, only three percent of high school seniors who had ever been regular smokers reported not using tobacco at all (9).

It is clear that tobacco use is a significant problem among young people—one which is carried into adulthood and ultimately contributes to disability and premature death. It is also evident that many young tobacco users would like support to discontinue their habits. However, there are few mechanisms or programs available to youth who want to quit. While it is known that increasing the excise tax on tobacco products reduces tobacco use among youth (10), there is very little research evidence demonstrating the effectiveness of cessation interventions—whether behavioral or pharmacological (e.g., nicotine replacement therapy) in nature—with this population (11).

Therefore, the need is clear and urgent: to research, develop, and support policies and cessation interventions and services to help young tobacco users break their habits before they become long-term adult users.

Footnotes

(1) McGinnis JM, Foege WH (1993). Actual Causes of Death in the United States. JAMA, 270:18; 2207.
(2) Centers for Disease Control and Prevention. (1996). Youth Risk Behavior Survey, 1995, MMWR, 45:44.
(3) Centers for Disease Control and Prevention. (2000). Tobacco use among middle and high school students—United States, 1999. MMWR, 49;49-53.
(4) Johnston LD, et al. (December 1999). Cigarette smoking among American teens continues gradual decline. University of Michigan News and Information Services: Ann Arbor, Michigan. http://www.monitoringthefuture.org; accessed 6/6/00.
(5) U.S. Department of Health and Human Services. (1996). Clinical Practice Guideline Number 18: Smoking Cessation, AHCPR Publication No. 96-0692.
(6) U.S. Department of Health and Human Services. (1998). Summary findings from the 1998 National Household Survey on Drug Abuse. Substance Abuse and Mental Health Services Administration.
(7) U.S. Department of Health and Human Services. (1994). Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Centers for Disease Control and Prevention, Office on Smoking and Health.
(8) Ibid.
(9) Johnston LD, et al. (1999) National Survey Results on Drug Use from the Monitoring the Future Study, 1975-1998. Washington, DC: U.S. Department of Health and Human Services, National Institute on Drug Abuse. NIH Publication No. 99-4660.
(10) Heyman RB. (2000). Turning the tide: Tobacco and the 21st century. Adolescent Medicine: State of the Art Reviews, 11(1):69-78.
(11) U.S. Department of Health and Human Services, 1996.