Tobacco - Substance Information

Underage Tobacco Use:

Smoking and smokeless tobacco use are initiated and established primarily during adolescence. More than 80% of adult smokers begin smoking before 18 years of age. Additionally, adolescent smokeless tobacco users are more likely than nonusers to become adult cigarette smokers.

Youth cigarette use declined sharply during 19972003. Since that time, rates have declined far more slowly.

Youth smokeless tobacco use also declined in the late 1990s and early 2000s, but an increasing number of U.S. high school students in some subgroups (such as white males) have reported using smokeless tobacco products in recent years.

Current Estimates of Youth Tobacco Use:


Each day in the United States, approximately 3,800 young people under 18 years of age smoke their first cigarette, and an estimated 1,000 youth in that age group become daily cigarette smokers.

Percentage of high school students who smoked one or more cigarettes in the previous month.

  • 19.5% of high school students.
  • 19.1% of female high school students.
  • 19.8% of male high school students.
  • 9.5% of black, non-Hispanic high school students.
  • 18.0% of Hispanic high school students.
  • 22.5% of white, non-Hispanic high school students.
Smokeless Tobacco

Percentage of high school students who are current smokeless tobacco users.

  • 8.9% of high school students.
  • 2.2% of female high school students.
  • 15.0% of male high school students.
  • 3.3% of black, non-Hispanic high school students.
  • 5.1% of Hispanic high school students.
  • 11.9% of white, non-Hispanic high school students.

Consequences of Adolescent Tobacco Use:

Youth who use tobacco are more likely to:

  • Engage in high-risk sexual behavior.
  • Use alcohol.
  • Abuse of other drugs.

Health Effects of Cigarette Smoking


Smoking harms nearly every organ of the body. Smoking causes many diseases and reduces the health of smokers in general.

Smoking and Death

Smoking Causes Death.
  • The adverse health effects from cigarette smoking account for an estimated 443,000 deaths, or nearly one of every five deaths, each year in the United States.
  • More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.
  • Smoking causes an estimated 90% of all lung cancer deaths in men and 80% of all lung cancer deaths in women.
  • An estimated 90% of all deaths from chronic obstructive lung disease are caused by smoking.

Smoking and Increased Health Risks

Compared with nonsmokers, smoking is estimated to increase the risk of:

  • coronary heart disease by 2 to 4 times,
  • stroke by 2 to 4 times,
  • men developing lung cancer by 23 times,
  • women developing lung cancer by 13 times, and
  • dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times.

Smoking and Cardiovascular Disease

  • Smoking causes coronary heart disease, the leading cause of death in the United States.
  • Cigarette smoking causes reduced circulation by narrowing the blood vessels (arteries) and puts smokers at risk of developing peripheral vascular disease (i.e., obstruction of the large arteries in the arms and legs that can cause a range of problems from pain to tissue loss or gangrene).
  • Smoking causes abdominal aortic aneurysm (i.e., a swelling or weakening of the main artery of the body - the aorta - where it runs through the abdomen).

Smoking and Respiratory Disease

  • Smoking causes lung cancer.1,2
  • Smoking causes lung diseases (e.g., emphysema, bronchitis, chronic airway obstruction) by damaging the airways and alveoli (i.e., small air sacs) of the lungs.

Smoking and Cancer

Smoking causes the following cancers:1

  • Acute myeloid leukemia
  • Bladder cancer
  • Cancer of the cervix
  • Cancer of the esophagus
  • Kidney cancer
  • Cancer of the larynx (voice box)
  • Lung cancer
  • Cancer of the oral cavity (mouth)
  • Pancreatic cancer
  • Cancer of the pharynx (throat)
  • Stomach cancer

Smoking and Other Health Effects

Smoking has many adverse reproductive and early childhood effects, including increased risk for:

  • infertility,
  • preterm delivery,
  • stillbirth,
  • low birth weight, and
  • sudden infant death syndrome (SIDS).1,8

Smoking is associated with the following adverse health effects:

  • Postmenopausal women who smoke have lower bone density than women who never smoked.
  • Women who smoke have an increased risk for hip fracture than women who never smoked.

Health Effects of Smokeless Tobacco Use


  • Smokeless tobacco contains 28 cancer-causing agents (carcinogens).
  • Smokeless tobacco is a known cause of human cancer; it increases the risk of developing cancer of the oral cavity.

Oral Health

  • Smokeless tobacco is also strongly associated with leukoplakia - a precancerous lesion of the soft tissue in the mouth that consists of a white patch or plaque that cannot be scraped off.
  • Smokeless tobacco is associated with recession of the gums, gum disease, and tooth decay.

Reproductive Health

  • Smokeless tobacco use during pregnancy increases the risks for preeclampsia (i.e., a condition that may include high blood pressure, fluid retention, and swelling), premature birth, and low birth weight.
  • Smokeless tobacco use by men causes reduced sperm count and abnormal sperm cells.

Nicotine Addiction

  • Smokeless tobacco use can lead to nicotine addiction and dependence.
  • Adolescents who use smokeless tobacco are more likely to become cigarette smokers.

Additional Information

Data provided by the Centers for Disease Control and Prevention . For more information, visit