Tobacco Use - Youth in Missouri

Missouri

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. 

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. 

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. Cigarette smoking cost the United States more than $600 billion in health care expenditures and lost productivity in 2018.

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:

• American Indian/Alaska Native youth compared with Asian youth.
• Lesbian, gay and bisexual youth compared with heterosexual youth. Transgender youth have a similarly high prevalence.
• Students experiencing psychological distress.

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:

• 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. 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:

• 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. “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.

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.

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health.” Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, November 2023. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report.

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.

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