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In 2016, 3.2% of children and adolescents aged 12 to 17 began smoking cigarettes in the past year.
Introduction
Tobacco smoking often starts during adolescence but can have detrimental health effects throughout life. Nearly 90 percent of adult daily smokers in the United States began smoking by age 18 and 98 percent first smoked by age 26. Initiation of smoking during adolescence is closely associated with persistent smoking in adulthood and with the many adverse health effects associated with chronic smoking.
While cigarettes represent the predominant form of tobacco, data for other tobacco products such as cigars and smokeless tobacco have recently been tracked as well. Understanding trends in the initiation of --cigarette and cigar smoking, and smokeless tobacco use, and their combined use -- among youth enables policy makers to target prevention resources more effectively. To decrease tobacco use and susceptibility to use among youth, restrictions on advertising, promotion, and availability of tobacco products to youth should be combined with full implementation of evidence-based, community-wide, comprehensive tobacco control policies such as product taxes and smoke-free air laws. (See also Chapters on “Youth Tobacco Use” and “Adult Tobacco Use”).
Measure
The percentage of individuals among those aged 12 to 17 years and 18 to 25 years who said they had initiated cigarette smoking during the past 12 months.
The percentage of individuals among those aged 12 to 17 years and 18 to 25 years who said they had initiated cigar smoking during the past 12 months.
The percentage of individuals among those aged 12 to 17 years and 18 to 25 years who said they had initiated smokeless tobacco use during the past 12 months.
The percentage of individuals among those aged 12 to 17 years and 18 to 25 years who said they had initiated use of any of these tobacco products during the past 12 months.
Healthy People 2020 Target
- Reduce the initiation of the use of tobacco products by children and adolescents aged 12 to 17 years to 5.8 percent.
- Reduce the initiation of the use of cigarettes by children and adolescents aged 12 to 17 years to 4.3 percent.
- Reduce the initiation of the use of smokeless tobacco products by children and adolescents aged 12 to 17 years to 0.6 percent.
- Reduce the initiation of the use of cigars by children and adolescents aged 12 to 17 years to 2.9 percent.
- Reduce the initiation of the use of tobacco products by young adults aged 18 to 25 years to 8.9 percent.
- Reduce the initiation of the use of cigarettes by young adults aged 18 to 25 years to 6.4 percent.
- Reduce the initiation of the use of smokeless tobacco products by young adults aged 18 to 25 years to 0.2 percent.
- Reduce the initiation of the use of cigars by young adults aged 18 to 25 years to 4.3 percent.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Substance Abuse and Mental Health Services Administration, National Household Survey on Drug Use and Health, 2002-2014.
Trends and Most Recent Estimates
Product Comparison
Ages 12-17
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Tobacco Products
|
4.4 | 4.0 - 4.8 |
Cigarettes
|
3.2 | 2.8 - 3.6 | |
Smokeless Tobacco
|
1.5 | 1.3 - 1.7 | |
Cigars
|
2.4 | 2.1 - 2.7 | |
Ages 18-25
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Tobacco Products
|
8.0 | 7.2 - 8.8 |
Cigarettes
|
5.4 | 4.8 - 6.1 | |
Smokeless Tobacco
|
1.6 | 1.3 - 1.9 | |
Cigars
|
5.2 | 4.6 - 5.8 | |
All Tobacco Products
Ages 12-17 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
4.4 | 4.0 - 4.8 |
Male
|
4.9 | 4.3 - 5.6 | |
Female
|
3.8 | 3.3 - 4.4 | |
Ages 18-25 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
8.0 | 7.2 - 8.8 |
Male
|
10.2 | 8.8 - 11.8 | |
Female
|
6.3 | 5.5 - 7.3 | |
Ages 12-17 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
4.4 | 4.0 - 4.8 |
Non-Hispanic White
|
4.9 | 4.3 - 5.5 | |
Non-Hispanic Black
|
3.2 | 2.4 - 4.3 | |
Hispanic
|
4.1 | 3.2 - 5.3 | |
Ages 18-25 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
8.0 | 7.2 - 8.8 |
Non-Hispanic White
|
9.7 | 8.4 - 11.2 | |
Non-Hispanic Black
|
5.5 | 4.1 - 7.2 | |
Hispanic
|
7.6 | 6.0 - 9.5 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Ages 12-17
|
4.4 | 4.0 - 4.8 |
Ages 18-25
|
8.0 | 7.2 - 8.8 | |
Cigarettes
Ages 12-17 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
3.2 | 2.8 - 3.6 |
Male
|
3.3 | 2.9 - 3.9 | |
Female
|
3.0 | 2.6 - 3.5 | |
Ages 18-25 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
5.4 | 4.8 - 6.1 |
Male
|
6.4 | 5.4 - 7.6 | |
Female
|
4.6 | 3.8 - 5.4 | |
Ages 12-17 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
3.2 | 2.8 - 3.6 |
Non-Hispanic White
|
3.6 | 3.1 - 4.1 | |
Non-Hispanic Black
|
2.0 | 1.4 - 2.8 | |
Hispanic
|
3.1 | 2.4 - 4.0 | |
Ages 18-25 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
5.4 | 4.8 - 6.1 |
Non-Hispanic White
|
6.4 | 5.5 - 7.5 | |
Non-Hispanic Black
|
3.0 | 2.1 - 4.2 | |
Hispanic
|
5.5 | 4.3 - 7.0 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Ages 12-17
|
3.2 | 2.8 - 3.6 |
Ages 18-25
|
5.4 | 4.8 - 6.1 | |
Smokeless Tobacco
Ages 12-17 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
1.5 | 1.3 - 1.7 |
Male
|
2.0 | 1.7 - 2.5 | |
Female
|
0.9 | 0.7 - 1.2 | |
Ages 18-25 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
1.6 | 1.3 - 1.9 |
Male
|
2.6 | 2.1 - 3.2 | |
Female
|
0.8 | 0.6 - 1.0 | |
Ages 12-17 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
1.5 | 1.3 - 1.7 |
Non-Hispanic White
|
2.0 | 1.7 - 2.4 | |
Non-Hispanic Black
|
0.5 | 0.2 - 1.0 | |
Hispanic
|
1.0 | 0.6 - 1.7 | |
Ages 18-25 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
1.6 | 1.3 - 1.9 |
Non-Hispanic White
|
2.5 | 2.1 - 3.0 | |
Non-Hispanic Black
|
0.3 | 0.2 - 0.7 | |
Hispanic
|
0.7 | 0.5 - 1.1 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Ages 12-17
|
1.5 | 1.3 - 1.7 |
Ages 18-25
|
1.6 | 1.3 - 1.9 | |
Cigars
Ages 12-17 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
2.4 | 2.1 - 2.7 |
Male
|
3.1 | 2.7 - 3.7 | |
Female
|
1.6 | 1.4 - 2.0 | |
Ages 18-25 by Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Both Sexes
|
5.2 | 4.6 - 5.8 |
Male
|
7.2 | 6.3 - 8.3 | |
Female
|
3.6 | 3.0 - 4.2 | |
Ages 12-17 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
2.4 | 2.1 - 2.7 |
Non-Hispanic White
|
2.9 | 2.5 - 3.3 | |
Non-Hispanic Black
|
1.8 | 1.2 - 2.5 | |
Hispanic
|
1.8 | 1.4 - 2.5 | |
Ages 18-25 by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
All Races
|
5.2 | 4.6 - 5.8 |
Non-Hispanic White
|
6.7 | 5.8 - 7.6 | |
Non-Hispanic Black
|
3.6 | 2.7 - 4.9 | |
Hispanic
|
4.0 | 3.1 - 5.2 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2016) | |
|---|---|---|---|
| Percent | 95% Confidence Interval | ||
|
Ages 12-17
|
2.4 | 2.1 - 2.7 |
Ages 18-25
|
5.2 | 4.6 - 5.8 | |
Evidence-based Resources
Tobacco control resources are available that support collaboration, identify evidence-based approaches and list research-tested interventions on the Cancer Control P.L.A.N.E.T. web portal. To identify high-risk populations and prioritize cancer control efforts, state and county-level tobacco data can be found on State Cancer Profiles.
Additional Information on Tobacco Use Initiation
For the public
- Tobacco and Cancer. American Cancer Society.
- Youth Tobacco Prevention. Centers for Disease Control and Prevention.
- 50 Years of Progress: A Report of the Surgeon General, 2014. U.S. Department of Health and Human Services.
- Youth and Tobacco. U.S. Food and Drug Administration.
For tobacco users
- Smokefree.gov. National Cancer Institute.
- Tobacco. National Cancer Institute.
- How to Quit Smoking or Smokeless Tobacco. American Cancer Society.
- North American Quitline Consortium.
For health professionals
- Best Practices for Comprehensive Tobacco Control Programs—2014. Centers for Disease Control and Prevention.
Scientific reports
- Smoking and Tobacco Control Monographs. Monograph 14: Changing Adolescent Smoking Prevalence. National Cancer Institute.
- Smoking and Tobacco Control Monographs. Monograph 19: The Role of the Media in Promoting and Reducing Tobacco Use. National Cancer Institute.
- CDC Grand Rounds: Current Opportunities in Tobacco Control. Centers for Disease Control and Prevention. MMWR 2010;59(16):487–492.
- Cigarette use among high school students – United States, 1991–2009. Centers for Disease Control and Prevention. MMWR 2010;59(26):797–801.
- Tobacco product use among middle and high school students – United States, 2011–2017. Centers for Disease Control and Prevention. MMWR 2013;62(45): 893-897.
- Smoking initiation associated with specific periods in the life course from birth to young adulthood: data from the National Longitudinal Survey of Youth 1997. Chen X, Jacques-Tiura AJ. Am J Public Health 2014;104(2):e119–26.
- Individual- and community-level correlates of cigarette-smoking trajectories from age 13 to 32 in a U.S. population-based sample. Fuemmeler B, Lee CT, Ranby KW, Clark T, et al. Drug Alcohol Depend. 2013;132(1–2):301–8.
- Risk factors for adolescent smoking: parental smoking and the mediating role of nicotine dependence. Selya AS, Dierker LC, Rose JS, Hedeker D, Mermelstein RJ. Drug Alcohol Depend. 2012;124(3):311–8.
- 2014 Surgeon General’s Report - The Health Consequences of Smoking: 50 Years of Progress. SurgeonGeneral.gov.
- 2012 Surgeon General’s Report—Preventing Tobacco Use Among Youth and Young Adults. Centers for Disease Control and Prevention.
Year Range
2002-2016
Recent Summary Trend Year Range
2012-2016
Summary Tables
Smoking
Recent Summary Trend
Falling
Desired Direction
Falling