1400 I Street, NW Suite 1200 Washington, DC 20005

Phone (202) 296-5469 Fax (202) 296-5427 www.tobaccofreekids.org

Lifetime smoking and other tobacco use almost always begins by the time kids graduate from high
school.
1
Young kids nave experimentation frequently develops into regular smoking, which typically
turns into a strong addictionwell before the age of 18that can overpower the most well-intentioned
efforts to quit. Any efforts to decrease future tobacco use levels among high school students, college-
aged youths or adults must include a focus on reducing experimentation and regular tobacco use among
teenagers (pre-teens, too). Delaying the age when kids first experiment or begin using tobacco can also
reduce the risk that they become regular or daily tobacco users and increase their chances of
successfully quitting, if they do become regular users.

How Early Do Kids Try Smoking?

Very little data about smoking is regularly collected for kids under 12, but the peak years for first trying to
smoke appear to be in the sixth and seventh grades, or between the ages of 11 and 13, with a
considerable number starting even earlier.
2
In 2011, 6.1 percent of eighth grade students reported having
had their first cigarette by fifth grade (ages 1011), and 15.5 percent had tried smoking by eighth grade.
More than half of twelfth graders who were current smokers had tried smoking by the end of ninth grade.
3


A 1991 survey of 1,663 fifth grade students in Washington State found that 30 percent of youth ages 10
and 11 had already tried at least one cigarette; a little less than 10 percent had already tried at least two.
4

Similarly, a 1992 survey of youth smokers ages 10 to 17 in Massachusetts found that they had tried their
first cigarette at an average age of 12.
5
In 2011, a nationwide survey found that 10.3 percent of high
school students had smoked at least one whole cigarette before age 13 years, with more ninth graders
(12.1%) having smoked a full cigarette than eleventh graders (9.8%) or twelfth graders (8.2%).
6
And
nearly 40 percent (39.5%) of twelfth graders have tried smoking.
7


How Soon Do Kids Become Regular, Daily Smokers?

More than a third of all kids who ever try smoking a cigarette become regular, daily smokers before
leaving high school.
8
In fact, the addiction rate for smoking (the percentage of experimenters who
ultimately become habitual users) is higher than the addiction rates for marijuana, alcohol or cocaine.
9

Moreover, a September 2000 study found that symptoms of addictionstrong urges to smoke, anxiety,
irritability or unsuccessfully quit attemptscan appear in young kids within weeks or only days after
occasional smoking first begins, and well before daily smoking has even started.
10
A 2007 study in the
Archives of Pediatric and Adolescent Medicine found that some youths experience tobacco dependence
within a day of first inhaling.
11


This addictive power of cigarettes explains the findings of a 2012 Monitoring the Future survey which
show that five percent of tenth graders were already regular, daily smokers. In the twelfth grade, nearly
one-fifth (17.1%) of all students had smoked in the past 30 days; and nearly one in ten (9.3%) were
regular, daily smokers.
12
Smoking rates among kids who drop out of high school are even higher.
13


To look at it another way, every day 3,500 kids under 18 try smoking for the first time; and nearly 1,000
additional kids who have already experimented with cigarettes become new regular daily smokers.
14

Overall, 80 percent of all adult smokers begin smoking by the age of 18, and 90 percent do so before
leaving their teens.
15


Although some kids who become regular, daily smokers quit before leaving high school, the majority tries
to quit and fails. More than 60 percent of high school students who are daily smokers have tried to quit, but
less than one in eight has been successful at quitting for just 30 days or more.
16
And while only three
percent of daily smokers in high school think that they will still be smoking in five years, more than 60
percent are still regular, daily smokers seven to nine years later.
17


THE PATH TO TOBACCO ADDICTION STARTS AT VERY YOUNG AGES

The Path to Smoking Addiction Starts at Very Young Ages / 2

Although Stopping Youth Smoking Initiation is Best, Simply Delaying It Can Produce Substantial
Benefits

The earlier a kid first tries smoking, the higher his or her chances of ultimately becoming a regular
smoker, and the less likely he or she is to quit.
18


Research also shows that the earlier people begin smoking, the higher their risk of contracting lung
cancer or experiencing a range of risk factors and health problems in adulthood.
19
Overall, roughly one-
third of all kids who become regular smokers before adulthood will eventually die from smoking.
20
If
current trends continue, more than five million of the kids under 18 who are alive today will die from
tobacco-related causes.
21


Evidence also shows that smoking can be a first step toward other substance abuse. Stopping or
delaying that first step will reduce the risk that kids will progress to using other harmful substances.
22


Campaign for Tobacco-Free Kids, April 23, 2013 / Lorna Schmidt
More information on kids and tobacco use is available at
http://www.tobaccofreekids.org/facts_issues/fact_sheets/toll/tobacco_kids/.


1
Substance Abuse and Mental Health Services Administration (SAMHSA), HHS, Calculated based on data in National Household Survey on
Drug Abuse, 2001. See also, HHH, Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, 2012,
http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.
2
Johnston, LD, et al., Monitoring the Future national survey results on drug use, 1975-2011. Volume I, Secondary school students, 2012,
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2011.pdf. [This school-based study does not survey kids who have dropped out
of school, who tend to have higher smoking rates].
3
Johnston, LD, et al., Monitoring the Future national survey results on drug use, 1975-2011. Volume I, Secondary school students, 2012,
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2011.pdf.
4
Bowen, DJ, et al., Description of Early Triers, Addictive Behavior 16(3-4):95-101, 1991.
5
DiFranza, JR, et al., Tobacco Acquisition and Cigarette Brand Selection Among Youth, Tobacco Control 3:334-38, 1994.
6
U.S. Centers for Disease Control and Prevention (CDC), Youth Risk Behavior Surveillance, United States, 2011, Morbidity and Mortality
Weekly Report (MMWR) 61(4), June 8, 2012, http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf.
7
Johnston, LD, et al., Monitoring the Future survey, 2012, http://www.monitoringthefuture.org/data/12data/pr12cig_1.pdf.
8
CDC, Selected Cigarette Smoking Initiation and Quitting Behaviors Among High School StudentsUnited States, 1997, MMWR 47(19):386-
389, May 22, 1998, http://www.cdc.gov/mmwr/preview/mmwrhtml/00052816.htm.
9
Addiction rates can be determined by looking at the ratio between the number of people who try a substance and the number who become
regular daily users. This data is available from both the Monitoring the Future Studies and the National Household Surveys on Drug Abuse.
See, also, CDC, Symptoms of Substance Dependence Associated with Use of Cigarettes, Alcohol, and Illicit DrugsUnited States, 1991-
1992, MMWR 44(44):830-831,837-839, November 10, 1995, http://www.cdc.gov/mmwr/preview/mmwrhtml/00039501.htm; Anthony, JC, et al.,
Comparative Epidemiology of Dependence on Tobacco, Alcohol, Controlled Substances, and Inhalants: Basic findings from the National
Comorbidity Survey, Experimental and Clinical Psychopharmacology 2:244-268, 1994, www.hcp.med.harvard.edu/ncs.
10
DiFranza, JR, et al., Initial Symptoms of Nicotine Dependence in Adolescents, Tobacco Control 9:313-19, September 2000.
11
DiFranza, JR, et al., Symptoms of Tobacco Dependence After Brief Intermittent Use, Archives of Pediatric and Adolescent Medicine 161(7),
July 2007.
12
Johnston, LD, et al., Monitoring the Future survey, 2012, http://www.monitoringthefuture.org/data/12data/pr12cig_1.pdf.
13
See, e.g., Grunbaum JA, et al., Youth Risk Behavior Surveillance--National Alternative High School Youth Risk Behavior Survey, United
States, 1998, MMWR Surveillance Summary 48(7):1-44, October 29, 1999; Weller, NF, et al., Health Risk Behaviors of Texas Students
Attending Dropout Prevention/Recovery Schools in 1997, Journal of School Health 69(1):22-28, January 1999; de Moor, C, et al., Patterns
and Correlates of Smoking and Smokeless Tobacco Use Among Continuation High School Students, Addictive Behavior 19(2):175-84, March-
April 1994.
14
Substance Abuse and Mental Health Services Administration (SAMHSA), HHS, Results from the 2011 National Survey on Drug Use and
Health, NSDUH: Summary of National Findings, 2012.
http://www.samhsa.gov/data/NSDUH/2k11Results/NSDUHresults2011.htm.
15
SAMHSA, Calculated based on data in 2011 National Survey on Drug Use and Health.
16
CDC, High School Students Who Tried to Quit Smoking CigarettesUnited States, 2007, MMWR, 58(16):428431, May 1, 2009,
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5816a4.htm.
17
Johnston, LD, et al., National Survey Results on Drug Use from The Monitoring the Future Study, 1975-1998, Volume II: College Students
and Young Adults, 1999, http://www.monitoringthefuture.org/pubs/monographs/mtf-vol2_1998.pdf.
18
See, e.g., Khuder, SA, et al., Age at Smoking Onset and its Effect on Smoking Cessation, Addictive Behavior 24(5):673-7, September-
October 1999; DAvanzo ,B, et al., Age at Starting Smoking and Number of Cigarettes Smoked, Annals of Epidemiology 4(6):455-59,
November 1994; Chen, J & Millar, WJ, Age of Smoking Initiation: Implications for Quitting, Health Reports 9(4):39-46, Spring 1998; Everett,
SA, et al., Initiation of Cigarette Smoking and Subsequent Smoking Behavior Among U.S. High School Students, Preventive Medicine

The Path to Smoking Addiction Starts at Very Young Ages / 3


29(5):327-33, November 1999; Breslau, N & Peterson, EL, Smoking cessation in young adults: Age at initiation of cigarette smoking and other
suspected influences, American Journal of Public Health 86(2):214-20, February 1996.
19
Hegmann, KT, et al., The Effect of Age at Smoking Initiation on Lung Cancer Risk, Epidemiology 4(5):444-48, September 1993; Lando, HA,
et al., Age of Initiation, Smoking Patterns, and Risk in a Population of Working Adults, Preventive Medicine 29(6 Pt 1):590-98, December 1999.
20
CDC, Incidence of Initiation of Cigarette SmokingUnited States, 1965-1996, MMWR 47(39):837-840, October 9, 1998,
http://www.cdc.gov/mmwr/preview/mmwrhtml/00055070.htm.
21
CDC, Projected Smoking-Related Deaths Among YouthUnited States, MMWR 45(44):971-974, November 8, 1996,
http://www.cdc.gov/mmwr/preview/mmwrhtml/00044348.htm.
22
See, e.g., HHS, Preventing Tobacco Use Among Young People: A Report of the Surgeon General, 1994; Center on Addiction and
Substance Abuse, Columbia University, Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use, October 1994. See, also, Chaloupka, F,
et al., Do Higher Cigarette Prices Encourage Youth to Use Marijuana?, National Bureau of Economic Research, February 1999,
www.uic.edu/~fjc/Presentations/Papers/W6939.pdf, Campaign for Tobacco-Free Kids Factsheet, Smoking and Other Drug Use,
http://www.tobaccofreekids.org/research/factsheets/pdf/0106.pdf.