Why do Teens Still Smoke? On Addiction, Advertising, and the Rise of E-Cigarettes


By Melinda Carstensen

U.S. teen smoking rates have dipped below 10 percent, but public health advocates worry that progress may soon level off, as other surveys suggest teens think light smoking is safe, and e-cigarette use is on the rise.

“The real public impact is preventing teens from smoking— that remains the key, and one of the things that the furor over e-cigarettes can do is distract you from that debate,” Amy Fairchild, professor of sociomedical sciences at Columbia University, told FoxNews.com.

Why teens smoke at all is a question that public health advocates have been scratching their heads over since the 1960s— when a U.S. Surgeon General’s report exposed the health risks of smoking— and even more so since the 1970s, when the federal government set strict marketing rules that made it tougher for tobacco companies to target minors.

According to a 2014 survey of 40,000 to 50,000 students in eighth, 10th and 12th grade, 8 percent of teens at 400 secondary schools in the United States reported smoking cigarettes in the month prior to answering the questionnaire. The findings, from the University of Michigan’s Monitoring the Future study, presented the lowest teen smoking rates since the study was first conducted in 1975.

But a separate survey of almost 25,000 teens in grades six through 12 suggests that many teens think light smoking is safe. The findings, from the 2012 National Youth Tobacco Survey and published December in the journal Pediatrics, found that only 64 percent of the teens surveyed knew having a few cigarettes a day is very harmful.  And only 33 percent of the study participants knew that intermittent smoking on some days, but not every day, was unhealthy.

“Kids accept and know that heavy smoking is really, really bad for you, but what they’re not so aware of is that light and intermittent smoking is also really bad for you,” Robin Koval, CEO of anti-smoking nonprofit Legacy, who wasn’t involved in either study, told FoxNews.com. “They think it’ll be easy for them to quit later on, but once your brain gets that taste of nicotine, it actually won’t.”

According to the National Institutes of Health (NIH), smoking is the leading cause of preventable death in the U.S. Tobacco smoke contains 250 known harmful chemicals, 69 of which can cause cancer. The Centers for Disease Control and Prevention (CDC) estimates that 443,000 people die prematurely from smoking or secondhand smoke, and that another 8.6 million live with a serious illness caused by smoking.


Derek Yach, a former professor of global health at Yale University, and former executive director for noncommunicable diseases and mental health at the World Health Organization (WHO), agreed.

“We don’t want to send a signal that e-cigarettes are worse than cigarettes,” Yach told FoxNews.com.

Yach, the executive director of research organization The Vitality Institute— which is owned by the same company funding research at the University of Pennsylvania on e-cigarettes as a stop-smoking tool— predicts that e-cigarettes can likely be used as a harm-reduction alternative to traditional cigarettes.

“That doesn’t mean there’s zero risk or that there’s some contaminant here and there,” he noted, “but we’re talking about a product (tobacco cigarettes) that kills almost half a million Americans, and anything that can intervene to cut that needs to be supported.”

For now, the most urgent message that parents and governing bodies need to relay to teens is that “tobacco products are not a good idea,” Yach said. “Many of the people calling for tighter control of e-cigarettes have failed to call for tougher control on the known killer product: cigarettes— especially when it comes to youth access.”


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