[6] If the current smoking trends continue, 5.6 million youths alive today will die prematurely.
[9] National epidemiological surveys often deliver key findings on the proportion of youth that are consuming tobacco.
Prevention and control measures that reduce smoking in among adolescents can improve the nation's short- and long-term health.
In 2012, Australia became the first country in the world to mandate standardized plain packaging intended to make cigarettes less appealing to new and existing smokers, especially adolescents and those focused on a personal brand image.
[citation needed] Youth who begin smoking pass through various stages, each influenced by a variety of factors, before becoming a daily smoker.
Notably, these attitudes towards smoking may often be negative, but are not as salient nor impactful to the adolescent because of either positive media messages or role models (i.e. parents who are smokers).
Additionally, youth in this stage may begin to associate themselves with a personal identity of being a smoker as they are learning how to smoke (i.e. how to handle a cigarette, inhale correctly, etc.).
At this point, a combination of physiological and biological factors maintains the smoking behavior as part of the adolescent's self-regulation.
An additional major risk factor is alcohol use, which has been demonstrated as being more influential during the earlier stages of smoking.
Specifically, youth who experience numerous highly stressful events throughout childhood are at increased risk of beginning to smoke by the age of 14.
[28] Particularly important stressors that contribute to this early onset of cigarette smoking include experiencing parental separation, being witness or victim to abuse, or residing in a household with a family member that is incarcerated or has a mental disorder.
Since tobacco use among youth reached a peak in the 1990s, perceptions that cigarettes are harmful has increased, which has been a critical contributor the declining rates over the past twenty years.
[30] Thus, adolescents perceived psychological dependence appears to be an important risk factor for vulnerability to smoking.
Adolescents place less weight on the physical dependence to nicotine that can develop and perpetuate their smoking behavior.
[31][32] Genome wide association studies and sequencing are still in progress to examine which relevant genetic variants exert robust contributions to cigarette smoking behavior.
The top negative health causes that have been causally linked to cigarette smoking include cancers of the upper digestive tract, lung cancer, and chronic diseases including diabetes, coronary heart diseases, pneumonia, and overall poorer immune function.
In a study examining nearly 10,000 males and females ranging in age from ten to eighteen across the United States, adolescents who smoked cigarettes exhibited impaired pulmonary function.
[34] While heart disease and stroke are consequences more commonly seen in adulthood, early signs of these effects can often be found in adolescent smokers.
[4] In a nationwide examination as part of the National Youth Tobacco Survey 2011 and 2012 cohort, e-cigarette use was associated with a greater likelihood of having a history or currently being an active cigarette smoker.
[51] Cigar use is associated with a range of negative health consequences including oral, lung, and esophageal cancer.
Snus may aid youth in cessation of smoking or in harm reduction, but it can also be used in conjunction with cigarettes and thus increase risk for disease.
[54] Attractive qualities of snus products to adolescents include that they come in flavors, is a form of spitless tobacco, and they are often advertised as being able to use in public places where traditional cigarette smoking is not allowed.
Orbs are dissolvable tobacco pills that come in a variety of flavors such as cinnamon or citrus that resemble breath mints.
[56] An additional study found that adolescents who were exposed to movies with a large amount of smoking were nearly three times as likely to experiment with or become regular smokers.
[57] For smoking initiation, this effect was most prominent for individuals who were at the lowest risk for becoming a smoker (i.e. adolescents low in sensation seeking).
[57] The Master Settlement Agreement (MSA) aimed to limit the promotional activities of tobacco companies, however since its passing there has been minimal change in advertising.
[58] It has been suggested that to decrease exposure, parents should not allow their children to wear anything or place anything in their rooms like posters of celebrities smoking or other things that promote tobacco companies.
In 1999, Philip Morris ran a series of full-page advertisements in news magazines, which were aimed at parents and conveyed the "forbidden fruit" message.
These covers, which were meant to make students aware of the potential dangers of smoking while at the same time enticing them to defy parental authority, failed as a result of the intervention of the California Department of Education and Justice.
[69] The Truth campaign makes use of the mass-media communication strategy known as counter-marketing which previous research has shown to be an effective method of reducing smoking prevalence among youth.