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This Surgeon General’s report details the causes and the consequences of tobacco use among youth and young adults by focusing on the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. This is the first time tobacco data on young adults as a discrete population has been explored in detail. The report also highlights successful strategies to prevent young people from using tobacco.

Adolescence and young adulthood are the times when people are most susceptible to starting tobacco use.   Nearly all tobacco use begins during youth and young adulthood.
If young people don’t start using tobacco by age 26, they almost certainly will never start.
Tobacco contains nicotine, a highly-addictive drug that causes many young people to progress from smoking occasionally to smoking every day.

New research shows that smoking during adolescence and young adulthood causes early damage to the abdominal aorta, the large artery that carries oxygen-rich blood from the heart through the abdomen to major organs.

Early smoking can  harm lungs  
Young people are still growing. Their lungs don’t reach full size until late teens for girls and after age 20 for boys. Adults who smoked during adolescence can have lungs that never grow to their potential size and never perform at full capacity.
Why is early smoking so harmful?
People who start smoking as young teens are more likely to:
• Get addicted to nicotine.
• Become lifetime smokers.
• Get diseases caused by tobacco use.
• Die from a disease caused by tobacco use

Quitting isn’t easy, but it can be done. Better yet—don’t start! Not starting is even better than quitting. Learn what risk factors to look for and how to help yourself, your friends, or the young people in your life stay tobacco-free. Their health depends on it!
There are many reasons young people begin using tobacco. Teenagers, and even preteens, are developing behaviours, social connections, and attitudes. They often experiment with different behaviours because they see these behaviours in peers they admire, in adults they hope to be like someday, or in media or entertainment idols.
Communities that allow the sale of cigarettes and other tobacco products near schools have higher rates of youth tobacco use than do communities that have tobacco-free zones around schools. If teens and young adults see tobacco use in their homes or in public places within their communities, these images encourage them to see smoking as a normal part of adult behaviour.

For many years, tobacco companies paid studios to have their products appear in movies. Young people may also look up to movie stars, both on and off screen, and may want to imitate behaviours they see. Over time, the number of images of tobacco use in movies has gone down

Why the industry targets young people?
Young people are a prime market for tobacco products. With smoking among adults declining, tobacco makers need to replace long-term users who have quit . . . or died. So the tobacco industry recruits replacement smokers from youth and young adults—the age groups in which 99 percent of tobacco use begin. Young adults are a prime target for tobacco advertising and marketing. And messages aimed at this age group also attract the attention of younger consumers—a plus for the tobacco industry.

Using media to promote products
The tobacco industry uses media to promote its products to young people. Here are some of the channels it uses. Digital Media Many cigarette companies use websites to promote their products. Some of these websites feature videos, games, coupons, and contests that may appeal to youth.

Working together, we can end the tobacco epidemic.

If we choose to, we can end the tobacco epidemic in this country, in this world. But it’s going to take all of us—parents, teachers, health care providers, communities, states, schools, and policymakers—supporting policies, programmes, and media campaigns that prevent tobacco use by youth and young adults.
Here are some policies proven to work best:
Make tobacco products less affordable.
Restrict tobacco marketing.

Ban smoking in public places—such as workplaces, schools, day-care centres, hospitals, restaurants, hotels, and parks.

Require tobacco companies to label tobacco packages with large, graphic health warnings.
Many states and communities have programmes to prevent tobacco use by young people.
The most effective ones combine several elements; include evidence-based curricula in secondary schools; work with policies; and influence people at work, at home, in school, in health care settings, and in public places.

What we should do?
• Create a world where seeing people smoke or use other tobacco products is the exception, not the norm.
• Take steps that make it harder for youth to use tobacco, such as raising cigarette prices and enforcing laws that prohibit the sale of tobacco to children.
• Further limit tobacco marketing that is likely to be seen by young people.
• Limit youth exposure to smoking environments.
• Educate young people and help them make healthy choices.
• Set an example—encourage young people not to smoke.

Mass media campaigns
Mass media campaigns against tobacco use—most often TV advertisements—have proven very effective at helping prevent tobacco use by young people.
Studies show that teens respond most to advertisements that trigger strong negative feelings, such as advertisements about how smoking and secondhand smoke harm health and advertisements that expose the tobacco industry’s marketing strategies that target young people. Even advertisements that are designed for adult audiences help reduce tobacco use among young people.
We can take steps to prevent youth smoking.