Why are teens still smoking?

If cigarette smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans younger than 18 will die early from a smoking-related illness, according to the Centers for Disease Control and Prevention. That’s about one of every 13 Americans aged 17 years or younger.

Why would a teen choose to smoke?

Adolescence is a time of experimentation. Internal forces such as curiosity or rebellion may drive a teen’s choices regarding tobacco use. There is also a strong relationship between youth smoking and mental health, with increased rates related to depression and anxiety. Young people may associate positive things with smoking, such as coping with stress or losing weight, with little concern for future consequences.

External forces such as peer pressure and the media can also contribute. Teens who have friends who smoke or vape or who are exposed to smokers in the home are more likely to use tobacco products themselves. Research shows that exposure to tobacco advertising makes it more likely that young people will experiment with tobacco use and that 90% of adults who smoke started smoking before they turned 19. In a 2021 study, researchers found that 78.9% of teens surveyed had been exposed to ads for cigarettes. One study found that cigarette ads may make teens feel like smoking would make them popular, sophisticated, attractive or tough.

As regulations have changed, tobacco companies have developed new products such as e-cigarettes and other smokeless tobacco products aimed at addicting a new generation. Many teens view these products as safe alternatives to cigarettes. Flavorings in tobacco products can make them more appealing to youth. The CDC reports that in 2021, 85.8% of high school students and 79.2% of middle school students who used e-cigarettes in the past 30 days reported using a flavored e-cigarette during that time.

So what can you do to decrease risk of tobacco use in your teen?

• If there are smokers in your household, encourage them to discuss smoking cessation with their physician. Being a positive role model can go a long way in preventing your child from smoking.
• Speak openly and often with your child about the risks of using nicotine containing products including cigarettes, e-cigarettes and smokeless tobacco. Talk about peer behaviors and get to know you child’s friend group.
• Encourage your child to be engaged at school and pursue outside interests/activities – studies show that academic success and involvement with extracurricular and community organizations, including religious organizations, can decrease risk of substance use overall.
• Focus on health as a family, including eating healthy family meals and exercising together.

Dr. Christina Swanson is a pediatrician with Advocate Children’s Medical Group.