If adult smoking rates remain at the current level of about 26%, 18 million of the 70 million children now living in the United States will smoke cigarettes as adults and nearly 5 million of them will die as a consequence. As former Surgeon General Koop observed "This figure should alarm anyone who is concerned with the future health of today's children"
(Children and Youth, D'Onofrio and Altman).

Prevalence Among Youth

Tobacco addiction is a childhood disease. More than 3 million children under age 18 consume 947 million packs of cigarettes each year and 26 million containers of smokeless tobacco, accounting for illegal sales of $1.26 billion and profits of $221 million in 1988 (American Council on Science and Health Special Report).

Each day more than 3,000 children start smoking (Office of the Inspector General May 1990).

More and more young women are beginning to smoke-in fact. cigarette smoking prevalence among adolescents is about equal for both males and females-between 18 and 19% (Antonia Novello, Former Surgeon General).

Prevalence Among Ethnic Minority Youth

'The 1990 Youth Risk Behavior Survey (YRBS) of youth in grades 9-12 found smoking prevalence lower among African-Americans: 36% of white and 31% of Hispanics, but only 16% of African-Americans reported smoking within the past 30 days. African-American and Asian adolescent males are less likely to use smokeless tobacco than are white and Hispanic males, while Native American males and females report higher rates of use than youth in other ethnic groups. Nonetheless, ethnic patterns of smokeless tobacco use may vary by region (Children and Youth, D'Onofrio and Altman).

Average Age at Initiation

Three million children use smokeless tobacco product, the average age of the first use is 10.8 years, and the mean age of initiating regular use is 12 years (Kids Against Tobacco Fact Sheet, AMA).

Seventy-five% of current adult smokers started smoking before 18th birthday; research shows that the earlier a child starts using tobacco, the more likely he/she will be unable to quit (Office of the Inspector General).

Two-thirds of adult males who use smokeless tobacco initiate use before they are 21 years old (Children and Youth, D'Onafrio and Altman).

Among high school students who had ever smoked about one-quarter had smoked their first cigarette by grade 6, one-half by grade 8, three-fourths by grade 9, and 94% by grade 11 (Children and Youth, D'Onofrio and Altman)..

Whites start smoking at a younger age than African-Americans, and males tend to begin smoking earlier than females but girls catch up with higher rates of initiation in grades 7-9 (Children and Youth, D'Onofrio and Altman).

Addiction Starts Early

By the eighth grade 8% of both boys and girls report smoking a pack or more of cigarettes in the past month, and this proportion more than doubles by grade 10. Many light smokers make the transition to daily smoking by age 14 (Children and Youth, D'Onofrio and Altman).

The Monitoring the Future Survey found that about 2/3rds (66%) of graduating high school seniors reported ever smoking, 28% smoked in the past 30 days, 19% were daily smokers, and 11 % smoked a half-pack or more per day (Children and Youth , D'Onofrio and ALtman).

The Monitoring the Future Survey excludes school dropouts, who smoke at a rate as high as 75 or 80% (Children and Youth, D'Onofio and Altman).

Cessation Rates

Several studies indicate that from 18 to 24% of youth who smoke stop within 1 year. Data from Germany suggest that teenagers may go through several cycles of on, regular smoking, and cessation before becoming either confirmed smokers or quitters. In 1991, only 17% of graduating high school seniors who had ever smoked regularly reported they did not smoke at all in the past 30 days (Children and Youth, D'Onofrio and Altman).

Health Considerations

Tobacco smoke contains over 4,000 known compounds. including many that are pharmacologically active, toxic, mutagenic. or carcinogenic. The start of even modest cigarette smoking during the school-age years reduces lung function, increases respiratory symptoms, and results in pathologic changes (Children and Youth, D'Onofrio and Altman).

Girls who smoke and use oral contraceptive greatly increase their risk of cardiovascular disease (Children and Youth, D'Onofrio and Altman).

Youth Access

Minors are able to purchase cigarettes illegally about 80% of the time. All but three states ban the sale of tobacco to minors under age of 18, but in many states there is a serious problem of enforcing the law (Only two States-Florida and Vermont-are actively enforcing their minors' access to tobacco laws statewide! (Office of the Inspector General)

Eighty-five percent of youth 12-17 years of age buy cigarettes at convenience stores and gas stations, 50% buy cigarettes from large stores, and 15% buy cigarettes from vending machines (Antonia Novello, Former Surgeon General).

The pervasive availability of tobacco products convey messages that tobacco products are safe, in great demand, and an integral part of everyday life. Product placement within stores often reinforces these impressions. For example. one survey of stores surrounding California high schools found smokeless tobacco next to candy and snacks in 42% of these establishments. Conversely, placing tobacco products next to alcohol or out of consumer reach behind the counter associates use with the attainment of adult status, or for youth, with risk-taking (Children and Youth, D'Onofrio and Altman).

Youth as Replacement Smokers

The tobacco industry must attract 2 million new smokers each year to replace those who quit or die prematurely; most of the replacement smokers are children or adolescents. Almost 5,000 children and teenagers need to be addicted to nicotine every day simply to maintain the size of the smoking population (ACSH Special Report).

Cigarette Advertising and Promotion Directed Toward Youth

While tobacco companies say they don't intend to market to young people, numerous new empirical studies show that campaigns like RJ. Reynolds' 'Old Joe' campaign are reaching children as young as 3 years old and that they am affecting the behavior of children who are at an age when they are making the decision to smoke. Since the start of the 'Old Joe' campaign, Camel's share of the illegal children's cigarette market has increased from 0.5% to 32.8%, representing about $476 million in annual sales (Advocacy Institute Action Alert, December 1991).

Cigarette advertisements appear in many publications teenagers read, particularly those featuring sports celebrities and attractive lifestyles The prime example, TV Guide, receives more cigarette advertising revenue than any other magazine-S36 million in 1985-and reaches almost 9 million adolescents 12 to 17 years old (ACSH Special Report).

The recommend techniques are still apparent in tobacco advertising: tobacco use is associated with maturity, good times, good looks. popularity, independence, affluence, adventure and risk-taking. These themes relate to basic developmental needs of children and adolescents. In essence, they promote tobacco use as a sign of adulthood and a short-cut to the difficult of growing up (Children and Youth, D'Onofrio and Altman).

Health Care Costs

The health cam pays a high price for children's smoking. Each year, $9-10 billion in excess lifetime health care costs are added to the bill became of the I million who take up smoking that year (Coalition on Smoking OR Health).

Children's Costs

Every 9 days, children pay Federal cigarette taxes equivalent to the entire budget for the Office on Smoking and Health ($3.5 million), the only Federal agency devoted solely to smoking (Journal of the American Medical Association).

The Benefits of Taxing

A significant increase on the tax on tobacco products would tobacco use, particularly by reducing the number of children who start smoking-research shows these teenagers are significantly more responsive to price changes than adults. A $2 a pack increase would also raise over $20 billion dollars per year (Coalition of Smoking OR Health).