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Drug Free Youth-Nicotine Back to Course Index








Substance Abuse and Mental Health Services Administration/Center of Substance Abuse Prevention (SAMHSA/CSAP) identified information dissemination/education as one of their initiatives to reduce alcohol, tobacco, and other drug (ATOD) use and abuse among youths.  The goal of this initiative is to provide awareness and knowledge of the nature and extent of use, abuse, and addiction and their effects on individual, families, and communities.  This initiative is also intended to provide knowledge and awareness of available prevention programs and services.  Information dissemination is characterized by one-way communication from the source (Parent) to the audience (children) whereas the education focus involves two-way communication and is distinguished from the information dissemination strategy by the fact that interaction between the educator/facilitator and the participants is the basis of its activities (target adolescences and older).  Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, coping and problem solving skills, critical analysis and systematic judgment abilities.


To achieve the greatest impact, educational programs must be appropriate to each audience, geared to specific needs, and used in conjunction with other strategies.   Programs components for educational initiatives may consist of family management training, alcohol, tobacco and other drug (ATOD) curricula, health and wellness curricula, violence prevention training and skills training. 


This continuing education course is intended to provide general information and instruction to help keep our youth drug and smoke free.  The early sections are general and not necessarily substance specific.  However, the final section is specific to tobacco and provides parents/caregiver and others information they can use to educate youth regarding use of tobacco.  Subsequent Parts of this CEU series “Drug Free Youth” will deal with other drugs.






Researchers have concluded that recent trends in youth alcohol and other drug use have stabilized; unfortunately, the rate of use remains at a high level and many youths are adversely affected by their choice to use.  For tobacco, the 2007 Monitoring The Future survey of 8th, 10th and 12th graders showed a slight decrease in use.  Many youths that use ATOD develops emotional and physical problems have more conflicts with their family and in school than those youth that do not use.  Also, the risk of injury increases almost exponentially when they choose to use alcohol and other drugs (AOD) and then operate a motor vehicle.  As a matter of fact, I cannot envision a higher risk situation than when a youth drinks (or uses other drugs) and drives.  The risk increases because a youth under the influence is less inhibited and more easily persuaded to take higher risks; consequently, the self-induced mental distortions coupled with limited driving experience often results in tragedy.   The risks associated with tobacco use are related primarily to health.


Researchers have also concluded that the earlier ATOD use is initiated, the more likely a person is to develop problems later in life.  Youth substance abuse may lead to many other problems that affect not only the youth, but also the youths family and community.


When examining this situation it is obvious that the parents/home environment is the first line of defense against ATOD use.  As President George W. Bush stated: it is essential that our parents understand that theyre the childs most important teacher, and that the message of the parents must be unequivocal: dont use drugs. Based upon my personal counseling experiences I totally agree.  Parents are the most important role models in their childrens lives.  What they say and do about drugs matters a lot when it comes to the choices their children make.  For example parents can:


  •         Be a positive example; avoid use of all alcohol, tobacco, and other drugs (ATOD) in the home and in the presence of their children.
  •          Never involve them in adults use of ATOD or use with them.
  •          Talk early and often about drugs.  The parents must be aware of the latest trends and the best way to combat them.  For example, some chemicals and other items that are commonly found in the home can be very dangerous.
  •           Discuss the consequences of drug use; focus on teen pregnancy, school dropout, violence, teen health issues, and other antisocial consequences.
  •          Create clear, consistent expectations and enforce them.


Parents should stay involved in their childrens life; show that they care about the choices they make about ATOD.  Parents should always remember that children learn by example; consequently, they adopt the values the parents demonstrate through their example.  It should be noted that good values are modeled, as well as bad values, and we owe our children every positive value that we can offer to help them avoid the pitfalls associated with drug use.




HOW TO HELP:  Early Adolescence  nic1


For many parents and other caregivers it may seem too early to discuss ATOD with this age group, but the attitudes and habits that they form during this phase of their life will have an important bearing on the decisions they make when they are older. Most psychologists support the early education concept.  For example, psychologists believe that an individuals value/belief system reflects his/her perception of self and represents values, judgments and myths that he/she believes to be true.  The psychologists go on to say that a person’s value/belief system is fairly well established by about age seven and is refined and honed by lifes experiences to make them into the persons they are at any given time in their life.   The value/belief system is the major control and decision-making guide and helps the youth to choose between right and wrong and things we do versus things we dont do.  Most youths have a value/belief system about:



  •         Good and bad conduct; playing fair; being helpful
  •          Alcohol and other drug use; smoking
  •          Religion/Church activities/Sunday School
  •          Peer pressure/social acceptance
  •          Social involvement
  •          Family roles



If a substance abuse or behavioral problem is encountered, then the clinician, counselor or parent/caregiver should explore a youths value/belief system to better understand what they believe about various topics including topics related to ATOD use.  An area I like to explore is the environment they were exposed to during their early life.  For example, I want to determine if their parents or caregivers had a permissive attitude toward drugs and specifically tobacco.  I also want to know if the youth had friends who used drugs or smoke and what the norm was regarding use of alcohol and other drugs in their community.  Also, one may also want to explore other issues to determine what boundaries, if any, were established for the youth.  For example:


  •         Was limits or restrictions imposed on the youth?
  •          Was the youth allowed to experiment with tobacco, alcohol, and other drugs?  Did anyone smoke in the home?
  •        At what age did the youth start to drink or smoke?
  •        Was there a permissive attitude regarding social activities?
  •         Did the youth have a detailed schedule?
  •        Did the parents involve themselves with the youths friends?
  •          Did the parents monitor school and other activities?


Obviously, this exploration is an attempt to assess the variables that help the youth to establish or revise his or her value/belief system.  Generally, a permissive attitude and environment will provide early opportunities to experiment with alcohol, tobacco and other drugs.  This liberal, permissive environment enables a young person to form a flawed image of most activities (no boundaries or limits) and/or to establish a distorted mental picture of specific activity (such as smoking).   To give an example of how our belief/values work in the life of a smoker, lets suppose a youth forms a concept of a problem smoker as one who coughs a lot and is ill.  Now, lets suppose this individual is a heavy smoker but does not meet his or her pre-programmed characteristics of how a problem smoker would be.  In this case, the individual would test his or her situation against his or her value/belief system and would conclude he or she does not have a problem.  The cycle may be repeated until there is a match between his/her behavior and his/her pre-programmed belief/value system about smoking.  It should also be noted that an individuals value/belief system about smoking might change in response to his or her own experiences (heart attack, stroke) and influences from clinicians and other treatment providers.  The cycle may also be disrupted by other factors (generally a crisis) in the users life.



The aforementioned concepts are presented in support of and to promote early family discussions regarding ATOD.  Again, most professionals agree that to wait until a drug problem is encountered, smoking habit is entrenched in their everyday life, or until about age 16 is much too late (the value/belief system is already in place and the kid down the street will have more influence at this age than the parents).  Consequently, I encourage parents, caregivers, teachers and others to get involved early and stay focused on the negative consequences of ATOD use and abuse.  Also, everyone needs to remember that youths key on inconsistency.  For example, a youth is often confused when the parents says one thing and then does differently.  Youth also pit parents against each other and then migrate toward the most liberal parent; consequently, the parents should present a unified front to the chield and resolve any difference in private.



We have put a heavy load on the parents/caregivers and have not offered any preventative measures the youth can take to help themselves.  So here are some considerations that will help the child or adolescent to shape and mold themselves (or to be shaped and molded by others) into well-adjusted young citizens that have developed age appropriate coping and problem solving skills.  Hopefully, they will also be capable of making good decisions about most aspects of their lives (what should and should not go into their bodies, social activities, peers, school, hobbies, etc.).  Remember, at this age, they are generally eager to know and memorize rules, and they want your opinion on whats good and whats bad.  Although they are old enough to understand that smoking is bad for them, they generally are not ready to take on complex facts about tobacco.  So here are some ways to help the youth make good decisions, have a high self-esteem and to develop age appropriate coping and problem solving skills:



  •         The youth should eat healthy foods; discuss food types and favorites and inform them how certain foods help build healthy bodies.
  •          Build strong bonds of trust though dedicated play and discussion times between parent and child.
  •          Focus on the child’s likes and dislikes and complement them when possible on their choices.  Let them know that you enjoy spending special time with them and doing activities they like.  Also, let them know that you love them and want them.
  •         Encourage and enforce fair play; provide guidelines for sharing toys and telling the truth so that the youth knows what kind of behavior is expected of them.  Be consistent especially when playing games.  Its challenging to hold the line when both the child and parents want the child to win.   However, one must remember the goal is to help shape a well rounded youth that can cope with both winning as well as loosing.  To bring up a child in an environment where they always get their way and/or win can yield a child with antisocial behavior patterns and is a high risk for poor coping skills such as bullying.
  •          Encourage the child to follow directions and to ask questions if he or she doesn’t understand the instructions.  Encourage the youth to verbalize the situation as opposed to acting out.
  •       Encourage the child to be self-sufficient.  For example, let them choose their clothing as this reinforces their ability to make decisions and also helps their self-esteem.  Look for opportunities to compliment (or praise) the child; remember to praise in public and instruct in private.



Most youth are naturally curious and want to learn new things and to experiment.  This curiosity is normal and presents parents an opportunity to explain things in the home environment that could be harmful to them.  Remember, a childs curiosity will be satisfied one way or the other.  I remember a story about little Johnny.  With the enthusiasm that only a six year old can have he burst into the living room and ask his father to tell him about beer. The father was deeply engrossed in a football game and told him that he did not have time to talk and for him to go outside and play.  He left and went down the street and met little Jimmie.  He asks Jimmie to tell him about beer and Jimmies response was: I dont know but lets go get one and find out. The childs natural curiosity also offers parents/caregivers opportunities to explain why its okay for adults do certain thing and not okay for children.  For example, when questions come up about ATOD its a good time to introduce the concept that adults may drink in moderation or smoke (although I personally recommend total abstinence when the children are present) but children may not, even in small amounts because its harmful to their developing brains and bodies.






The adolescence years are both exciting and challenging and this is the time when peer pressure becomes very important, as most youths desperately want to fit in.  Also, there are encounters with older youths that may have already begin to use alcohol, tobacco and other drugs and may think they are cool and self-assured.  This environment may also tempt your youth to experiment with drinking, smoking or both; consequently, it should be every parents goal to make sure your youths life is structured in such a way that drugs have no place in it.  The following actions are recommended to help to keep your youth drug/smoke free:



  •         Ensure that they are well versed in the reasons why they should avoid use of ATOD.  Parents should go beyond because I said so and get age appropriate educational material and videos for them to digest.  There is loads of material on the Internet from website like National Institute of Drug Abuse (NIDA) that is free and readily available.
  •           Make the home youth friendly.  Get acquainted with the parents of the childrens friends and learn about their childrens interests and habits.  Exchange phone numbers and addresses and agree to forbid youth from consuming alcohol, tobacco, and other drugs.  
  •          If possible, parents should provide adult supervision for youth.  Its never good for them to be left on there on for long periods of time.  It is essential that parents/caregivers arrange to have their youth looked after and engaged in the after-school hours. An acceptable alternative is that the youth can get involved with reputable youth groups, arts, music, sports, community service and academic clubs.
  •          If it is mandatory to leave the youth alone make sure the youth feels adult presence.  Give them a schedule and set limits on their behavior.  Give them household chores to accomplish and enforce strict phone-in-to-you policy.
  •       Make it easy for youth to leave a place where substances are being used.  Discuss with them in advance how o contact you or another designated adult in order to get a ride home.  If another adult provides the transportation.  
  •       Set age appropriate curfews and enforce them.
  •          Encourage open dialogue with youth about their experiences.  Tell a child, I love you and trust you, but I dont trust the world around you, and I need to know whats going on in your life so I can be a good parent to you.




Public and private schools have a responsibility to educate and protect all students; consequently, there should be nothing confusing or contradictory in what children learns about drugs from the parents and in the school system. For example, school policies need to reflect the same attitude toward use and abuse of ATOD as is express in the home:  Drug use is not acceptable.   Its critical that youth understand that drugs diminish their ability to concentrate and follow through on academic responsibilities, they cause absenteeism and loss of motivation, and students who use them can be disruptive and drain teachers time and energy. The best way to ensure that the anti-drug policies at a childs school are strong is for parents to be involved.  Parents can:



  •         Learn about the current policy regarding ATOD at your school.  If there is not an anti-drug policy in place, schedule a meeting with the school administration to help develop a policy.  The policy should specify what constitutes an ATOD offense, spell out the consequences for failing to follow the rules and describe procedures for handling violations.
  •         Know the drug education program at your school.  Staff should be trained about ATOD use and abuse and how to recognize symptoms in those who choose to use and abuse.  Drug education should be taught in an age appropriate way throughout the school year rather than once during a special week.  All teachers should incorporate anti-drug information into their classes.  The school program should be based on current research.  If the drug activity is high in your school you may want to become more involved and inform the school administration that there is a need for improvement in this area.
  •          Study the schools drug education program at home.  You should examine any existing material to ensure that they contain clear messages that ATOD use is wrong and harmful.  You should also verify that the information is accurate and up to date.
  •         Ask about the consequences for those who are caught abusing drugs.   Does the school offer a list of referrals for students who need substance abuse counseling?




Determine if a school drug program is effective.  Research indicates that some of the most effective programs emphasize the value of life skills training such as coping with anxiety, problem solving, being assertive and feeling comfortable socially.  When these lessons are combined with drug education, students confronted with drugs are better equipped to resist them.




Drug addiction (including smoking) has been labeled a disease of the brain; consequently, lets take a look at the brain and how it functions to enhance our study on how to keep our youth drug free.  This material was taken for the National Institute of Drug Abuse (NIDA) website.


The brain is the command center of the body. It weighs about three pounds, and has different centers or systems that process different kinds of information. The brain stem is the most primitive structure at the base of your brain and controls heart rate, breathing, and sleeping; it does the things you never think about.


Various parts or lobes of the brain process information from your sense organs: the occipital lobe receives information from your eyes, for example. And the cerebral cortex, on top of the whole brain, is the “thinking” part of you. That’s where you store and process language, math, and strategies: It’s the thinking center. Buried deep within the cerebral cortex is the limbic system, which is responsible for survival: It remembers and creates an appetite for the things that keep you alive, such as good food and the company of other human beings.


The cerebellum is responsible for things you learn once and never have to think about, such as balance when walking or how to throw a ball.


The brain’s job is to process information. Brain cells called neurons receive and send messages to and from other neurons. There are billions of neurons in the human brain, each with as many as a thousand threadlike branches that reach out to other neurons.


In a neuron, a message is an electrical impulse. The electrical message travels along the sending branch, or axon, of the neuron. When the message reaches the end of the axon, it causes the release of a chemical called a neurotransmitter. The chemical travels across a tiny gap, or synapse, to other neurons.


Specialized molecules called receptors on the receiving neuron pick up the chemical. The branches on the receiving end of a neuron are called dendrites. Receptors there have special shapes so they can only collect one kind of neurotransmitter.


In the dendrite, the neurotransmitter starts an electrical impulse. Its work done, the chemical is released back into the synapse. The neurotransmitter then is broken down or is reabsorbed into the sending neuron.


Neurons in your brain release many different neurotransmitters as you go about your day thinking, feeling, reacting, breathing, and digesting. When you learn new information or a new skill, your brain builds more axons and dendrites first, as a tree grows roots and branches. With more branches, neurons can communicate and send their messages more efficiently.


What Do Drugs Do to the Brain? Some drugs work in the brain because they have a similar size and shape as natural neurotransmitters. In the brain in the right amount or dose, these drugs lock into receptors and start an unnatural chain reaction of electrical charges, causing neurons to release large amounts of their own neurotransmitter.  Some drugs lock onto the neuron and act like a pump, so the neuron releases more neurotransmitter. Other drugs block reabsorption or reuptake and cause unnatural floods of neurotransmitter.


All drugs of abuse, such as nicotine, cocaine, and marijuana, primarily affect the brain’s limbic system. Scientists call this the “reward” system. Normally, the limbic system responds to pleasurable experiences by releasing the neurotransmitter dopamine, which creates feelings of pleasure.


What Happens if Someone Keeps Using Drugs?  Think about how you feel when something good happens-maybe your team wins a game, you’re praised for something you’ve done well, or you drink a cold lemonade on a hot day-that’s your limbic system at work. Because natural pleasures in our lives are necessary for survival, the limbic system creates an appetite that drives you to seek those things.


The first time someone uses a drug of abuse, he or she experiences unnaturally intense feelings of pleasure. The limbic system is flooded with dopamine. Of course, drugs have other effects, too; a first-time smoker may also cough and feel nauseous from toxic chemicals in a tobacco or marijuana cigarette.


But the brain starts changing right away as a result of the unnatural flood of neurotransmitters. Because they sense more than enough dopamine, for example, neurons begin to reduce the number of dopamine receptors. Neurons may also make less dopamine. The result is less dopamine in the brain: This is called down regulation. Because some drugs are toxic, some neurons may also die.


How Many Times Does Someone Have To Take a Drug To Become an Addict? No one knows how many times a person can use a drug without changing his or her brain and becoming addicted.


A person’s genetic makeup probably plays a role. But after enough doses, an addicted teen’s limbic system craves the drug as it craves food, water, or friends. Without a dose of the drug, dopamine levels in the drug abuser’s brain are low. The abuser feels flat, lifeless, depressed. Without drugs, an abuser’s life seems joyless. Now the abuser needs drugs just to bring dopamine levels up to normal levels. Larger amounts of the drug are needed to create a dopamine flood or high, an effect known as tolerance.


By abusing drugs, the addicted teen has changed the way his or her brain works. Drug abuse and addiction lead to long-term changes in the brain. These changes cause addicted drug users to lose the ability to control their drug use. Drug addiction is a disease.


If Drug Addiction Is a Disease, Is There a Cure?  There is no cure for drug addiction, but it is a treatable disease; drug addicts can recover. Drug addiction therapy is a program of behavior change or modification that slowly retrains the brain. Like people with diabetes or heart disease, people in treatment for drug addiction learns behavioral changes and often take medications as part of their treatment regimen.





Tobacco use is the leading preventable cause of disease, disability, and death in the United States. Between 1964 and 2004, cigarette smoking caused an estimated 12 million deaths, including 4.1 million deaths from cancer, 5.5 million deaths from cardiovascular diseases, 2.1 million deaths from respiratory diseases, and 94,000 infant deaths related to mothers smoking during pregnancy. According to the Centers for Disease Control and Prevention (CDC), cigarette smoking results in more than 400,000 premature deaths each yearabout 1 in every 5 U.S. deaths.


nic4How Does Tobacco Affect the Brain?  

Cigarettes and other forms of tobacco, including cigars, pipe tobacco, snuff, and chewing tobacco, contain the addictive drug nicotine. Nicotine is readily absorbed into the bloodstream when a tobacco product is chewed, inhaled, or smoked. A typical smoker will take 10 puffs on a cigarette over a period of 5 minutes that the cigarette is lit. Thus, a person who smokes about 1/2 packs (30 cigarettes) daily gets 300 hits of nicotine each day.

Upon entering the bloodstream, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate. Glucose is released into the blood while nicotine suppresses insulin output from the pancreas, which means that smokers have chronically elevated blood sugar levels.

Like cocaine, heroin, and marijuana, nicotine increases levels of the neurotransmitter dopamine, which affects the brain pathways that control reward and pleasure. For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addictiona condition of compulsive drug seeking and use, even in the face of negative consequences. Studies suggest that additional compounds in tobacco smoke, such as acetaldehyde, may enhance nicotines effects on the brain.3 A number of studies indicate that adolescents are especially vulnerable to these effects and may be more likely than adults to develop an addiction to tobacco.

When an addicted user tries to quit, he or she experiences withdrawal symptoms including powerful cravings for tobacco, irritability, difficulty paying attention, sleep disturbances, and increased appetite. Treatments can help smokers manage these symptoms and improve the likelihood of successfully quitting.


What Other Adverse Effects Does Tobacco Have on Health?

Cigarette smoking accounts for about one-third of all cancers, including 90 percent of lung cancer cases. In addition to cancer, smoking causes lung diseases such as chronic bronchitis and emphysema, and increases the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm. Smoking has also been linked to leukemia, cataracts, and pneumonia. On average, adults who smoke die 14 years earlier than nonsmokers.

Although nicotine is addictive and can be toxic if ingested in high doses, it does not cause cancer; other chemicals are responsible for most of the severe health consequences of tobacco use. Tobacco smoke is a complex mixture of chemicals such as carbon monoxide, tar, formaldehyde, cyanide, and ammoniamany of which are known carcinogens. Tar exposes the user to an increased risk of lung cancer, emphysema, and bronchial disorders. Carbon monoxide increases the chance of cardiovascular diseases. Smokeless tobacco (such as chewing tobacco and snuff) also increases the risk of cancer, especially oral cancers.

Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birth weight. Maternal smoking may also be associated with learning and behavioral problems in children. Smoking more than a pack of cigarettes per day during pregnancy nearly doubles the risk that the affected child will become addicted to tobacco if that child starts smoking.

Secondhand smoke, also known as environmental tobacco smoke, consists of exhaled smoke and smoke given off by the burning end of tobacco products. According to Center of Disease Control (CDC), approximately 38,000 deaths per year can be attributed to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent.  In addition, secondhand smoke causes respiratory problems in nonsmokers, such as coughing, phlegm, and reduced lung function. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems, and more severe asthma.

Although quitting can be difficult, the health benefits of smoking cessation are immediate and substantial, including reduced risk for cancers, heart disease, and stroke. A 35-year old man who quits smoking will, on average, increase his life expectancy by 5 years.


Are There Effective Treatments for Tobacco Addiction?

Tobacco addiction is a chronic disease that often requires multiple attempts to quit. Although some smokers are able to quit without help, many others need assistance. Generally, rates of relapse for smoking cessation are highest in the first few weeks and months and diminish considerably after about 3 months. Both behavioral interventions (counseling) and medication can help smokers quit; the combination of medication with counseling is more effective than either alone.


Behavioral Treatments

Behavioral treatments employ a variety of methods to assist smokers in quitting, ranging from self-help materials to individual counseling. These interventions teach individuals to recognize high-risk situations and develop coping strategies to deal with them. The U.S. Department of Health and Human Services (DHHS) national toll-free quitline, 800-QUIT-NOW, is an access point for any smoker seeking information and assistance in quitting.


Nicotine Replacement Treatments

Nicotine replacement therapies (NRTs), such as nicotine gum and the nicotine patch were the first pharmacological treatments approved by the Food and Drug Administration (FDA) for use in smoking cessation therapy. NRTs deliver a controlled dose of nicotine to a smoker in order to relieve withdrawal symptoms during the smoking cessation process. They are most successful when used in combination with behavioral treatments. FDA-approved NRT products include nicotine chewing gum, the nicotine transdermal patch, nasal sprays, inhalers, and lozenges.



Other Medications

Bupropion and varenicline are two FDA-approved non-nicotine medications that effectively increase rates of long-term abstinence from smoking. Bupropion, a medication that goes by the trade name Zyban, was approved by the FDA in 1997 for use in smoking cessation. Varenicline tartrate (trade name: Chantix) targets nicotine receptors in the brain, easing withdrawal symptoms and blocking the effects of nicotine if people resume smoking.


Current Treatment Research

Scientists are currently pursuing many other avenues of research to develop new tobacco cessation therapies. One promising intervention is a vaccine that targets nicotine, blocking the drugs access to the brain and preventing its reinforcing effects. Preliminary trials of this vaccine have yielded promising results.


How Widespread is Tobacco Use?

Monitoring the Future Survey

Current smoking rates among high school students reached an all-time low in 2007. According to the Monitoring the Future survey, 7.1 percent of 8th-graders, 14 percent of 10th-graders, and 21.6 percent of 12th-graders reported that they had used cigarettes in the previous month.  Although unacceptably high numbers of youth continue to smoke, these numbers represent a significant decrease from peaks reached in the late 1990s.

The decrease in smoking rates among young Americans corresponds to several years in which increased proportions of teens said they believe there is a great health risk associated with cigarette smoking and expressed disapproval of smoking one or more packs of cigarettes per day. Students personal disapproval of smoking has risen for some years: In the past 10 years, for example, the percentage of 12th-graders disapproving of smoking one or more packs of cigarettes per day increased significantly, from 67.1 percent in 1997 to 80.7 percent in 2007. During the same period, the number of 8th-graders who said it was very easy or fairly easy to get cigarettes declined from 76 percent in 1997 to 55.6 percent in 2007.

Current use of smokeless tobacco among high school students also reached an all-time low in 2007: 3.2 percent of 8th-graders, 6.1 percent of 10th-graders, and 6.6 percent of 12th-graders reported that they had used smokeless tobacco in the previous month.


National Survey on Drug Use and Health (NSDUH)

In 2006, 29.6 percent of the U.S. population 12 and older72.9 million peopleused a tobacco product at least once in the month prior to being interviewed. This figure includes 3.3 million young people aged 12 to 17 (12.9 percent of this age group). In addition, 61.6 million Americans (25 percent of the population) were current cigarette smokers; 13.7 million smoked cigars; 8.2 million used smokeless tobacco; and 2.3 million smoked tobacco in pipes.

Between 2002 and 2006, past-month cigarette use among persons 12 or older decreased from 26 percent to 25 percent. Cigarette use in the past month among 12- to 17-year-olds declined from 13 percent in 2002 to 10.4 percent in 2006.