FFFTobacco And Kids

No. 68; April 2026

Children's addiction to nicotine from cigarette smoking, smokeless tobacco (chew), cigars, hookahs (water pipes), and vaping (e-cigarettes) is a major public health problem.

The Facts about teen smoking:

  • Tobacco use is the most common cause of preventable disease and death in the United States.
  • Nicotine within tobacco and e-cigarette vapors is very addictive and e-cigarettes can delivery higher concentrations of nicotine.
  • Approximately 4.5 million U.S. teenagers smoke.
  • Approximately 3,000 teenagers start smoking every day.
  • Most adult smokers started smoking before the age of 18.
  • The earlier a person smokes, the harder it is to quit.
  • High school cigarette smokers is associated with other impulsive or risk taking behaviors such as ignoring seat belts, physical fights, carrying weapons, and having sex at earlier ages.
  • Early nicotine use is associated with higher rates of later substance use/abuse.
  • Tobacco and other nicotine use increases risks for cancer and lung disease, also worsens existing medical problems.
  • Both temporarily raise heart rate and blood pressure and long term use can lead to hypertension a condition that damages many organs of the body.

Children at MOST risk for tobacco and e-cigarette use:

  • Have parents, siblings, or friends who smoke.
  • Show characteristics such acting grown up, overly tough and deny the harmful effects of tobacco.
  • Have fewer coping skills and smoke to alleviate stress.
  • Have poor self-esteem or depression, and associate smoking with desirability (e.g. being cool or thin).
  • Have poor academic performance, especially girls

What parents can do to prevent tobacco and e-cigarette use:

  • Discuss explicitly, the addictive and other harmful effects of nicotine use.
  • Remember, parents are role models. If you smoke, quit.
  • If you have not or cannot easily, then do not smoke in front of your children or allow it in the home.
  • It’s okay and encouraged to tell them that you regret that you started.
  • Do not allow your children to handle smoking materials.
  • Ask whether tobacco and vaping are used by friends and discussed in school and support community anti-smoking efforts.
  • Compliment children who do not smoke.
  • Discuss with your children how images used in media and advertising, portraying smoking as glamorous, mature, and cool are false and misleading.
  • Emphasize the negative effects of smoking such as decreased energy, ability to concentrate and focus, decreased athletic performance, shortness of breath, and in the case of tobacco products, bad breath and smelly clothes.
  • Help children to say "No" to tobacco by role playing situations in which tobacco is offered by peers.

If your child or teen has already begun to use tobacco, the following steps can help him or her to stop:

  • In a respectful, supportive, and non-confrontational way, advise them to stop, and express your desire to help.
  • If you smoke, agree to quit with your child and negotiate a quit date.
  • Explicitly discuss e-cigarettes & vapes, which they may view as harmless.
  • Counter dismissiveness by highlighting the negative effects on energy, focus/concentration, and increased risk for anxiety.
  • Identify teen-focused community quitting programs such as telephone/text quit lines (e.g. My Life My Quit 855-891-9989), and individual and group counseling programs at local mental health services.
  • If the child is also abusing alcohol or other drugs or you suspect depression, anxiety, or other mental health problem, consider seeking help from a child and adolescent psychiatrist or other mental health professional.

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The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 10,000 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

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