Is tobacco making a comeback among young people?
For decades, smoking has been on the decline: The World Health Organization estimates that almost 20 percent of American men and 15 percent of American women smoked in 2015, down from 23 percent in 2000. And the number of people who lit up a pack a day or more hit record lows last year. According to Gallup, 26 percent of tobacco users have at least a pack-a-day habit, compared with 65 percent in 1978.
And as more people kicked tobacco to the curb, public health improved: Rates of lung cancer, which accounts for more than 1 in 4 cancer deaths, fell sharply. Stroke mortality slipped. And rates fell for of sudden infant death syndrome, which can be exacerbated by parental smoking among other factors.
Yet smoking isn’t likely to go extinct anytime soon — and that could put these public health successes in peril. The U.S. surgeon general warns that the rate of decline for cigarette smoking has slowed in recent years among young people, and that smokeless tobacco is actually increasing among some groups.
Roughly 15 percent of American adults smoke, according to the Centers for Disease Control and Prevention, but for high schoolers the number for tobacco use tops 20 percent. A 2015 survey by Ipsos Public Affairs found that the highest rate of tobacco use is among 18- to 34-year-olds. And a Gallup poll found that this is the most likely group to use smokeless tobacco, like e-cigarettes, and to smoke pipes and cigars.
For millennials, tobacco use is seen as a way to appear relaxed and comfortable among college peers or new co-workers, and as a means to fit in with a group and build connections, says Mimi Nichter, PhD, a professor of public health at the University of Arizona, and author of “Lighting Up.” “It’s telling that 80 percent of millennials begin smoking at parties while consuming alcohol,” she says. “Parties are viewed as a social space where rules of everyday behavior do not apply.”
In fact, researchers at the University of Texas at Austin found that, even while overall cigarette consumption has fallen over the past two decades, 1 in 5 women between the ages of 18 and 25 are “very light” smokers, meaning they consume five or fewer cigarettes a day. Many young, social smokers assume that such infrequent tobacco use isn’t worthy of alarm — or labels, Nichter says.
Where There’s Smoke, There’s Fire
E-cigarettes seem to be at least partly to blame for tobacco’s popularity among young users. “They are marketed as hip and cool and a good alternative to a dirty, unhealthy product,” Nichter says.
In a 2017 PLOS One study, researchers combed through social media posts for the rationale behind e-cigarette use. In 2012, the top reason was quitting combustibles, such as cigarettes and cigars, and only 21 percent of people used e-cigarettes to increase their social image. By 2015, the rationale had shifted, with 37 percent of people vaping to bolster their social image — making it the top motivator.
Equating tobacco with social status doesn’t happen only among peers. Between 2005 and 2010, there was a steady decline in the depiction of tobacco use in movies for young people. But since 2010, on-screen smoking has been increasing, the CDC reports. In 2016, the number of tobacco impressions on viewers of youth-rated films (meaning those not rated R) jumped 58 percent from the year before. And when comparing only the biggest blockbusters of the year, smoking appearances surged 80 percent.
That’s especially troubling when one considers the effect all that on-screen tobacco use could have on younger viewers: A Pediatrics study found that for every 500 smoking scenes a teenager sees, the likelihood of that teen taking up tobacco use increases by 49 percent.
Public health campaigns moved the needle on tobacco use for older generations, and more education is now needed to convince young vapers that e-cigarettes also carry significant health risks, says Scott McIntosh, PhD, associate director of the Smoking Research Program at the University of Rochester’s Wilmot Cancer Institute.
E-cigarettes and vapes have multiple carcinogens, and significant levels of other toxins, like heavy metals, that could cause acute lung problems. They’re also associated with elevated blood pressure and diabetes.
“Switching from regular cigarettes to vaping for safety reasons is like switching from jumping out of a window on the 8th floor to jumping out of a window on the 4th floor,” McIntosh says. “It is infinitely much better to advise people to take the elevator or stairs, and to avoid window jumping completely.” While some e-cigarette companies market their products as a tool to help smokers quit, the Food and Drug Administration hasn’t approved any of them as safe or effective. And, in fact, research shows that users of smokeless products are more likely to light up with traditional cigarettes later.
And cigarette smoking can wreak havoc on your body, pretty much from head to toe: doubling or quadrupling your risk of stroke and heart disease; increasing your risk of lung cancer by roughly 25 times; weakening your bones; making tooth loss more likely; affecting sperm and increasing the risk of miscarriage; and upping the odds of developing diabetes by as much as 40 percent. Quitting is one of the best things you can do for your health, but e-cigs aren’t the solution. Instead, talk to your doctor about an FDA-approved approach, such as nicotine patches or gum, or prescription medications.
If you’re ready to quit, here are some tips:
- Write down your reason: Do you want to set a good example for your kids? Or stop worrying about an increased risk of stroke? Whatever your motivation, jot it down — having a clear sense of why can buoy your success, the CDC found.
- Brace for withdrawal: Nicotine is an addictive substance, and quitting may lead to bad moods and intense desires. Know that these cravings will ease in time.
- Stay busy: Spending time with nonsmoking friends and going for walks can help distract you from old habits and cravings. So can small distractions, such as chewing gum and playing a new mobile game.
- Avoid triggers: To keep temptation at bay, change your routine to avoid situations where you used to smoke (say, smoking breaks at work). Clean out your home, office and car and remove all cigarettes, lighters and ashtrays.
- Don’t go it alone: Head to Smokefree.gov for free guidance and support, or check with your employer to see if they offer a smoking cessation program. You can also join a group led by a certified facilitator who offers a step-by-step cessation plan that can also help. The American Lung Association offers nationwide clinics, which help participants work on the process individually and as part of a group. Or consider reaching out to a certified tobacco treatment specialist at 800-LUNGUSA.
- Support others: Actively encourage friends and family who are trying to quit and, if you’re a former smoker, consider sharing your experience.