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Priority Population: Youth (under 18)

Tobacco use and exposure to nicotine in any form are dangerous for kids under 18.

While many young people are aware of the negative health effects, they often underestimate the addictive power of tobacco products. Because brain development continues until age 25, youth are especially at risk for developing an addiction that can be a very difficult habit to kick and can result in debilitating or even deadly consequences later in life.

Tobacco Use Prevalence

Research and surveys such as the Youth Risk Behavior Surveillance Survey (YRBSS) were developed to monitor health behaviors that contribute to the leading causes of death, disability, and social problems among youth in the United States. This research plays a critical role in monitoring progress toward healthy goals, identifying emerging risk factors, and developing preventative strategies. The statistics listed here are based on current findings.

Tobacco use primarily begins during adolescence.

  • In the U.S., nearly 9 out of 10 cigarette smokers first tried smoking by age 18, and almost all (99%) first tried smoking by age 26.
  • Approximately 300 young people become daily cigarette smokers in SD per year.

E-cigarette use is skyrocketing.

  • E-cigarettes are the most commonly used form of nicotine among youth in the United States.
  • In 2019, 23.6% of high school students in the U.S. currently used e-cigarettes vs. 20.8% in 2018.
  • In 2019, 23.9% of SD high school students used e-cigarettes within in the past 30 days.
  • In 2019, nearly one in six middle school students reported trying an e-cigarette. E-cigarette use has climbed in popularity with middle schoolers, rising from 2% in 2011 to 16% in 2019.

Cigarette use is on the rise.

  • In 2019, 12% of SD high school students were current smokers—an increase from 10.1% in 2015.
  • In 2019, 3.5% of SD middle school students were current smokers—an increase from 2.9% in 2017.
  • 21,000 SD kids under 18 alive today will die prematurely from smoking.

Chewing tobacco use is nearly double the national rate.

  • In 2019, 7.1% of SD high school students reported using chewing tobacco in the last 30 days, vs. 3.8% of high school students in the U.S.

Risk Factors

Multiple factors contribute to youth being at higher risk for tobacco use and nicotine addiction.

Being a teen is stressful.

  • There is a strong relationship between tobacco use and depression, anxiety, and stress.
  • Teens who struggle with low self-image or self-esteem are more likely to experiment with tobacco products.
  • Teens may expect positive outcomes from tobacco use, such as being able to better cope with stress or control weight.

The media normalizes tobacco use.

  • When teens see tobacco products in advertising, movies, and social environments, they are more likely to view tobacco use as “normal.”

The tobacco industry targets youth.

  • Nationally, e-cigarette advertising expenditures have increased from $12 million in 2011 to $110 million in 2018. This does not include social media and sponsored events.
  • In 2016, 20.5 million middle and high school students in the U.S. were exposed to e-cigarette advertisements from at least one source. That’s 78.2%, or nearly 4 out of 5 students.
  • About one-third of teenage experimentation with smoking can be directly attributed to tobacco advertising and promotional activities in retail environments.

Family and peer groups are significant influences.

  • Teens may not know how to resist peer pressure.
  • Teens are more likely to use tobacco if their friends use it or if they think tobacco use is acceptable among their peers.
  • Teens often model family members who use tobacco.
  • Parents or positive role models may not be supportive or involved.
  • Teens whose families have lower income levels are at higher risk of using tobacco.

Teens underestimate tobacco use and addiction.

  • Defiance, rebellion, and risk taking are normal throughout adolescence, and regular tobacco use primarily begins during this stage.
  • Teens may think tobacco use is “not as dangerous” as other behaviors like drinking or drug use.
  • Tobacco products can be easy to access and inexpensive.
  • Teens are more sensitive to nicotine and can become dependent on it sooner than adults.

It’s difficult for teens to quit.

  • Teens are less likely to take part in tobacco cessation programs and to receive advice from their healthcare provider to quit.
  • Genetic factors can make it more difficult for some people to quit smoking once they have started.

Some behaviors increase risk.

  • Teens with lower levels of academic achievement are at higher risk for using tobacco.
  • Teens who are prone to aggressive behavior (e.g., fighting, carrying weapons) are more likely to experiment with tobacco products.

South Dakota Services for Youth

Rethink Tobacco

Rethink Tobacco is a prevention-oriented website designed specifically for youth and young adults. The site features state and national statistics and facts related to tobacco, vape, chew, and hookah use. It also provides background on the tobacco industry’s sneaky tactics to recruit the next generation of tobacco addicts and ways for young people to take action in their communities.

South Dakota QuitLine

South Dakota QuitLine services are free and available to anyone 13 years of age or older. Youth can get help with quitting any type of tobacco product, including e-cigarettes. Parents, educators, and healthcare professionals can also receive more information about E-cigarettes & Youth Risk on the South Dakota QuitLine website.

K-12 Programs

TATU and N-O-T workshops and training are free and held throughout the state. Mini-grants are available for qualifying schools. To learn more about tobacco prevention programs for South Dakota youth, contact your local Tobacco Prevention Coordinator.

Teens Against Tobacco Use (TATU)

TATU is a peer-to-peer tobacco prevention program developed by the American Cancer Society, American Heart Association, and American Lung Association. This program helps teens teach younger children about the hazards of tobacco use and the benefits of making healthy choices.

Not On Tobacco (N-O-T)

N-O-T is a program for students who want to quit smoking. The gender-based, multi-session curriculum provides support and education rather than punishment and includes booster sessions to keep participants from backsliding.

For students who face suspension for violating a school’s tobacco use policy, there is also a four-session Alternative to Suspension (ATS) program available. For schools choosing to implement this program, attendance is mandatory and the course is taught in mixed-gender groups. It may serve as a motivator for teens to join the N-O-T program when they are ready to quit.