Rates of underage drinking and smoking are on a steady decline, according to a recent report by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Just over 4 percent of teens aged 12 to 17 had smoked a cigarette in the past month, jumping to nearly 27 percent of young adults aged 18 to 25. But when compared with numbers from 2002, those numbers show dramatic decreases: In 2002, 13 percent of teens and 40 percent of young adults said they had smoked in the past month.
But SAMHSA's 2015 National Survey on Drug Use and Health shows that while alcohol and cigarette use has decreased among adolescents ages 12 to 17, rates of mental illness and other types of substance abuse have not. Furthermore, experts worry that the rising popularity of e-cigarettes could undo some of the progress made in curbing teen smoking. SAMHSA's survey does not ask respondents about e-cigarette use.
"We have more to do to help protect Americans from the dangers of tobacco and nicotine, especially our youth," said Health and Human Services Secretary Sylvia Burwell earlier this year. "As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of addiction."
The relationship between teenagers and e-cigarettes has been studied by a number of researchers in recent years, as "vaping" grows in popularity. In April, a study by the Centers for Disease Control and Prevention suggested that teenagers were particularly susceptible to advertising for e-cigarettes, which relies on many of the same strategies and themes as advertising for regular cigarettes in decades past.
Shortly afterward, researchers conducted a survey of high school students and found that teens who tried vaping were six times more likely to take up smoking than their non-vaping counterparts, though the study did not provide any evidence that vaping directly led to the students taking up smoking.
Concerns that teens may become addicted to nicotine through e-cigarettes were quelled to some degree in August, when another study found that the majority of teens surveyed reported using nicotine-free vaping solutions for "just flavoring" reasons.
But experts say teen vaping is still far from harmless. And e-cigarette use rose from 1.5 percent to 16 percent among high school students from 2011 to 2015, making them the most commonly used tobacco product among young people.
In May, the FDA banned the sales of electronic cigarettes in the US to anyone under the age of 18. A number of cities and two states, Hawaii and California, have also raised the minimum age to purchase tobacco cigarettes in recent years, making it illegal to sell to those under the age of 21.
Experts attribute much of the decline in teen cigarette use to changes within the cigarette industry, as The Christian Science Monitor's Stacy Teicher Khadaroo reported in 2014:
Experts on teen smoking attribute the progress to several factors in the late 1990s: the removal of Joe Camel as a marketing image and the settlement agreement with tobacco companies in 1998 after many state attorneys general sued. The agreement stopped other marketing directed at kids and resulted in a hike in cigarette prices, because the companies had to pay for health costs attributed to addiction. States also enhanced enforcement of laws against selling cigarettes to minors.
"In the past, people always said,... 'Kids will always smoke. You can't do anything about it.' But now we see you can," Joseph DiFranza, a professor at the University of Massachusetts Medical School in Worcester, told the Monitor at the time. "It’s not natural to smoke, and if you remove those things like cartoon advertising ... and make it difficult for kids to buy it, you can discourage 75 to 80 percent of would-be smokers from starting."