Cigarette Use

Cigarette smoking (and other forms of tobacco use) has been shown to have long-term—and often deadly—consequences.  It is estimated that more than six million children and adolescents who were born between 1983 and 2000 will eventually die of smoking-related illnesses (Hahn, Ravens, Chaloupka, Okoli, & Yang, 2002). Tobacco use harms nearly every organ of the body (National Institute on Drug Abuse, 2009).   About one-third of all deaths from cancer can be blamed on smoking.  Lung cancer is the largest single type, but smoking is also associated with cancers of the mouth, stomach, kidney, bladder, and cervix, among others.  Smoking is associated with emphysema, chronic bronchitis, and other lung disease; it aggravates asthma symptoms; and it increases the risk of heart disease.  There is also evidence linking smoking with symptoms of depression in adolescents, and with anxiety disorders (Goodman & Capitman, 2000; Johnson, Cohen, Pine, Klein, Kasen, &  Brook, 2000). 

One may refer to YRBS data to identify aggregate-level benchmarks for different grade-levels, genders, and racial/ethnic groups. For example, 2009 YRBS data suggest that, among 9th graders, the prevalence of 30-day cigarette use is around 14 percent.  Referring to this data, programs working with this grade level may set a benchmark that no more than 10.5 percent, for instance, of participants in the program report cigarette use in the past 30 days. An example of an individual-level benchmark is that self-reported frequency of cigarette use decrease by a certain percentage (e.g., a 25% decrease).

For most programs, it is reasonable to expect that the percent of youth reporting cigarette use in the past 30 days will increase over time, since older youth are more likely to smoke. The best way to gauge your program’s success is therefore to compare with data for the same age group from a source like the YRBS. If you find that the percent of youth who report recent cigarette use increases significantly while in your program, however, you may want to assess the fidelity and quality of service delivery (see Managing Service Delivery).



Sources Cited


Hahn, E. J., Rayens, M. K., Chaloupka, F. J., Okoli, C. T. C., & Yang, J. (2002). Projected smoking-related deaths among U.S. youth: A 2000 update.  ImpacTeen Research Paper Series, No. 22. Retrieved February 16, 2011, from

National Institute on Drug Abuse. (2009). Tobacco addiction.  Research Report Series. NIH publication number 09-4342. Washington, DC: National Institutes of Health, U.S. Department of Health and Human Services. Retrieved February 16, 2011.

Goodman, E., & Capitman, J. (2000). Depressive symptoms and cigarette smoking among teens. Pediatrics, 106(4), 748-755.

Johnson, J. G., Cohen, P., Pine, D. S., Klein, D. F., Kasen, S., & Brook, J. S. (2000). Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. Journal of the American Medical Association, 284(18), 2348-2351.

Additional Resources

Office of Adolescent Health, U.S. Department of Health and Human Services:

Centers for Disease Control and Prevention:

U.S. Surgeon General’s report on prevention of adolescent smoking: