Why Do Teens Smoke? Signs, Risks, And Prevention

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It is well-known that smoking poses several health hazards. According to research, the younger a person starts smoking, the harder it is to quit the habit. Also, teens who smoke are at an increased risk of falling for alcohol and drug abuse (1).

Moreover, statistics show that teenagers who do not start using tobacco by age 18 most likely never start. Read this post to learn more about the health risks of cigarettes and other smokable tobacco products and tips to prevent smoking in teenagers.

Incidence And Prevalence Of Smoking In Teens

According to the Centers for Disease Control and Prevention (CDC), almost nine out of ten adults who smoke cigarettes daily have tried smoking first before the age of 18. Moreover, about 200 youth start smoking in the US each day (2).

According to the American Lung Association, almost 2500 children under 18 years of age try their first cigarette, and more than 400 of them end up becoming daily smokers. Sadly, half of them ultimately die due to the addiction (3).

From the data collected in 2020, the CDC states that 4.6 percent of high school students (3.9% girls and 5.4% boys) and 1.5 percent of middle school students (2.0% girls and 1.3% boys) use cigarettes (2).

Factors Leading To Smoking In Teens

The following factors may make it more likely for a teen to smoke (2) (4).

  • The parents are smokers.
  • Teenagers may begin and continue smoking due to peer pressure.
  • They may rebel and begin smoking to assert their independence.
  • They might think that it is cool to smoke.
  • They might slip into the marketing gimmicks made by the tobacco industry to lure teens into the habit.
  • In places where low tobacco taxes have kept the price down, it is easier for theM to afford cigarettes.
  • Teenagers get thrilled about trying new things but do not have enough maturity to think of long-term repercussions.
  • Nicotine in cigarettes is a feel-good drug that does not cause intoxication.
  • Genetic factors may make it more difficult for teens to quit smoking.
  • Maternal smoking during pregnancy may increase the probability of smoking in the child as they grow up.
  • Smoking has a strong association with depression, anxiety, and stress.
  • It is more common in teens from low socioeconomic and those from uneducated backgrounds.
  • Lack of family involvement or support.
  • Accessibility and availability of tobacco products around them also determine if the teen would smoke or not.
  • It may be associated with poor performance at school.
  • Teens dealing with low self-image or self-esteem may fall for smoking.
  • Teens who have experienced physical, emotional, or sexual abuse may develop a smoking habit.
  • Teenagers who have experienced parental separation or the loss of a loved one are at a higher risk of developing a smoking habit.
  • Living with someone who has been to prison or does drugs or alcohol can make teens addicted to smoking.

Signs A Teen Is Smoking

The following are the signs that may indicate your teenager is smoking (5) (6).

1. Bad breath

Teens who smoke have a typical smell of smoke emanating from their clothes, breath, hands and can be easily identified. The intensity of smell may vary based on the cigarette they use.

2. Stains

The nails and fingers of smokers may get a yellow stain due to exposure to smoke and tar from the cigarette. The lips may also have a bluish or black tint. The teeth may also wear a yellowish discoloration on the outside and brownish-black on the inside.

3. Open windows

Children may frequently leave their windows open, even when it is cold outside, to ventilate the room and prevent it from smelling like a smoke room.

4. Making excuses to go out

If the teen suddenly begins to leave the house more frequently than previously for short breaks, they might be smoking.

5. Chronic cough

Hoarseness of voice, throat irritation, and chronic cough may arise from regular smoking. If no other illness may cause these symptoms, smoking can be a reason.

6. Extreme mood changes

If your teenager acts unreasonably angry, irritated, or agitated, and you cannot point to an underlying cause, it may indicate a habit of smoking. The teen may be calmer after stepping out of the house and coming back. The addictive qualities of nicotine may keep your teen always on edge.

Health Risks Of Smoking

CDC states that smoking leads to disease, disability and harms almost every organ of the body (7). Smoking can cause more than 50 serious health conditions (8).

Smoking may cause many types of cancer, such as (8):

  • Lung cancer (seven out of ten cases of lung cancer happen due to smoking)
  • Oral cancers
  • Throat cancer
  • Voice box or laryngeal cancer
  • Esophageal cancer
  • Urinary bladder cancer
  • Bowel cancer
  • Cervical cancer
  • Kidney cancer
  • Liver cancer
  • Stomach cancer
  • Pancreatic cancer

Smoking also increases your risk of developing the following heart and blood vessels diseases (8).

  • Stroke
  • Coronary heart disease
  • Cardiac arrest
  • Peripheral vascular disease (damaged blood vessels)
  • Cerebrovascular disease (a condition that affects the blood supply to the brain)

It may also damage the lungs and cause conditions such as (8)

It may worsen on exacerbate symptoms of respiratory conditions such as (8)

Smoking may also increase the risk for tuberculosis, diabetes, rheumatoid arthritis, eye infections, etc. (7). It also causes overall poor health, increased absence from school, college, or work, and increased hospital visits and associated expenses (9).

Other Modes Of Smoking Tobacco

Apart from cigarettes, people may use cigars, bidis, kreteks, pipes, or hookah, etc., to smoke tobacco (10).

1. Cigar
  • A cigar is a roll of tobacco wrapped in a leaf or other material that contains tobacco.
  • Large cigars, cigarillos, and little cigars are the different cigars.
  • Cigars may lead to cancers, gum disease, tooth loss, coronary heart diseases, and lung diseases (11).
2. Bidis
  • They are small, thin, hand-rolled cigarettes mainly found in India and other southeast Asian countries.
  • They are formed of tobacco wrapped in a tendu or temburni leaves and secured at both ends with colorful strings.
  • They may be flavored or unflavored.
  • Smoke from bidis contains three to five times the amount of nicotine when compared to a regular cigarette (12) .
3. Kreteks
  • They contain a mixture of tobacco, cloves, and other additives.
  • They are mainly found in Indonesia.
  • They have a higher concentration of nicotine, tar, and carbon monoxide than regular cigarettes.
  • Kreteks can cause acute lung injuries, and regular kretek smokers are at 13 to 20 times higher risk of abnormal lung function than nonsmokers (12).
4. Pipes or hookahs
  • They are water pipes used to smoke flavored tobacco.
  • While it is a common myth that hookahs are safe, they have the same health risks as cigarette smoking.
  • Newer forms of electric hookahs such as steams stones, and hookah pens are now available.
  • Passive smoking from hookah is also a health hazard (13).
5. E-cigarettes (14)
  • They are also called vapes, mods, tank systems, e-cigs, vape pens, e-hookahs, and electronic nicotine delivery systems (ENDS).
  • E-cigarettes produce an aerosol by heating a nicotine-containing liquid. Users inhale this aerosol, and people around them can breathe in the aerosol when it is exhaled in the air.
  • They are fairly new, and there is not much data regarding the risks. However, most e-cigarettes contain nicotine that is known to cause several adverse effects.
  • The batteries in e-cigarettes can cause injuries from fires or explosions while charging.

Prevention Of Smoking In Teens

The following tips can help you prevent your teen from smoking (15) (16) (17).

  1. Maintain dialogue and talk to your teens about smoking and vaping. You may begin as early as kindergarten. See things from your child’s perspective, and answer their questions honestly. Keep the conversation going even as the kids get older.
  2. Create an environment conducive for your teen to come and discuss their apprehensions and questions with you.
  3. Explain the ill effects of the other forms of tobacco, including smokeless tobacco, hookah, and e-cigarettes.
  4. Discuss with them what to say if a friend offers a cigarette or an e-cigarette.
  5. Lead by example, and do not smoke yourself.
  6. Do not allow your friends or family members to smoke around your children and make your home a no-smoking zone.
  7. Know the signs that may be present if a teen is smoking and keep an eye out. Identifying and nipping the habit in the bud is always the best choice.
  8. Know what they are doing and who their friends are.
  9. Do not intrude into their private space, but watch out for lighters or matchboxes in their possession.
  10. Discourage them from playing video games or watching content that may endorse or promote smoking.
  11. If your teen is already smoking and you have convinced them to quit, motivate them to decide on a date or a symbolic day when they may get the motivation to quit smoking.
  12. Teach your kid to say no to smoking the first time. This firm habit will help them in other areas of life as well.
  13. It is not easy for even elders to handle their urge to smoke. Prepare them for the cravings and about how to overcome them. Be with them through the quitting journey.
  14. You may discuss with the doctors if other options like nicotine patches, gums, or sprays could be helpful for your teen.
  15. Discourage them from taking the alternative of e-cigarettes.
  16. Keep yourself updated about the new trends and other options available for cigarettes so you can keep an eye on any new habits your teen may be developing.
  17. You may consider getting professional counseling for your child as they have the necessary means and ways to help your child quit smoking in a healthy way.

It is not easy to quit smoking – for adults or teens. There might be some challenges, but be positive and encouraging about it. Help them connect with local or online support groups where other people of their age are also trying to quit smoking. This way, they will get the necessary motivation to break the habit and lead a healthy life.


MomJunction’s articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
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Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. Dr. Shah’s deep interest in the well-being of babies and children… more

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