By age 18, about two-thirds of young people in the United States have tried smoking. Nicotine is generally the first drug used by young people who use alcohol, marijuana, and harder drugs. Adolescent tobacco use is associated with being in fights, carrying weapons, and engaging in higher-risk sexual behavior. Nearly all first use of tobacco occurs before high school graduation. Most young people who smoke are addicted to nicotine and report that they want to quit but are unable to do so.
Tobacco is often the first drug used by young people who use alcohol and illegal drugs.
Among young people, those with poorer grades and lower self-images are most likely to begin using tobacco. Cigarette advertising appears to increase young people's risk of smoking by conveying that smoking has social benefits and that it is far more common than it really is. The most effective preventive programs are communitywide ones that combine education and public policy approaches. The younger a person begins smoking, the greater the risk for developing the numerous illnesses associated with smoking. General decrease in physical fitness.