Why Do Young People Smoke?
In the United States, between 20 and 25 percent of people ages 18 to 35 smoke cigarettes (1). Given the vast amount of information available about the health consequences of smoking, it can seem incongruous, and it’s certainly tragic, that so many young people continue to smoke.
While health behavior choices are complex, there are a number of studies and reports that can shed light on why so many young people smoke.
If decisions about health behaviors were made based upon an objective assessment of the facts, surely nobody would begin smoking. Unfortunately, young people don’t make decisions about whether to smoke based upon accurate information. Misperceptions often underlie decisions to begin smoking.
Misperceptions about smoking include:
1. Underestimating one’s personal risk from smoking. Young people may not see themselves as personally vulnerable to the risks of smoking (2).
They know smoking causes health consequences, but don’t perceive themselves as personally at risk for those negative consequences. They think that “other people” are more at risk of developing smoking-related health problems.
2. Underestimating the risk for health problems caused by smoking relative to other behaviors. While a large majority of young people know that smoking is unhealthy, most will underestimate the harm caused by smoking relative to other health risks.
For instance, the majority of young people incorrectly believe that more people will die from gun violence or illegal drug use than from smoking.
3. Underestimating the full extent of the health consequences caused by smoking. Young people will often underestimate the full range of negative health consequences that are caused by smoking.
Most will know that smoking causes lung cancer, but won’t know that smoking also causes many other types of cancers, as well as heart disease, sudden infant death syndrome, impotence and more (3).
4. Overestimating smoking prevalence. Young people will often overestimate the number of people who smoke, and this will make it more likely that they will begin to smoke. One cohort study found that a variety of factors are associated with young people overestimating smoking prevalence and the likelihood of them starting to smoke.
These include their grade level, whether they observe smoking at school, the number of their close friends who smoke, whether there’s smoking in their home, and whether their parents smoke (4).
Beyond misperceptions, there appear to be a few other reasons why young people smoke.
These include parental influence, as whether parents smoke seems to be a key factor associated with whether their kids begin smoking (5).
Another is advertising and product placement. Exposure to tobacco advertising and product placements are strongly associated with smoking initiation. One very large longitudinal study found that a person’s risk for becoming an established smoker was associated with his or her exposure to movies that showed smoking (6).
Finally, physiology plays a role — adolescents seem to become addicted much earlier than previously believed. Research has shown that the symptoms of addiction — craving and withdrawal — can begin when kids are smoking as few as two cigarettes a week. While this isn’t the case with everyone, those for whom it’s true are much more likely to become daily smokers (7).
- Prevalence and Trends Data, Behavior Risk Factor Surveillance System. Centers for Disease Control and Prevention. Available at http://apps.nccd.cdc.gov/BRFSS/
- Weinstein ND. Smokers’ recognition of their vulnerability to harm. In: Slovic P, ed. Smoking: Risk, Perception and Policy. Thousand Oaks, Calif.: Sage Publications Inc.; 2001:81.
- Romer D, Jamieson P. The role of perceived risk in starting and stopping smoking. In: Slovic P, ed. Smoking: Risk, Perception and Policy. Thousand Oaks, Calif.: Sage Publications Inc.; 2001:64.
- Reid JL, et al. Factors related to adolescents’ estimation of peer smoking prevalence. Health Education Research. 2008;23:81.
- Gilman SE, at al. Parental smoking and adolescent smoking initiation: An intergenerational perspective on tobacco control. Pediatrics. 2009;123:e274.
- Sargent JD, et al. Exposure to smoking depictions in movies: Its association with established adolescent smoking. Archives of Pediatrics & Adolescent Medicine. 2007;161:849.
- DiFranza JR. Hooked from the first cigarette. Scientific American. 2008;298:82.