essay about drinking alcohol and smoking

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Smoking and Drinking: A Deadly Combination

Smoking and drinking are seen by many as complimentary: two habits that go hand in hand. while people who smoke are more likely to drink and vice-versa, this definitely isn’t a good idea. smoking is dangerous, drinking is dangerous, and doing both is even worse..

Around 8.5 million people die each year as a result of alcohol and tobacco, according to the World Health Organization . Both alcohol and cigarettes represent serious risks to public health, but for many users, there is an unavoidable sense that these two habits are linked, or even complement each other. This perception may be based on a grain of truth, but smoking and drinking in combination are more likely to kill you than either one individually, but there is evidence that smokers drink more than non-smokers and vice-versa. Finding out more about the link between smoking and drinking shows why it’s a combination we should take seriously.

The Link Between Smoking and Drinking

People who both smoke and drink often say that they two habits complement each other, and feel more like smoking when they have an alcoholic drink and vice-versa. This perception is supported by studies – for example, a study looking at the socio-cultural influences on smoking and drinking found that 36.9 % of adults who were current drinkers were also current smokers, compared to just 17.5 % of never-smokers. This study used data from 1997, and it’s worth noting that more recent polls have shown less of a difference between smoking rates between drinkers and non-drinkers, though drinkers were still more likely to smoke.

This may leave you wondering why smoking and drinking appear to be so closely related. Although there isn’t a definite answer on this yet, research does suggest that nicotine enhances the pleasurable effects of alcohol, and this has been confirmed in research. Another important factor is that nicotine and alcohol work on the same brain systems, which may mean they interact when taken together. Finally, the same genes may be responsible for predisposition to both smoking and drinking, so this could make it more likely for a drinker to smoke and vice-versa.

The Health Risks of Smoking

The health risks of smoking are so well-known that they scarcely even need to be repeated. Smoking causes lung cancer, heart disease, stroke, COPD, many other cancers and a multitude of health problems. It’s been called the leading preventable cause of death in the world.

The Health Risks of Drinking

Although drinking is much more socially accepted that smoking, it too carries serious health risks. Drinking heavily is known to cause mouth, throat and breast cancer, stroke, brain damage, heart disease and liver disease. While low-risk drinkers drastically reduce their risk of developing such health problems as a result of their drinking, no level of alcohol consumption can be considered safe.

The Risks of Smoking and Drinking

With plenty of risks associated with the individual substances, the fact that combining alcohol and tobacco creates even bigger risk shouldn’t come as much of a surprise. However, since these conditions have many risk factors (things which increase your risk of developing them), it can be difficult to estimate what the effect of combining smoking and drinking will be.

One area where there is solid evidence is for mouth and throat cancers. Both smoking and drinking increase the risks of these conditions, and studies show that people who do both are much more likely to get mouth cancer. Even worse, the risk of mouth cancer from smoking multiplies the existing risk from drinking, rather than just adding to it.

Other conditions – like cardiovascular disease and liver cancer – are both affected by alcohol and tobacco, but it’s unclear whether the risk is bigger than the risks from drinking and smoking added together. For liver cancer, there is some suggestion that the combined effect is worse than the sum of the individual parts, but for cardiovascular disease there doesn’t seem to be such “synergistic” effects.

Overall, research has shown that people who both smoke and drink increase their risk of all-cause death more than non-smokers and non-drinkers, or people who drink or smoke without doing the other.

Staying Safe: Reducing Your Risks From Smoking and Drinking

The risks of smoking and drinking are serious, especially if you combine the two habits. This is why reducing your risk is essential, and the best approach is to quit one or (ideally) both habits, or at very least cut back or switch to less harmful alternatives.

Quitting smoking is the more crucial goal, particularly if you aren’t a heavy drinker. There are many approaches to quitting, including alternative nicotine products like patches, gums, inhalers, smokeless tobacco or e-cigarettes, and medications such as Chantix. If you want to maximize your chances of quitting smoking, combining one of these strategies with behavioral counseling gives you the best chance.

Although there may be more of a social expectation that you will drink alcohol at some social gatherings, stopping drinking or cutting down is still important to minimize your health risks. If you can’t or don’t want to stop drinking entirely, simple tips like drinking more slowly, alternating between alcoholic and non-alcoholic drinks and drinking with food can help you drink a lot less.

Overall, quitting smoking and drinking is the best thing you can do for your health, but if you can’t do either or both of these, minimizing the risks to your health should be the next big priority.

Home — Essay Samples — Nursing & Health — Drinking — The Issue of Smoking and Alcohol Drinking Among Adolescents

The Issue of Smoking and Alcohol Drinking Among Adolescents

Categories: Drinking Smoking Underage Drinking

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Published: Feb 8, 2022

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Late singer Amy Winehouse, whose name is displayed in lights, performs on a stage with musical instruments and a guitar player behind her.

Binge drinking is a growing public health crisis − a neurobiologist explains how research on alcohol use disorder has shifted

essay about drinking alcohol and smoking

Assistant Professor of Biology, Biomedical Engineering and Pharmacology, Penn State

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With the new Amy Winehouse biopic “Back to Black ” in U.S. theaters as of May 17, 2024, the late singer’s relationship with alcohol and drugs is under scrutiny again. In July 2011, Winehouse was found dead in her flat in north London from “death by misadventure” at the age of 27. That’s the official British term used for accidental death caused by a voluntary risk.

Her blood alcohol concentration was 0.416%, more than five times the legal intoxication limit in the U.S. – leading her cause of death to be later adjusted to include “alcohol toxicity” following a second coroner’s inquest.

Nearly 13 years later, alcohol consumption and binge drinking remain a major public health crisis , not just in the U.K. but also in the U.S.

Roughly 1 in 5 U.S. adults report binge drinking at least once a week, with an average of seven drinks per binge episode . This is well over the amount of alcohol thought to produce legal intoxication, commonly defined as a blood alcohol concentration over 0.08% – on average, four drinks in two hours for women, five drinks in two hours for men.

Among women, days of “heavy drinking” increased 41% during the COVID-19 pandemic compared with pre-pandemic levels , and adult women in their 30s and 40s are rapidly increasing their rates of binge drinking , with no evidence of these trends slowing down. Despite efforts to comprehend the overall biology of substance use disorders, scientists’ and physicians’ understanding of the relationship between women’s health and binge drinking has lagged behind.

I am a neurobiologist focused on understanding the chemicals and brain regions that underlie addiction to alcohol . I study how neuropeptides – unique signaling molecules in the prefrontal cortex , one of the key brain regions in decision-making, risk-taking and reward – are altered by repeated exposure to binge alcohol consumption in animal models.

My lab focuses on understanding how things like alcohol alter these brain systems before diagnosable addiction, so that we can better inform efforts toward both prevention and treatment.

Full color cross-section side view of a child's brain with labels.

The biology of addiction

While problematic alcohol consumption has likely occurred as long as alcohol has existed, it wasn’t until 2011 that the American Society of Addiction Medicine recognized substance addiction as a brain disorder – the same year as Winehouse’s death. A diagnosis of an alcohol use disorder is now used over outdated terms such as labeling an individual as an alcoholic or having alcoholism.

Researchers and clinicians have made great strides in understanding how and why drugs – including alcohol, a drug – alter the brain. Often, people consume a drug like alcohol because of the rewarding and positive feelings it creates, such as enjoying drinks with friends or celebrating a milestone with a loved one. But what starts off as manageable consumption of alcohol can quickly devolve into cycles of excessive alcohol consumption followed by drug withdrawal.

While all forms of alcohol consumption come with health risks, binge drinking appears to be particularly dangerous due to how repeated cycling between a high state and a withdrawal state affect the brain. For example, for some people, alcohol use can lead to “ hangxiety ,” the feeling of anxiety that can accompany a hangover.

Repeated episodes of drinking and drunkenness, coupled with withdrawal, can spiral, leading to relapse and reuse of alcohol. In other words, alcohol use shifts from being rewarding to just trying to prevent feeling bad.

It makes sense. With repeated alcohol use over time, the areas of the brain engaged by alcohol can shift away from those traditionally associated with drug use and reward or pleasure to brain regions more typically engaged during stress and anxiety .

All of these stages of drinking, from the enjoyment of alcohol to withdrawal to the cycles of craving, continuously alter the brain and its communication pathways . Alcohol can affect several dozen neurotransmitters and receptors , making understanding its mechanism of action in the brain complicated.

Work in my lab focuses on understanding how alcohol consumption changes the way neurons within the prefrontal cortex communicate with each other. Neurons are the brain’s key communicator, sending both electrical and chemical signals within the brain and to the rest of your body.

What we’ve found in animal models of binge drinking is that certain subtypes of neurons lose the ability to talk to each other appropriately. In some cases, binge drinking can permanently remodel the brain. Even after a prolonged period of abstinence, conversations between the neurons don’t return to normal .

These changes in the brain can appear even before there are noticeable changes in behavior . This could mean that the neurobiological underpinnings of addiction may take root well before an individual or their loved ones suspect a problem with alcohol.

Researchers like us don’t yet fully understand why some people may be more susceptible to this shift, but it likely has to do with genetic and biological factors, as well as the patterns and circumstances under which alcohol is consumed.

Image of hormone receptors in the prefrontal cortex of the brain, lit up in varying colors.

Women are forgotten

While researchers are increasingly understanding the medley of biological factors that underlie addiction, there’s one population that’s been largely overlooked until now: women.

Women may be more likely than men to have some of the most catastrophic health effects caused by alcohol use, such as liver issues, cardiovascular disease and cancer . Middle-aged women are now at the highest risk for binge drinking compared with other populations.

When women consume even moderate levels of alcohol, their risk for various cancers goes up, including digestive, breast and pancreatic cancer , among other health problems – and even death. So the worsening rates of alcohol use disorder in women prompt the need for a greater focus on women in the research and the search for treatments.

Yet, women have long been underrepresented in biomedical research.

It wasn’t until 1993 that clinical research funded by the National Institutes of Health was required to include women as research subjects. In fact, the NIH did not even require sex as a biological variable to be considered by federally funded researchers until 2016. When women are excluded from biomedical research, it leaves doctors and researchers with an incomplete understanding of health and disease, including alcohol addiction.

There is also increasing evidence that addictive substances can interact with cycling sex hormones such as estrogen and progesterone . For instance, research has shown that when estrogen levels are high, like before ovulation, alcohol might feel more rewarding , which could drive higher levels of binge drinking. Currently, researchers don’t know the full extent of the interaction between these natural biological rhythms or other unique biological factors involved in women’s health and propensity for alcohol addiction.

Adult woman faces away from the camera, holding a glass of white wine in one hand and pressing her left hand against her neck.

Looking ahead

Researchers and lawmakers are recognizing the vital need for increased research on women’s health. Major federal investments into women’s health research are a vital step toward developing better prevention and treatment options for women.

While women like Amy Winehouse may have been forced to struggle both privately and publicly with substance use disorders and alcohol, the increasing focus of research on addiction to alcohol and other substances as a brain disorder will open new treatment avenues for those suffering from the consequences.

For more information on alcohol use disorder, causes, prevention and treatments, visit the National Institute on Alcohol Abuse and Alcoholism .

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How Smoking and Drinking Affect the Body

Dr Chia Stanley

Cardiologist

Most people are aware that smoking and heavy drinking are unhealthy habits, but not many realise just how much harm they can cause.

Dr Stanley Chia , cardiologist at Mount Elizabeth Hospitals, explains the effects of smoking and drinking on our health.

Growing up, many children may view drinking and smoking as privileges of adults and therefore 'cool' activities to engage in. Media portrayal of smoking and alcohol use has certainly helped to perpetuate the appeal of these social habits. The importance of public awareness about the dangers of heavy smoking and drinking has never been greater.

The danger of smoking

Cigarettes contain more than 4,000 chemical compounds and 400 toxic chemicals that include tar, carbon monoxide, DDT, arsenic and formaldehyde. The nicotine in cigarettes, in particular, makes them highly addictive. There are so many diseases caused by smoking that it's hard to decide where to begin.

Any amount and type of smoking is bad for your health. Besides being a notorious risk factor for lung cancer , coronary artery disease , heart attack and stroke , smoking can damage almost any organ in our body, leading to leukaemia and cancers of the kidney, pancreas, bladder, throat, mouth and uterus. It can damage the airways and air sacs of our lungs to cause chronic bronchitis and breathing difficulties. It can also raise our blood pressure and cholesterol levels, reduce bone density in women and increase the risk of infertility, preterm delivery, stillbirth and sudden infant death syndrome.

The danger of heavy drinking: How much alcohol is too much?

Most people like to have a drink or two, be it beer, wine or spirits. Light drinking is acceptable and may even be beneficial for the heart. Heavy and binge drinking, on the other hand, can lead to serious medical problems.

Drinking 7 or more drinks per week is considered excessive drinking for women, while 15 drinks or more per week is deemed to be excessive for men.

A healthy limit for drinking is usually no more than 2 drinks (3 units of alcohol) a day for men and 1 drink (2 units) a day for women. Binge drinking means having 5 or more drinks for men and 4 or more drinks for women on one occasion.

Certain groups of people should not drink alcohol at all. These include young people under the age of 18, pregnant women, people with certain health conditions, patients on medication that will interact with alcohol, recovering alcoholics, and people who intend to drive or do activities that require attention and coordination.

Heavy drinking can lead to many serious health conditions. Binge drinking can cause immediate problems such as acute intoxication, nausea and vomiting, blurred vision, impaired judgment and alcohol poisoning.

In the long term, heavy alcohol consumption can cause high blood pressure, gastric problems, liver cirrhosis, liver cancer, pancreatitis, memory impairment, alcohol dependence and various psychological conditions. Excessive alcohol drinking can also result in accidental injuries and even death. Pregnant women who drink heavily can harm their babies.

Effects of smoking and drinking on the heart

Both tobacco and alcohol can affect the heart. While the deleterious effect of smoking on the risk of cardiovascular disease is well-recognised and straightforward (the risk of heart disease increases with the amount of smoking), the impact of drinking is more complex.

Some evidence suggests that moderate drinking (3 – 14 drinks a week) may be associated with a lower risk of heart attack, while heavier drinking may well increase the risk of heart attack, heart failure, stroke and high blood pressure.

As smoking is also common among alcohol drinkers, and smokers and drinkers frequently share similar behavioural and lifestyle patterns, it is currently unclear whether it is the combined or independent effects of smoking and alcohol that greatly raises cardiovascular risk.

Nonetheless, the health problems associated with excessive smoking and drinking are extensive. Public health efforts to minimise the dangers of both smoking and drinking may significantly improve the well-being of society.

Benefits of kicking the habit

It is important to realise that quitting smoking can improve your quality of life – physically, emotionally and financially. It can help you and those around you breathe better and live longer.

People who stop smoking generally have an improved sense of smell and taste, feel less stressed and become more energetic. They will usually have younger looking skin and improved fertility. Their loved ones will be healthier as passive smoking is reduced.

For people who drink too much, alcohol tolerance can lead to false reassurance that they are drinking within limits, since they do not feel drunk. Health benefits of reducing alcohol intake include weight loss, a reduced risk of many forms of cancer, less anxiety, clearer skin, no hangovers and better self-esteem.

Withdrawal symptoms of smoking

While you're trying to quit smoking, you will experience some withdrawal symptoms. These symptoms are usually the worst in the first week and then gradually improve. Common physical symptoms to expect include:

Appetite increase. You will feel hungry more often as the effects of chemicals from cigarettes are no longer present.
Nicotine cravings. Each craving will only last about 15 – 20 minutes but it will happen often and throughout the quitting process.
Cough. This may last for a few weeks as your respiratory system cleans itself.
Mild headaches and dizziness. These are often the first withdrawal symptoms to appear but they also resolve quickly.
Tiredness. In the absence of nicotine, which is a stimulant, you will likely feel tired, restless, and might have insomnia.
Constipation. This may occur in the first month of quitting.
Mental and emotional symptoms. These include anxiety, depression, irritability, and mental fog.

How to quit: Smoking cessation

Smoking cessation means abstaining from cigarettes and/or other tobacco products for at least 6 months, but preferably for a year. This can be a challenging attempt as the nicotine in tobacco is addictive and cause dependence. You will experience several unpleasant short-term effects and withdrawal symptoms as you embark on this effort. Nevertheless, smokers can and do quit smoking for good.

Smokers who quit smoking with support are more likely to succeed than those who do it on their own. Hence, it is helpful for those trying to stop to consult a health professional on engage a smoking cessation programme.

For regular, very heavy drinkers, stopping alcohol consumption abruptly can be dangerous. They should therefore consult their doctors to manage the withdrawal symptoms.

Always remember that our health is important to us and our families, and we should take care to safeguard it.

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Smoking and drinking: a review of the literature

Affiliation.

1 Department of Psychology, University of New Mexico, Albuquerque 87131.
PMID: 2094682
DOI: 10.3109/10826089009056229

Smoking and drinking share many detrimental effects, some of which operate synergistically. Over 90% of alcoholic inpatients are smokers, with similar findings regarding outpatients. In the general population, the relationship between smoking and drinking appears positive but modest. Nicotine appears to facilitate ethanol consumption and vice versa. While ample theoretical viewpoints exist to explain the covariance of alcohol and cigarette consumption, conclusive data supporting one or another of these views are lacking. The assumption that alcoholics should be discouraged from quitting smoking as well as drinking is without empirical basis. Research should ascertain whether problem drinkers with greater positive association between alcohol and smoking benefit differentially from quitting both.

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Research Support, U.S. Gov't, P.H.S.
Alcohol Drinking / adverse effects*
Alcohol Drinking / prevention & control
Alcohol Drinking / psychology
Alcoholism / psychology
Alcoholism / rehabilitation
Health Behavior
Smoking / adverse effects*
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SMOKING CIGARETTES, DRINKING ALCOHOLIC BEVERAGES, AND STUDENTS' ACADEMIC PERFORMANCE IN SCIENCE AND TECHNOLOGY IN A PHILIPPINE NATIONAL HIGH SCHOOL

2021, IOER International Multidisciplinary Research

This research ascertained the relationships between the smoking behavior, alcohol drinking behavior and academic performance of Science and Technology students in Dasmariňas National High School using descriptive-correlational method. Specifically, the study aimed to describe the cigarette smoking behavior and alcohol drinking behavior among high school students; determine the academic performance of the students; determine the significant relationship among academic performance, cigarette smoking behavior, and alcohol drinking behavior; and determine the significant relationship between smoking cigarette and alcohol drinking behavior. Data were gathered using a validated researcher-made test questionnaires and were further analyzed using frequency counts, percentage and chi-square test. More than one-fourth of the respondents who were identified drinkers smoked mostly 1-3 times per week, and the majority were mild drinkers who can consume 1-3 bottles of alcoholic beverages per week. The academic performance of the respondents belonged to the average level. This study reveals that frequency of smoking and drinking alcoholic beverages affects the academic performance of the students. Drinking alcoholic beverages is highly significant to smoking. Results of this study serve as reminders for parents to provide more time to their children in dealing with the habits of smoking cigarettes and drinking alcoholic beverages.

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The prevalence in the use of alcohol calls for concern especially in the hands of adolescents. This study therefore sought to determine the Prevalence and Patterns of Alcohol Use among Senior Secondary School Students in Abraka, Delta state, Nigeria. This was a cross sectional study among 456 respondents drawn from 4 randomly selected mixed secondary schools in Abraka. The respondents were Senior Secondary School Students who were selected through multi-stage random sampling. Data collected were analysed with SPSS Version 20. Majority (97%) of the respondents were aged 11-20 years; 52% were males; 95% were Christians and 77% lived with both parents. Alcohol use prevalence was 55%; there were more male(35%) than female(20%) drinkers; 66% consumed beer, 86% of them consumed alcoholic wine; 45% began drinking at 11-15 years; 42% drank at ceremonies; 10% drank for pleasure; 22% drank because they feel it was a sociable thing to do; 4% and 2% respectively drink because their parents and friends also drank.71% were currently drinking; Alcoholic wines are most favoured. Alcohol drinking habit was associated with gender but not with religion and class specialization. In conclusion, alcohol use prevalence among senior secondary school students in Abraka was quite high, with most of the students initiating the habit at an early age. The prevalent socio-cultural environment and traditions appeared to be a key factor in this community. There is need, therefore, to develop viable underage preventive programmes on alcohol use for adolescents in this community.

Harshitha Menon

Man on earth ever since had a major role to play in the development of him and the country, slowly was drawn to drink to relax, celebrate and socialize as alcohol is legal and a popular social activity. Alcohol taken in low-risk patterns is called Social drinkers. Many people who drink are not alcoholics. Alcohol in moderation is what keeps social drinkers merely social and not full-blown alcoholics. The precipice of alcoholism is slippery and anybody can slide down, no matter how much they think they will never become one. People who drink heavily is at risk for adverse health consequences (biologically) and the drinker be it social drinker or alcoholic develops guilt (psychologically) if the intake is crossing the regular limit. The encyclopedia of psychology defines Guilt as a cognitive or an emotional experience that occurs when a person believes or realizes accurately or not that he or she has compromised his or her own standards of conduct or has violated a moral standard and bears significant responsibility for that violation. It is closely related to the concept of remorse. Guilt prone, leads to feel low in esteem as they do not perform an expected active and responsible role in the family and ultimately to the society. So the present study attempts to find out whether the social drinkers and alcoholics differ in terms of guilt and self esteem. The sample consists of 100 members of which 50 are social drinkers and the remaining 50 are alcoholics. They are in the age group of 35 to 55 years. Purposive sampling technique is used to select the sample and Expost facto research design is being used. Guilt Questionnaire by Malcolm Miller, and Rosenberg Self Esteem Scale (1965) are used to measure Guilt and self esteem respectively.Independent t test (critical ratio) and Pearson‟s product moment correlation are used to analyse the data.

Addictive Behaviors

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Persuasive Essay About Smoking - Making a Powerful Argument with Examples

What You Need To Know About Persuasive Essay

A persuasive essay is a type of writing that aims to convince its readers to take a certain stance or action. It often uses logical arguments and evidence to back up its argument in order to persuade readers.

It also utilizes rhetorical techniques such as ethos, pathos, and logos to make the argument more convincing. In other words, persuasive essays use facts and evidence as well as emotion to make their points.

A persuasive essay about smoking would use these techniques to convince its readers about any point about smoking. Check out an example below:

Simple persuasive essay about smoking

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Persuasive Essay Examples About Smoking

Smoking is one of the leading causes of preventable death in the world. It leads to adverse health effects, including lung cancer, heart disease, and damage to the respiratory tract. However, the number of people who smoke cigarettes has been on the rise globally.

A lot has been written on topics related to the effects of smoking. Reading essays about it can help you get an idea of what makes a good persuasive essay.

Here are some sample persuasive essays about smoking that you can use as inspiration for your own writing:

Persuasive speech on smoking outline

Persuasive essay about smoking should be banned

Persuasive essay about smoking pdf

Persuasive essay about smoking cannot relieve stress

Persuasive essay about smoking in public places

Speech about smoking is dangerous

Persuasive Essay About Smoking Introduction

Persuasive Essay About Stop Smoking

Short Persuasive Essay About Smoking

Stop Smoking Persuasive Speech

Check out some more persuasive essay examples on various other topics.

Argumentative Essay About Smoking Examples

An argumentative essay is a type of essay that uses facts and logical arguments to back up a point. It is similar to a persuasive essay but differs in that it utilizes more evidence than emotion.

If you’re looking to write an argumentative essay about smoking, here are some examples to get you started on the arguments of why you should not smoke.

Argumentative essay about smoking pdf

Argumentative essay about smoking in public places

Argumentative essay about smoking introduction

Check out the video below to find useful arguments against smoking:

Tips for Writing a Persuasive Essay About Smoking

You have read some examples of persuasive and argumentative essays about smoking. Now here are some tips that will help you craft a powerful essay on this topic.

Choose a Specific Angle

Select a particular perspective on the issue that you can use to form your argument. When talking about smoking, you can focus on any aspect such as the health risks, economic costs, or environmental impact.

Think about how you want to approach the topic. For instance, you could write about why smoking should be banned.

Check out the list of persuasive essay topics to help you while you are thinking of an angle to choose!

Research the Facts

Before writing your essay, make sure to research the facts about smoking. This will give you reliable information to use in your arguments and evidence for why people should avoid smoking.

You can find and use credible data and information from reputable sources such as government websites, health organizations, and scientific studies.

For instance, you should gather facts about health issues and negative effects of tobacco if arguing against smoking. Moreover, you should use and cite sources carefully.

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Make an Outline

The next step is to create an outline for your essay. This will help you organize your thoughts and make sure that all the points in your essay flow together logically.

Your outline should include the introduction, body paragraphs, and conclusion. This will help ensure that your essay has a clear structure and argument.

Use Persuasive Language

When writing your essay, make sure to use persuasive language such as “it is necessary” or “people must be aware”. This will help you convey your message more effectively and emphasize the importance of your point.

Also, don’t forget to use rhetorical devices such as ethos, pathos, and logos to make your arguments more convincing. That is, you should incorporate emotion, personal experience, and logic into your arguments.

Introduce Opposing Arguments

Another important tip when writing a persuasive essay on smoking is to introduce opposing arguments. It will show that you are aware of the counterarguments and can provide evidence to refute them. This will help you strengthen your argument.

By doing this, your essay will come off as more balanced and objective, making it more convincing.

Finish Strong

Finally, make sure to finish your essay with a powerful conclusion. This will help you leave a lasting impression on your readers and reinforce the main points of your argument. You can end by summarizing the key points or giving some advice to the reader.

A powerful conclusion could either include food for thought or a call to action. So be sure to use persuasive language and make your conclusion strong.

To conclude,

By following these tips, you can write an effective and persuasive essay on smoking. Remember to research the facts, make an outline, and use persuasive language.

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Keep reading

235 Smoking Essay Topics & Examples

Looking for smoking essay topics? Being one of the most serious psychological and social issues, smoking is definitely worth writing about.

🏆 Best Smoking Essay Examples & Topic Ideas

🥇 good titles for smoking essay, 👍 best titles for research paper about smoking, ⭐ simple & easy health essay titles, 💡 interesting topics to write about health, ❓ essay questions about smoking.

In your essay about smoking, you might want to focus on its causes and effects or discuss why smoking is a dangerous habit. Other options are to talk about smoking prevention or to concentrate on the reasons why it is so difficult to stop smoking. Here we’ve gathered a range of catchy titles for research papers about smoking together with smoking essay examples. Get inspired with us!

Smoking is a well-known source of harm yet popular regardless, and so smoking essays should cover various aspects of the topic to identify the reasons behind the trend.

You will want to discuss the causes and effects of smoking and how they contributed to the persistent refusal of large parts of the population to abandon the habit, even if they are aware of the dangers of cigarettes. You should provide examples of how one may become addicted to tobacco and give the rationales for smokers.

You should also discuss the various consequences of cigarette use, such as lung cancer, and identify their relationship with the habit. By discussing both sides of the issue, you will be able to write an excellent essay.

Reasons why one may begin smoking, are among the most prominent smoking essay topics. It is not easy to begin to enjoy the habit, as the act of smoke inhalation can be difficult to control due to a lack of experience and unfamiliarity with the concept.

As such, people have to be convinced that the habit deserves consideration by various ideas or influences. The notion that “smoking is cool” among teenagers can contribute to the adoption of the trait, as can peer pressure.

If you can find polls and statistics on the primary factors that lead people to tweet, they will be helpful to your point. Factual data will identify the importance of each cause clearly, although you should be careful about bias.

The harmful effects of tobacco have been researched considerably more, with a large body of medical studies investigating the issue available to anyone.

Lung cancer is the foremost issue in the public mind because of the general worry associated with the condition and its often incurable nature, but smoking can lead to other severe illnesses.

Heart conditions remain a prominent consideration due to their lethal effects, and strokes or asthma deserve significant consideration, as well. Overall, smoking has few to no beneficial health effects but puts the user at risk of a variety of concerns.

As such, people should eventually quit once their health declines, but their refusal to do so deserves a separate investigation and can provide many interesting smoking essay titles.

One of the most prominent reasons why a person would continue smoking despite all the evidence of its dangers and the informational campaigns carried out to inform consumers is nicotine addiction.

The substance is capable of causing dependency, a trait that has led to numerous discussions of the lawfulness of the current state of cigarettes.

It is also among the most dangerous aspects of smoking, a fact you should mention.

Lastly, you can discuss the topics of alternatives to smoking in your smoking essay bodies, such as e-cigarettes, hookahs, and vapes, all of which still contain nicotine and can, therefore, lead to considerable harm. You may also want to discuss safe cigarette avoidance options and their issues.

Here are some additional tips for your essay:

Dependency is not the sole factor in cigarette consumption, and many make the choice that you should respect consciously.
Cite the latest medical research titles, as some past claims have been debunked and are no longer valid.
Mortality is not the sole indicator of the issues associated with smoking, and you should take chronic conditions into consideration.

Find smoking essay samples and other useful paper samples on IvyPanda, where we have a collection of professionally written materials!

Conclusion of Smoking Should Be Banned on College Campuses Essay However, it is hard to impose such a ban in some colleges because of the mixed reactions that are held by different stakeholders about the issue of smoking, and the existing campus policies which give […]
Should Smoking Be Banned in Public Places? Besides, smoking is an environmental hazard as much of the content in the cigarette contains chemicals and hydrocarbons that are considered to be dangerous to both life and environment.
How Smoking Is Harmful to Your Health The primary purpose of the present speech is to inform the audience about the detrimental effects of smoking. The first system of the human body that suffers from cigarettes is the cardiovascular system.
Smoking: Problems and Solutions To solve the problem, I would impose laws that restrict adults from smoking in the presence of children. In recognition of the problems that tobacco causes in the country, The Canadian government has taken steps […]
Causes and Effects of Smoking Some people continue smoking as a result of the psychological addiction that is associated with nicotine that is present in cigarettes.
Smoking Cigarette Should Be Banned Ban on tobacco smoking has resulted to a decline in the number of smokers as the world is sensitized on the consequences incurred on 31st May.
On Why One Should Stop Smoking Thesis and preview: today I am privileged to have your audience and I intend to talk to you about the effects of smoking, and also I propose to give a talk on how to solve […]
Smoking: Effects, Reasons and Solutions This presentation provides harmful health effects of smoking, reasons for smoking, and solutions to smoking. Combination therapy that engages the drug Zyban, the concurrent using of NRT and counseling of smokers under smoking cessation program […]
Advertisements on the Effect of Smoking Do not Smoke” the campaign was meant to discourage the act of smoking among the youngsters, and to encourage them to think beyond and see the repercussions of smoking.
Smoking and Its Negative Effects on Human Beings Therefore, people need to be made aware of dental and other health problems they are likely to experience as a result of smoking.
Smoking Among Teenagers as Highlighted in Articles The use of tobacco through smoking is a trend among adolescents and teenagers with the number of young people who involve themselves in smoking is growing each day.
Smoking and Youth Culture in Germany The report also assailed the Federal Government for siding the interest of the cigarette industry instead of the health of the citizens.
Health Promotion Plan: Smokers in Mississippi The main strategies of the training session are to reduce the number of smokers in Mississippi, conduct a training program on the dangers of smoking and work with tobacco producers.
Public Health Education: Anti-smoking Project The workshop initiative aimed to achieve the following objectives: To assess the issues related to smoking and tobacco use. To enhance the health advantages of clean air spaces.
Smoking and Its Effects on Human Body The investigators explain the effects of smoking on the breath as follows: the rapid pulse rate of smokers decreases the stroke volume during rest since the venous return is not affected and the ventricles lose […]
Causes and Effects of Smoking in Public The research has further indicated that the carcinogens are in higher concentrations in the second hand smoke rather than in the mainstream smoke which makes it more harmful for people to smoke publicly.
Smoking Habit, Its Causes and Effects Smoking is one of the factors that are considered the leading causes of several health problems in the current society. Smoking is a habit that may be easy to start, but getting out of this […]
“Thank You For Smoking” by Jason Reitman Film Analysis Despite the fact that by the end of the film the character changes his job, his nature remains the same: he believes himself to be born to talk and convince people.
Summary of “Smokers Get a Raw Deal” by Stanley Scott Lafayette explains that people who make laws and influence other people to exercise these laws are obviously at the top of the ladder and should be able to understand the difference between the harm sugar […]
Aspects of Anti-Smoking Advertising Thus, it is safe to say that the authors’ main and intended audience is the creators of anti-smoking public health advertisements.
Introducing Smoking Cessation Program: 5 A’s Intervention Plan The second problem arises in an attempt to solve the issue of the lack of counseling in the unit by referring patients to the outpatient counseling center post-hospital discharge to continue the cessation program.
Teenage Smoking and Solution to This Problem Overall, the attempts made by anti-smoking campaigners hardly yield any results, because they mostly focus on harmfulness of tobacco smoking and the publics’ awareness of the problem, itself, but they do not eradicate the underlying […]
Smoking Qualitative Research: Critical Analysis Qualitative research allows researchers to explore a wide array of dimensions of the social world, including the texture and weave of everyday life, the understandings, experiences and imaginings of our research participants, the way that […]
Tobacco Debates in “Thank You for Smoking” The advantage of Nick’s strategy is that it offers the consumer a role model to follow: if smoking is considered to be ‘cool’, more people, especially young ones, will try to become ‘cool’ using cigarettes.
The Change of my Smoking Behavior With the above understanding of my social class and peer friends, I was able to create a plan to avoid them in the instances that they were smoking.
Inequality and Discrimination: Impact on LGBTQ+ High School Students Consequently, the inequality and discrimination against LGBTQ + students in high school harm their mental, emotional, and physical health due to the high level of stress and abuse of various substances that it causes.
Factors Affecting the Success in Quitting Smoking of Smokers in West Perth, WA Australia Causing a wide array of diseases, health smoking is the second cause of death in the world. In Australia, the problem of smoking is extremely burning due to the high rates of diseases and deaths […]
Health Promotion for Smokers The purpose of this paper is to show the negative health complications that stem from tobacco use, more specifically coronary heart disease, and how the health belief model can help healthcare professionals emphasize the importance […]
Gender-Based Assessment of Cigarette Smoking Harm Thus, the following hypothesis is tested: Women are more likely than men to believe that smoking is more harmful to health.
Hazards of Smoking and Benefits of Cessation Prabhat Jha is the author of the article “The Hazards of Smoking and the Benefits of Cessation,” published in a not-for-profit scientific journal, eLife, in 2020.
The Impact of Warning Labels on Cigarette Smoking The regulations requiring tobacco companies to include warning labels are founded on the need to reduce nicotine intake, limit cigarette dependence, and mitigate the adverse effects associated with addiction to smoking.
Psilocybin as a Smoking Addiction Remedy Additionally, the biotech company hopes to seek approval from FDA for psilocybin-based therapy treatment as a cigarette smoking addiction long-term remedy.
Tobacco Smoking: The Health Outcomes Tobacco smoke passing through the upper respiratory tract irritates the membrane of the nasopharynx, and other organism parts, generating copious separation of mucus and saliva.
Investing Savings from Quitting Smoking: A Financial Analysis The progression of interest is approximately $50 per year, and if we assume n equal to 45 using the formula of the first n-terms of the arithmetic progression, then it comes out to about 105 […]
Smoking as a Community Issue: The Influence of Smoking A review of the literature shows the use of tobacco declined between 1980 and 2012, but the number of people using tobacco in the world is increasing because of the rise in the global population.
Smoking Public Education Campaign Assessment The major influence of the real cost campaign was to prevent the initiation of smoking among the youth and prevent the prevalence of lifelong smokers.
Smoking Cessation Therapy: Effectiveness of Electronic Cigarettes Based on the practical experiments, the changes in the patients’ vascular health using nicotine and electronic cigarettes are improved within one-month time period. The usage only of electronic cigarettes is efficient compared to when people […]
Quitting Smoking and Related Health Benefits The regeneration of the lungs will begin: the process will touch the cells called acini, from which the mucous membrane is built. Therefore, quitting the habit of smoking a person can radically change his life […]
Smoking and Stress Among Veterans The topic is significant to explore because of the misconception that smoking can alleviate the emotional burden of stress and anxiety when in reality, it has an exacerbating effect on emotional stress.
Smoking as a Predictor of Underachievement By comparing two groups smoking and non-smoking adolescents through a parametric t-test, it is possible to examine this assumption and draw conclusions based on the resulting p-value.
Smoking and the Pandemic in West Virginia In this case, the use of the income variable is an additional facet of the hypothesis described, allowing us to evaluate whether there is any divergence in trends between the rich and the poor.
Anti-Smoking Policy in Australia and the US The anti-smoking policy is to discourage people from smoking through various means and promotion of a healthy lifestyle, as well as to prevent the spread of the desire to smoke.
Smoking Prevalence in Bankstown, Australia The secondary objective of the project was to gather and analyze a sufficient amount of auxiliary scholarly sources on smoking cessation initiatives and smoking prevalence in Australia.
Drug Addiction in Teenagers: Smoking and Other Lifestyles In the first part of this assignment, the health problem of drug addiction was considered among teens and the most vulnerable group was established.
Anti-Smoking Communication Campaign’s Analysis Defining the target audience for an anti-smoking campaign is complicated by the different layers of adherence to the issue of the general audience of young adults.
Smoking as a Risk Factor for Lung Cancer Lung cancer is one of the most frequent types of the condition, and with the low recovery rates. If the problem is detected early and the malignant cells are contained to a small region, surgery […]
Smoking Cessation Project Implementation In addition, the review will include the strengths and weaknesses of the evidence presented in the literature while identifying gaps and limitations.
Smoking Cessation and Health Promotion Plan Patients addicted to tobacco are one of the major concerns of up-to-date medicine as constant nicotine intake leads to various disorders and worsens the health state and life quality of the users.
Maternal and Infant Health: Smoking Prevention Strategies It is known that many women know the dangers of smoking when pregnant and they always try to quit smoking to protect the lives of themselves and the child.
A Peer Intervention Program to Reduce Smoking Rates Among LGBTQ Therefore, the presumed results of the project are its introduction into the health care system, which will promote a healthy lifestyle and diminish the level of smoking among LGBTQ people in the SESLHD.
Tackling Teenage Smoking in Community The study of the problem should be comprehensive and should not be limited by the medical aspect of the issue. The study of the psychological factor is aimed at identifying the behavioral characteristics of smoking […]
Peer Pressure and Smoking Influence on Teenagers The study results indicate that teenagers understand the health and social implications of smoking, but peer pressure contributes to the activity’s uptake.
Smoking Cessation Programs Through the Wheel of Community Organizing The first step of the wheel is to listen to the community’s members and trying to understand their needs. After the organizer and the person receiving treatment make the connection, they need to understand how […]
Smoking: Benefits or Harms? Hundreds of smokers every day are looking for a way to get rid of the noose, which is a yoke around the neck, a cigarette.
The Culture of Smoking Changed in Poland In the 1980-90s, Poland faced the challenge of being a country with the highest rates of smoking, associated lung cancer, and premature mortality in the world.
The Stop Smoking Movement Analysis The paper discusses the ideology, objective, characteristics, context, special techniques, organization culture, target audience, media strategies, audience reaction, counter-propaganda and the effectiveness of the “Stop Smoking” Movement.”The Stop Smoking” campaign is a prevalent example of […]
Smoking Health Problem Assessment The effects of smoking correlate starkly with the symptoms and diseases in the nursing practice, working as evidence of the smoking’s impact on human health.
Integration of Smoking Cessation Into Daily Nursing Practice Generally, smoking cessation refers to a process structured to help a person to discontinue inhaling smoked substances. It can also be referred to as quitting smoking.
E-Cigarettes and Smoking Cessation Many people argue that e-cigarettes do not produce secondhand smoke. They believe that the e-fluids contained in such cigarettes produce vapor and not smoke.
Outdoor Smoking Ban in Public Areas of the Community These statistics have contributed to the widespread efforts to educate the public regarding the need to quit smoking. However, most of the chronic smokers ignore the ramifications of the habit despite the deterioration of their […]
Nicotine Replacement Therapy for Adult Smokers With a Psychiatric Disorder The qualitative research methodology underlines the issue of the lack of relevant findings in the field of nicotine replacement therapy in people and the necessity of treatment, especially in the early stages of implementation.
Smoking and Drinking: Age Factor in the US As smoking and drinking behavior were both strongly related to age, it could be the case that the observed relationship is due to the fact that older pupils were more likely to smoke and drink […]
Poland’s Smoking Culture From Nursing Perspective Per Kinder, the nation’s status as one of Europe’s largest tobacco producers and the overall increase in smoking across the developing nations of Central and Eastern Europe caused its massive tobacco consumption issues.
Smoking Cessation Clinic Analysis The main aim of this project is to establish a smoking cessation clinic that will guide smoker through the process of quitting smoking.
Cigarette Smoking Among Teenagers in the Baltimore Community, Maryland The paper uses the Baltimore community in Maryland as the area to focus the event of creating awareness of cigarette smoking among the teens of this community.
Advocating for Smoking Cessation: Health Professional Role Health professionals can contribute significantly to tobacco control in Australia and the health of the community by providing opportunities for smoking patients to quit smoking.
Lifestyle Management While Quitting Smoking Realistically, not all of the set goals can be achieved; this is due to laxity in implementing them and the associated difficulty in letting go of the past lifestyle.
Smoking in the Actuality The current use of aggressive marketing and advertising strategies has continued to support the smoking of e-cigarettes. The study has also indicated that “the use of such e-cigarettes may contribute to the normalization of smoking”.
Analysis of the Family Smoking Prevention and Tobacco Control Act The law ensures that the FDA has the power to tackle issues of interest to the public such as the use of tobacco by minors.
“50-Year Trends in Smoking-Related Mortality in the United States” by Thun et al. Thun is affiliated with the American Cancer Society, but his research interests cover several areas. Carter is affiliated with the American Cancer Society, Epidemiology Research Program.
Pulmonology: Emphysema Caused by Smoking The further development of emphysema in CH can lead to such complications caused by described pathological processes as pneumothorax that is associated with the air surrounding the lungs.
Smoking and Lung Cancer Among African Americans Primarily, the research paper provides insight on the significance of the issue to the African Americans and the community health nurses.
Health Promotion and Smoking Cessation I will also complete a wide range of activities in an attempt to support the agency’s goals. As well, new studies will be conducted in order to support the proposed programs.
Maternal Mental Health and Prenatal Smoking It was important to determine the variables that may lead to postpartum relapse or a relapse during the period of pregnancy. It is important to note that the findings are also consistent with the popular […]
Nursing Interventions for Smoking Cessation For instance, the authors are able to recognize the need to classify the level of intensity in respect to the intervention that is employed by nurses towards smoking cessation.
Smoking and Cancer in the United States In this research study, data on tobacco smoking and cancer prevalence in the United States was used to determine whether cancer in the United States is related to tobacco smoking tobacco.
Marketing Plan: Creating a Smoking Cessation Program for Newton Healthcare Center The fourth objective is to integrate a smoking cessation program that covers the diagnosis of smoking, counseling of smokers, and patient care system to help the smokers quit their smoking habits. The comprehensive healthcare needs […]
Smoking Among the Youth Population Between 12-25 Years I will use the theory to strengthen the group’s beliefs and ideas about smoking. I will inform the group about the relationship between smoking and human health.
Risks of Smoking Cigarettes Among Preteens Despite the good news that the number of preteen smokers has been significantly reducing since the 1990s, there is still much to be done as the effects of smoking are increasingly building an unhealthy population […]
Healthy People Program: Smoking Issue in Wisconsin That is why to respond to the program’s effective realization, it is important to discuss the particular features of the target population in the definite community of Wisconsin; to focus on the community-based response to […]
Health Campaign: Smoking in the USA and How to Reduce It That is why, the government is oriented to complete such objectives associated with the tobacco use within the nation as the reduction of tobacco use by adults and adolescents, reduction of initiation of tobacco use […]
Smoking Differentials Across Social Classes The author inferred her affirmations from the participant’s words and therefore came to the right conclusion; that low income workers had the least justification for smoking and therefore took on a passive approach to their […]
Cigarette Smoking Side Effects Nicotine is a highly venomous and addictive substance absorbed through the mucous membrane in the mouth as well as alveoli in the lungs.
Long-Term Effects of Smoking The difference between passive smoking and active smoking lies in the fact that, the former involves the exposure of people to environmental tobacco smoke while the latter involves people who smoke directly.
Smoking Cessation Program Evaluation in Dubai The most important program of this campaign is the Quit and Win campaign, which is a unique idea, launched by the DHCC and is in the form of an open contest.
Preterm Birth and Maternal Smoking in Pregnancy The major finding of the discussed research is that both preterm birth and maternal smoking during pregnancy contribute, although independently, to the aortic narrowing of adolescents.
Enforcement of Michigan’s Non-Smoking Law This paper is aimed at identifying a plan and strategy for the enforcement of the Michigan non-smoking law that has recently been signed by the governor of this state.
Smoking Cessation for Patients With Cardio Disorders It highlights the key role of nurses in the success of such programs and the importance of their awareness and initiative in determining prognosis.
Legalizing Electronic Vaping as the Means of Curbing the Rates of Smoking However, due to significantly less harmful effects that vaping produces on health and physical development, I can be considered a legitimate solution to reducing the levels of smoking, which is why it needs to be […]
Self-Efficacy and Smoking Urges in Homeless Individuals Pinsker et al.point out that the levels of self-efficacy and the severity of smoking urges change significantly during the smoking cessation treatment.
“Cigarette Smoking: An Overview” by Ellen Bailey and Nancy Sprague The authors of the article mentioned above have presented a fair argument about the effects of cigarette smoking and debate on banning the production and use of tobacco in America.
“The Smoking Plant” Project: Artist Statement It is the case when the art is used to pass the important message to the observer. The live cigarette may symbolize the smokers while the plant is used to denote those who do not […]
Dangers of Smoking While Pregnant In this respect, T-test results show that mean birthweight of baby of the non-smoking mother is 3647 grams, while the birthweight of smoking mother is 3373 grams. Results show that gestation value and smoking habit […]
The Cultural Differences of the Tobacco Smoking The Middle East culture is connected to the hookah, the Native American cultures use pipes, and the Canadian culture is linked to cigarettes.
Ban on Smoking in Enclosed Public Places in Scotland The theory of externality explains the benefit or cost incurred by a third party who was not a party to the reasoning behind the benefit or cost. This will also lead to offer of a […]
How Smoking Cigarettes Effects Your Health Cigarette smoking largely aggravates the condition of the heart and the lung. In addition, the presence of nicotine makes the blood to be sticky and thick leading to damage to the lining of the blood […]
Alcohol and Smoking Abuse: Negative Physical and Mental Effects The following is a range of effects of heavy alcohol intake as shown by Lacoste, they include: Neuropsychiatric or neurological impairment, cardiovascular, disease, liver disease, and neoplasm that is malevolent.
Smoking Prohibition: Local Issues, Personal Views This is due to the weakening of blood vessels in the penis. For example, death rate due to smoking is higher in Kentucky than in other parts of the country.
Smoking During Pregnancy Issues Three things to be learned from the research are the impact of smoking on a woman, possible dangers and complications and the importance of smoking cessation interventions.
The Smoking Problem: Mortality, Control, and Prevention The article presents smoking as one of the central problems for many countries throughout the world; the most shocking are the figures related to smoking rate among students. Summary: The article is dedicated to the […]
Tobacco Smoking: Bootleggers and Baptists Legislation or Regulation The issue is based on the fact that tobacco smoking also reduces the quality of life and ruins the body in numerous ways.
Ban Smoking in Cars Out of this need, several regulations have been put in place to ensure children’s safety in vehicles is guaranteed; thus, protection from second-hand smoke is an obvious measure that is directed towards the overall safety […]
Smoking: Causes and Effects Considering the peculiarities of a habit and of a disease, smoking can be considered as a habit rather than a disease.
Smoking Behavior Under Clinical Observation The physiological aspect that influences smokers and is perceived as the immediate effect of smoking can be summarized as follows: Within ten seconds of the first inhalation, nicotine, a potent alkaloid, passes into the bloodstream, […]
Smoking and Its Effect on the Brain Since the output of the brain is behavior and thoughts, dysfunction of the brain may result in highly complex behavioral symptoms. The work of neurons is to transmit information and coordinate messengers in the brain […]
Smoking Causes and Plausible Arguments In writing on the cause and effect of smoking we will examine the issue from the point of view of temporal precedence, covariation of the cause and effect and the explanations in regard to no […]
Post Smoking Cessation Weight Gain The aim of this paper is to present, in brief, the correlation between smoking cessation and weigh gain from biological and psychological viewpoints.
Marketing a Smoking Cessation Program In the case of the smoking cessation program, the target group is made up of smokers who can be further subdivided into segments such as heavy, medium, and light smokers.
Smoking Cessation for Ages 15-30 The Encyclopedia of Surgery defines the term “Smoking Cessation” as an effort to “quit smoking” or “withdrawal from smoking”. I aim to discuss the importance of the issue by highlighting the most recent statistics as […]
Motivational Interviewing as a Smoking Cessation Intervention for Patients With Cancer The dependent variable is the cessation of smoking in 3 months of the interventions. The study is based on the author’s belief that cessation of smoking influences cancer-treated patients by improving the efficacy of treatment.
Media Effects on Teen Smoking But that is not how an adult human brain works, let alone the young and impressionable minds of teenagers, usually the ads targeted at the youth always play upon elements that are familiar and appealing […]
“Passive Smoking Greater Health Hazard: Nimhans” by Stephen David The article focuses on analyzing the findings of the study and compares them to the reactions to the ban on public smoking.
Partnership in Working About Smoking and Tobacco Use The study related to smoking and tobacco use, which is one of the problematic areas in terms of the health of the population.
Cigar Smoking and Relation to Disease The article “Effect of cigar smoking on the risk of cardiovascular disease, chronic obstructive pulmonary disease and cancer in Men” by Iribarren et al.is a longitudinal study of cigar smokers and the impact of cigar […]
Quitting Smoking: Motivation and Brain As these are some of the observed motivations for smoking, quitting smoking is actually very easy in the sense that you just have to set your mind on quitting smoking.
Health Effects of Tobacco Smoking in Hispanic Men The Health Effects of Tobacco Smoking can be attributed to active tobacco smoking rather than inhalation of tobacco smoke from environment and passive smoking.
Smoking in Adolescents: A New Threat to the Society Of the newer concerns about the risks of smoking and the increase in its prevalence, the most disturbing is the increase in the incidences of smoking among the adolescents around the world.
The Importance of Nurses in Smoking-Cessation Programs When a patient is admitted to the hospital, the nursing staff has the best opportunity to assist them in quitting in part because of the inability to smoke in the hospital combined with the educational […]
New Jersey Legislation on Smoking The advantages and disadvantages of the legislation were discussed in this case because of the complexity of the topic at hand as well as the potential effects of the solution on the sphere of public […]
Environmental Health: Tabaco Smoking and an Increased Concentration of Carbon Monoxide The small size of the town, which is around 225000 people, is one of the reasons for high statistics in diseases of heart rate.
Advanced Pharmacology: Birth Control for Smokers The rationale for IUD is the possibility to control birth without the partner’s participation and the necessity to visit a doctor just once for the device to be implanted.
Legislation Reform of Public Smoking Therefore, the benefit of the bill is that the health hazard will be decreased using banning smoking in public parks and beaches.
Female Smokers Study: Inferential Statistics Article The article “Differential Effects of a Body Image Exposure Session on Smoking Urge between Physically Active and Sedentary Female Smokers” deepens the behavioral mechanisms that correlate urge to smoke, body image, and physical activity among […]
Smoking Bans: Protecting the Public and the Children of Smokers The purpose of the article is to show why smoking bans aim at protecting the public and the children of smokers.
Clinical Effects of Cigarette Smoking Smoking is a practice that should be avoided or controlled rigorously since it is a risk factor for diseases such as cancer, affects the health outcomes of direct and passive cigarette users, children, and pregnant […]
Public Health and Smoking Prevention Smoking among adults over 18 years old is a public health issue that requires intervention due to statistical evidence of its effects over the past decades.
Smoking in the US: Statistics and Healthcare Costs According to the Centers for Disease Control and Prevention, tobacco smoking is the greatest preventable cause of death in the US.
Smoking Should Be Banned Internationally The questions refer to the knowledge concerning the consequences of smoking and the opinions on smoking bans. 80 % of respondents agree that smoking is among the leading causes of death and 63, 3 % […]
Microeconomics: Cigarette Taxes and Public Smoking Ban The problem of passive smoking will be minimized when the number of smokers decreases. It is agreeable that the meager incomes of such families will be used to purchase cigarettes.
Alcohol and Smoking Impact on Cancer Risk The research question is to determine the quantity of the impact that different levels of alcohol ingestion combined with smoking behavioral patterns make on men and women in terms of the risks of cancer.
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Tobacco Smoking and Its Dangers Sufficient evidence also indicates that smoking is correlated with alcohol use and that it is capable of affecting one’s mental state to the point of heightening the risks of development of disorders.
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Effects of Thought Suppression on Smoking Behavior In the article under analysis called I suppress, Therefore I smoke: Effects of Thought Suppression on Smoking Behavior, the authors dedicate their study to the evaluation of human behavior as well as the influence of […]
Suppressing Smoking Behavior and Its Effects The researchers observed that during the first and the second weeks of the suppressed behavior, the participants successfully managed to reduce their intake of cigarettes.
Smoking Cessation Methods These methods are a part of NRT or nicotine replacement therapy, they work according to the principle of providing the smoker with small portions of nicotine to minimize the addiction gradually and at the same […]
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How We Get Hooked: Understand Alcohol Misuse

Uncover how perceived benefits shape our relationship with alcohol..

Posted May 18, 2024 | Reviewed by Ray Parker

What Is Alcoholism?
Find a therapist to overcome addiction
Explore how early alcohol experiences shape our perceptions of alcohol.
Dive into how social learning reinforces drinking behaviors.
Replace judgment with understanding, using a drinking diary to cultivate healthier alcohol consumption.

“I don’t know why I keep drinking.” I threw myself onto my therapist’s bright yellow couch on a hot summer day.

“I am sure you had a reason,” my therapist replied.

I remembered looking up at her with disbelief. It was not the response I imagined I would get.

This pivotal moment was the beginning of my journey to understanding the deeper reasons behind alcohol consumption, a journey I now navigate with my clients. Six years have passed since then, and having become a therapist myself, the exchange above has also become one that takes place often between me and my clients.

Every Behavior Serves a Purpose: Perceived Benefits

People who come to me to work on their alcohol consumption often feel perplexed by their own behaviors. They see all the good reasons to drink less, yet for some reason, they just can’t seem to figure out how.

“Is there something wrong with me?” many of them end up asking. My answer to that question is a definitive “No.”

No. There is nothing wrong with you. You drink for a reason.

Here is the thing: behind each of our behaviors, there is a motive. Our behaviors serve purposes. They are driven by perceived benefits. We take a shot before walking up onto the stage for a boost of confidence ; we pour a glass of wine before initiating intimacy to soften the moods; and we reach for that fourth beer because we believe the more we drink, the more fun we will get. Behind each sip we take, there is always something that we hope to get. Recognizing these patterns has led me to explore the initial allure of alcohol and the perceived benefits that often go unnoticed.

The Power of Perception: The Initial Perceived Benefits

As we scratch our heads wondering why someone can’t stop drinking despite all the negative consequences, we often fail to acknowledge the perceived benefits. You see, if drinking was really just “all bad,” very few of us would ever get hooked. The tricky thing about alcohol is that it often starts with benefits—perceived benefits, at least.

Imagine a young man at his first college party, feeling awkward and out of place—until he has his first drink. Suddenly, the edges soften, the room seems friendlier, and he feels like he belongs. Or a teenage girl who is going through her first breakup. As the cold beer pours down her throat, the sadness in her chest slowly dissipates. (That girl was me.)

Our early encounters with alcohol often set the tone for our relationship with it, creating powerful perceptions. According to the expectancy theory, we make choices based on the expected outcome of our actions. After the initial encounters, the young man learned to pop open a beer every time he felt unease at a party, and the teenage girl learned to pour herself a glass whenever sadness arose in her chest.

These early perceptions often overshadow the delayed negative consequences. The immediate perceived benefits reinforce the behavior, making it easy to overlook the hangover the next day, the occasional throw-up by the sidewalk, or the long-term impact on one’s health and well-being. As these early experiences shape our perceptions, they lay the groundwork for new associations that reinforce our drinking habits over time.

Reinforcement and New Associations: How Alcohol's Appeal Grows

As we continue navigating through life, the perceived benefits we have around alcohol slowly multiply. Perhaps you were originally drawn to alcohol by the alleviation of discomfort in social situations. Over time, as you continue to drink during parties and gatherings, your brain starts to associate drinking with having a good time.

Moreover, our observations about others around us continue to add layers of perceived benefits to our understanding of alcohol. According to social learning theory , we learn by observing and imitating others. When we watch a housewife on TV pour herself a glass of “mommy’s juice” by the end of the day, we learn to associate alcohol with relaxation and stress relief. When we see our friend pair a Cabernet Sauvignon with a hearty steak, we learn to see wine as a part of fine dining. The observations create more and more perceived benefits we associate with the liquid in the bottle.

These perceived benefits keep us reaching for a drink even when the negative effects start to pile up. Grappling with dissatisfaction with attempts to cut down, many people become trapped in a sense of self-blame.

Replace Self-Blame With Understanding

Understanding the "why" behind our drinking can make a crucial difference, as shame and guilt often hinder our ability to understand and make changes. When we get caught up in painful questions like “What’s wrong with me,” we become distracted from constructive questions such as “How can I create changes?” Insights and awareness are often the first steps to change.

You had reasons to drink. Understanding those reasons gives room for you to learn how to drink less.

Inside my 7-Day Toolkit, you can find my favorite tool, the 3-minute drinking diary , to help you uncover the hidden perceived benefits of drinking.

Jeanette Hu, AMFT , based in California, is a former daily drinker, psychotherapist, and Sober Curiosity Guide. She supports individuals who long for a better relationship with alcohol, helping them learn to drink less without living less.

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Alcohol Use and Your Health
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Check Your Drinking. Make a Plan to Drink Less.
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Deaths from Excessive Alcohol Use in the United States
Addressing Excessive Alcohol Use: State Fact Sheets
Excessive alcohol use can have immediate and long-term effects.
Excessive drinking includes binge drinking, heavy drinking, and any drinking during pregnancy or by people younger than 21.
Drinking less is better for your health than drinking more.
You can lower your health risks by drinking less or choosing not to drink.

Young man and woman talking on a bridge at a park.

Why it's important

The rest of the alcohol can harm your liver and other organs as it moves through the body.
Using alcohol excessively on occasion or over time can have immediate and long-term health risks.
By drinking less alcohol, you can improve your health and well-being.

Deaths from excessive alcohol use‎

Understanding alcohol use, excessive alcohol use.

Excessive alcohol use is a term used to describe four ways that people drink alcohol that can negatively impact health. Excessive drinking can also be deadly.

Excessive alcohol use includes:

Binge drinking—Four or more drinks for women, or five or more drinks for men during an occasion.
Heavy drinking—Eight or more drinks for women, or 15 or more drinks for men during a week.
Underage drinking —any alcohol use by people younger than 21.
Drinking while pregnant—any alcohol use during pregnancy .

Moderate alcohol use

Moderate drinking is having one drink or less in a day for women, or two drinks or less in a day for men.

Keep in mind‎

Effects of short-term alcohol use.

Drinking excessively on an occasion can lead to these harmful health effects:

Injuries— motor vehicle crashes , falls, drownings, and burns.
Violence—homicide, suicide, sexual violence, and intimate partner violence.
Alcohol poisoning—high blood alcohol levels that affect body functions like breathing and heart rate.
Overdose—from alcohol use with other drugs , like opioids.
Sexually transmitted infections or unplanned pregnancy—alcohol use can lead to sex without protection, which can cause these conditions.
Miscarriage, stillbirth, or fetal alcohol spectrum disorder (FASD) —from any alcohol use during pregnancy.

Effects of long-term alcohol use

Over time, drinking alcohol can have these effects:

The risk of some cancers increases with any amount of alcohol use. 2 This includes breast cancer (in women). 2 A
More than 20,000 people die from alcohol-related cancers each year in the United States. 3

Other chronic diseases

Excessive alcohol use can lead to:

High blood pressure.
Heart disease.
Liver disease.
Alcohol use disorder—this affects both physical and mental health. B
Digestive problems.
Weaker immune system—increasing your chances of getting sick.

Social and wellness issues

Mental health conditions, including depression and anxiety.
Learning problems, and issues at school or work.
Memory problems, including dementia.
Relationship problems with family and friends.

You can take steps to lower your risk of alcohol-related harms.

The less alcohol you drink, the lower your risk for these health effects, including several types of cancer.

Check your drinking‎

The risk of alcohol use leading to breast cancer in men has not been established.
Most people who drink excessively do not have alcohol use disorder (also known as "alcohol dependence" or "alcoholism"). Many people who drink excessively can lower their alcohol use without specialized medical treatment. Facts about alcohol use disorder are available at: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder .
Esser MB, Sherk A, Liu Y, Naimi TS. Deaths from excessive alcohol use — United States, 2016-2021. MMWR Morb Mortal Wkly Rep . 2024;73:154–161. doi: http://dx.doi.org/10.15585/mmwr.mm7308a1
Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer . 2015;112(3):580-593. doi: 10.1038/bjc.2014.579
Esser MB, Sherk A, Liu Y, Henley SJ, Naimi TS. Reducing alcohol use to prevent cancer deaths: estimated effects among U.S. adults. Am J Prev Med . 2024;66(4):725–729. doi: 10.1016/j.amepre.2023.12.003

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Excessive alcohol use can harm people who drink and those around them. You and your community can take steps to improve everyone’s health and quality of life.

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From Walking Papers to Walking Tours: How I Went From Getting Laid Off to Loving My Historical Bar Crawl Business My deep love of history and booze finally collided in a side hustle that keeps my legs (and drinking arm) extremely active.

By Bill Schulz Edited by Dan Bova May 20, 2024

Opinions expressed by Entrepreneur contributors are their own.

After 20-plus years of enduring increasingly diminished returns as a bottom-shelf member of the media, along with recent "downsizing" at my now-former network , I realized that it was time to stop working for other people and to start working for the man in the mirror.

Successful entrepreneurs always advise "follow your passion." And so I did. My secret passion? I've always wanted to helm historical walking tours.

(Yes, shockingly, I'm also super single.)

I am a mass consumer of walking tours. Over the years, I've booked countless pavement-pounding adventures the minute my flight's wheels arrive on far-away runways. And I consistently marvel at how these knowledgeable hosts hold patrons in the palm of their hands whilst dispensing all manner of amazing info within any city I'm visiting. From morbid Jack the Ripper strolls within London's White Chapel district to sweaty Art Deco slogs down Miami Beach to a driving Dearly Departed tour (because Los Angelenos ONLY walk on red carpets) that illuminates areas where A-listers OD'ed, I log the good, bad and ugly experiences while thinking about how I might've made them better.

So with a mission in my heart and years of research in my head, I just had one big question: how does this industry even work?

The first step

"I think the biggest mistake people make when starting out is thinking that this is easy because it is not ," says Seth Kamil, President and Founder of Big Onion Walking Tours . There are all kinds of incorporation and insurance considerations, but before that, a biggie is defining what's going to make your tour different.

Seth founded, what remains the gold standard in New York walkabouts, as a graduate student at Columbia University in 1991. His mission statement was two-fold: A) Churn out thought-provoking tours that focus on the history, architecture, local personalities, etc.; and B) Provide real-world experience plus much-needed income to other graduate students or recent, underfunded PhD's which, to date, are the only types of employees he hires.

"All our guides have education backgrounds and are historians who lead tours," adds Kamil, "not tour guides who dabble in history."

[Note to self: Google "black-market PhD degrees".]

"Podcasting can be a solitary business," says Tom Meyers who, for fifteen years alongside Greg Young, has hosted the ridiculously popular, NYC-history-based-behemoth that is The Bowery Boys . "But when we're on one of our walking tours, [an offshoot of their enterprise that began in 2018 ] we get to hang out with fans and sometimes get ideas from them for upcoming shows!"

"We have slightly nerdier tours, like the 'Jane Jacobs versus Robert Moses' walk, which I'm especially proud of because I think it taps into the DNA of our podcast," says Meyers. "I had dreamed of that tour for years, but it wasn't until we finally got the perfect guide, Aaron Shielke, to research and write it, that the reality happened. Today it's one of our most popular walks and Aaron now even gives tours to city planners!"

(To know me is to know that I just had a full-on dorkgasm regarding the description of that walk.)

"This can be a dream job if you do it right," says Randy Walker , a New Orleans-based writer who has hosted French Quarter ghost adventures, primarily through Haunted History Tours , for over a decade. "Whether the night is awful, exciting, or both, it is never boring."

It also goes without saying that if you're looking to entertain visitors underneath the umbrella of an established company? Make sure you know a bit about the damn company.

"Our prospective guides have to be good storytellers, obsessed with New York history, and have a sense of humor," advises Meyers. "They also have to know the show — we don't test them, but they do get bonus points if they point out things we said in any of our past 430 episodes!"

Related: Can a Great Bloody Mary Cure a Bar's Financial Hangover?

Getting the word out on the street

"We were word-of-mouth, listings in print media and 'pagers plus payphones,'" remembers Kamil. "I approached Big Onion like a business, leading tours and presenting a full walk even if only one person showed up — it cannot be all about making money in the short-term because building a dedicated client base is more important."

The word-of-mouth thing works for me, but further afield necessities, like securing a website and dealing with eventual online anger, were worrisome.

"Those things are horrible because you have no power and one insult negates hundreds of compliments," laments Walker of online-reprobates-masquerading-as-objective-reviewers. "I equate it to that Adam-Sandler-running-a-resort sketch when he was hosting Saturday Night Live : 'If you're sad now, you'll probably feel sad there .' Basically, Yelp was invented by angry white people."

Adds Tom of live hecklers: "It's quite common for passing pedestrians to add their own commentary. Greg and I were once filming something in Seward Park when a woman in her 80s interrupted the shoot yelling, 'What do THEY know, why don't you ask ME?!' Of course, she was probably right."

The name game

Regarding my business's moniker, my long-time Compound Media graphic artist/genius, Matt Smith , kindly provided me with the below image and preliminary title, but as for a permanent name? I'm not married to Thirsty History Tours, Liver Let Die Historical Bar Crawls, Bar Apple Walking Tours, Old Brew York Tours, Pisstorical Bar Crawls or — even though blunt is usually best — Historic Big Apple Bar Crawls.

Credit: Matt Smith @FiveFanPS

None of my options moved me unless, you know, a site containing any of those words is still available. As anyone who has ever tried to name something knows, anything you really like is already taken. "We grabbed our domain name in the 1990s, so it wasn't hard back then," notes Kamil.

Come to think of it? I probably should've kept, even the crappiest of these nominees, to myself.

Making it legal (and funded)

Then there's the getting legit bit: New York has always found new ways to fun-police any small business and my category is no different. Sightseeing guides, in all shapes or forms, must be licensed . So the most daunting requirement for this former C-student was taking the local history exam. This quiz consists of 150 questions, requiring a minimum of 97 correct answers, plus a nonrefundable $50 exam fee. (Yikes.)

"We are big advocates of the Guides Association and we only hire those who have passed the official exam," explains Meyers. "But our guides love that test because taking it is like a night out for bar trivia!"

(Thanks for that, Tom. Doesn't make feel even remotely more confident about this test.)

In happier paperwork news, the Alliance for Downtown New York's Walking Tour Incubator Grant Program gives money to entrepreneurs starting walking tours in lower Manhattan. [Note: If me writing about starting a walking tour in lower Manhattan for Entrepreneur doesn't get me a grant based on entrepreneurs starting walking tours in lower Manhattan? Well, it's time to look into the lucrative work that is ditch digging.]

Expect the (alcohol-infused) unexpected

"I was hosting one tour on The Bowery and a man walked out of a flophouse, approached our group, dropped his pants and said to a client, 'Will you be the mother of my children?'" recalls Kamil of a 1994 gig. "We quickly walked away with the woman being shocked, her date angry and me telling them I should charge extra as they will tell this story forever."

While 24/7 intoxicated interlopers are an expected Manhattan job hazard, The Big Apple's got nothing on The Big Easy.

"My very first night, I'm nervously trying to hit every word correctly in front of a bachelorette party and, as I am doing this, a rubbery thing hits me on the cheek," winces Walker. "Well, they had an inflatable sex doll and decided to rub its dick into my face." Tenured tour guides also excel at picking out the free-loaders.

"It's common to have people try to join the group, thinking they're being sly," laughs Meyers. "We see you!" Related: At the Comedy Cellar, the Customer Is Always Right - Entrepreneur

On-the-asphalt experience

I've inadvertently been training for this labor of love per previous pieces on The Ear Inn (via both New York magazine plus a video package for Maxim ), Neir's ( Entrepreneur ) and The Heidelberg ( The New York Times ) for my entire adult life.

Yael Bar-tur, social media consultant and co-host of the awesome Ask A Jew podcast, recently let me premiere my business for her 40 th birthday which included…*gulp*… 30 of her closest pals. Yael's feedback was encouraging, yet vaguely insulting: "You were so thorough and meticulous in your preparation that it reminded me of those homeless people who walk around with a stack full of notes while mumbling to themselves." But it went well enough that I heard from some friends of her friends wondering if I could helm a follow-up walk for the much easier group of four. Answer? Yes!

Robin and Nick Meahn, of the latter party, emailed a much kinder review: "You're a riot! Great bars, comfortable pace, crazy history — definitely a fun way to spend an afternoon in the city!" My most recent effort centered around another birthday via Emmy-award-winning reporter and two-time Drunk History vet Lauren Sivan. This little-sister-I-never-wanted was game to the point of dressing up as " Sexy Alexander Hamilton " during the proceedings. Not to be outdone and to paraphrase an old adage: Dress for the job you want, not the job you…uh…currently don't have, I wore a movie-accurate homage to Daniel Day Lewis's "Bill The Butcher" character in 2002's Gangs Of New York. A nnoyingly, Sivan assumed I was going as Willy Wonka .

On these three initial tours, we hit Paris Café (1873), The Dead Rabbit , (2013, but the edifice was built in 1828), Fraunces Tavern (a debatable 1762), Old Town Bar (1892), Pete's Tavern (1864), and an indefensible Joey Roses (2022, mostly because comedian, Joe DeRosa, was on Sivan's tour and owns the joint).

The stops went great, I studied up on all of the locales, but boy was I nervous about getting stumped by super inquisitive patrons. This, it turns out, is not a fear unique to me. "Every new guide fears answering a question with the response: 'I don't know'", advises Walker. "The reality is there's so much history, nobody knows it all and most tourists are there to have a good time while rooting for you."

There are no small tours, only small tips

A reporter once asked Yankee great, Joe DiMaggio, why he played so hard during meaningless games. The Hall of Famer's response: "There might have been somebody in the stands today who'd never seen me play before and might never see me again."

Seth discovered the simple truth firsthand of why you need to go big every single outing during an early Big Onion gig. "We learned this on a rainy day in 1992 when one person showed up and I did the full walk for all of $10," recalls Kamil. His decision not to cancel or give it less than his all became his first big break. "The person on the tour ended up being an editor for The Washington Post and we were subsequently featured on the front page of their Sunday travel section."

Positive press is the kind of payment money can't buy, but actual gratuities are the gain when it comes to this game and my guy in NOLA learned this lesson when it came to being cute while requesting a little something for the effort.

"We try different things and the dumbest one I ever did was saying 'tips OR hugs are welcome'", laughs Walker. "Sure enough, 30 pairs of eyes lit up, drunkenly embraced me, but did NOT fill my wallet."

Adds Randy: "If I don't make $80 to $100 per tour, I'm not happy. There's no science to it, you can't tell who's going to be a good or bad tipper."

To quote the aforementioned Bill The Butcher: "Don't you NEVER come in here empty-handed again, you gotta PAY for the pleasure of MY company!"

My three downtown events garnered a little over two grand and I don't pretend that this will be the average take as things progress. Yet with more movable feasts on the ole calendar, it has occurred to me that this might be the one freelance gig that AI can't take. Yet .

Related: 7 Ways to Snag Tourist Dollars and Keep Locals Happy at the Same Time

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Can Drinking Tea Improve Your Bone Health?

Key takeaway.

A new study suggests that drinking certain kinds of tea may be linked to positive bone health outcomes.
Drinking tea isn’t enough to protect your bones as you age, so it’s important to think about other dietary and lifestyle changes that promote healthy bones.

Since your bones support and protect organs, anchor muscles, and store calcium, finding proactive ways to keep them strong as you get older is necessary for a long, healthy life.

Eating plenty of calcium-rich foods and participating in impact exercise (like jumping) are the usual recommendations for bone health, as well as avoiding caffeinated beverages like tea and coffee. But if you’re a tea lover who also wants strong bones , new data published in Frontiers in Nutrition may offer some reassurance.

Related: Oolong Tea: Benefits, Nutrients, & More

Tea: Bad for the Bones?

While some research has found that caffeine consumption may not be your body’s best friend when it comes to bone health, evidence suggests the benefits of other bioactive compounds in tea outweigh any cons of its caffeine content. Observational studies have shown that tea consumption does not contribute to calcium loss or reduced bone density.

Researchers think the anti-inflammatory benefits that tea drinkers get from the beverage may have something to do with its positive bone health-supporting effects.

Some studies have suggested that for post-menopausal women, the plant compounds found in true tea, like green tea, may have estrogen-like activities, which can help the body maintain bone health after the natural reduction in bone-supporting estrogen that happens during this life stage.

For example, a study from 2022 that included 3,530 postmenopausal women found that participants who consumed 1–3 cups of green tea daily had significantly lower rates of osteopenia (weakened bones) and osteoporosis (decreased bone mass) compared to people who either did not consume green tea or consumed less than one cup daily.

Related: Can Green Tea Prevent Rheumatoid Arthritis?

Testing Tea’s Bone-Boosting Benefits

Most research on tea consumption linked to positive bone health effects has largely been based on observational data, making it hard to prove there’s a cause-and-effect relationship.

To change the perspective on studying tea and bone health, researchers in China explored the potential link without leaning on observational data. Instead, they performed Mendelian randomization analyses, which meant they used genetic variations to help them draw conclusions and control for variables that could affect the results.

How Mendelian Randomization Works

Everyone has slight differences in the DNA sequence or genetic variations. These differences are linked to our different traits or characteristics, such as eye color, blood type, or increased chances of getting certain diseases.

Mendelian randomization is like a natural experiment scientists use to figure out if one thing (like a certain gene variation) actually causes a health outcome (such as a higher risk of a specific disease) without the confusion of other factors that could affect the results.

What’s key about these studies is that the researchers can think about genes being assigned randomly at birth, like a randomized controlled trial. From there, they can look at whether a gene is linked to both an exposure and outcome and feel more confident that the relationship is cause-and-effect.

Ultimately, researchers were looking to see how total body bone mineral density did or did not improve based on tea consumption. Healthy bone mineral density is crucial because it is a marker of bone strength and overall bone health. High bone density may reduce the risk of fractures , especially in older adults, for whom even minor falls can lead to serious injuries.

The results showed that individuals with a genetic inclination toward drinking more tea also had a higher likelihood of increased total bone mineral density. (Yes, there are variations in DNA sequences associated with liking tea.) This was most notable among the participants who were between the ages of 45 and 60 years old.

Related: Experts: Drink Tea for Your Body and Mind

The researchers said that their study debunked the misconception that drinking tea leads to osteoporosis, suggesting instead that tea can actually improve bone density. But right now, they can only infer this may be the case among people inclined to drink tea to begin with. In subgroup analyses, the researchers did not find a causal relationship between bone density and specific teas themselves, including green tea and herbal tea.

“While this study shows promising results for the benefits of drinking tea on bone mass , it was conducted solely on the European population,” Melissa Mitri, RDN , a Connecticut-based dietitian writer who is unaffiliated with the study, told Verywell. “More research is needed to confirm if these same benefits would apply to the global population.”

Alyssa Smolen, RDN , a New Jersey-based dietitian, said she is not surprised by the results.

“To the general public, drinking tea is considered a healthy behavior and normally poses no threats to one’s health,” she told Verywell. “The results only confirm the health benefit of drinking tea, especially to an older population.”

Related: Can Drinking Tea Interfere With Iron Absorption?

Other Ways to Support Bone Health

Tea alone is not enough to give you strong bones. You also need to take other steps to support bone health as you age.

Eat More Prunes

Research has shown that eating around 50 grams of prunes every day (that’s around 4-6 prunes) may help preserve hip bone mineral density in postmenopausal women . Researchers think that this effect could be because of prunes’ anti-inflammatory effects, phenolic compounds, and bone health-supporting micronutrients.

Related: Is There a Cure for Osteoporosis?

Do Impact Exercise

High-impact exercises, such as running, jumping rope, or plyometrics, are particularly beneficial for bone health. These activities create stress on the bones (which is a positive thing!), stimulating the bone-forming cells to increase bone density over time. This process helps reduce the risk of osteoporosis and bone fractures, making high-impact exercises an essential component of a well-rounded fitness routine.

Don’t Forget the Milk

Milk is widely recognized for its vital role in bone health, mostly because of its rich calcium and vitamin D content. These nutrients are essential for building and maintaining strong bones, which helps prevent diseases like osteoporosis. The protein in milk also contributes to bone strength, making it a key dietary player for supporting skeletal health .

Some data suggests that the lactose in dairy milk may enhance calcium absorption. If you are not a dairy milk drinker, choose milk alternatives that have bone health-supporting nutrients like vitamin D added to them.

Related: Supplements for Bone Health: Essential Vitamins & Minerals

Limit Alcohol and Avoid Cigarette Smoking

Limiting alcohol and avoiding cigarette smoking also support strong bone health. Excessive alcohol intake can interfere with the balance of calcium in the body, which is essential for bone density , while smoking has been shown to reduce blood flow to the bones, which can affect the delivery of essential nutrients to the skeletal structures. Together, these lifestyle choices not only weaken the skeletal structure but also slow down the healing process after fractures.

What This Means for You

While drinking true tea isn’t enough to keep your bones healthy, you may not need to totally avoid it if you want to keep your bones strong as you age. Incorporating calcium and vitamin D-rich foods in your diet, doing impact exercise, and avoiding smoking and alcohol can also protect your bone health.

Read the original article on Verywell Health .

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National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2012.

Cover of Preventing Tobacco Use Among Youth and Young Adults

Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General.

1 introduction, summary, and conclusions.

Introduction

Tobacco use is a global epidemic among young people. As with adults, it poses a serious health threat to youth and young adults in the United States and has significant implications for this nation’s public and economic health in the future ( Perry et al. 1994 ; Kessler 1995 ). The impact of cigarette smoking and other tobacco use on chronic disease, which accounts for 75% of American spending on health care ( Anderson 2010 ), is well-documented and undeniable. Although progress has been made since the first Surgeon General’s report on smoking and health in 1964 ( U.S. Department of Health, Education, and Welfare [USDHEW] 1964 ), nearly one in four high school seniors is a current smoker. Most young smokers become adult smokers. One-half of adult smokers die prematurely from tobacco-related diseases ( Fagerström 2002 ; Doll et al. 2004 ). Despite thousands of programs to reduce youth smoking and hundreds of thousands of media stories on the dangers of tobacco use, generation after generation continues to use these deadly products, and family after family continues to suffer the devastating consequences. Yet a robust science base exists on social, biological, and environmental factors that influence young people to use tobacco, the physiology of progression from experimentation to addiction, other health effects of tobacco use, the epidemiology of youth and young adult tobacco use, and evidence-based interventions that have proven effective at reducing both initiation and prevalence of tobacco use among young people. Those are precisely the issues examined in this report, which aims to support the application of this robust science base.

Nearly all tobacco use begins in childhood and adolescence ( U.S. Department of Health and Human Services [USDHHS] 1994 ). In all, 88% of adult smokers who smoke daily report that they started smoking by the age of 18 years (see Chapter 3 , “The Epidemiology of Tobacco Use Among Young People in the United States and Worldwide”). This is a time in life of great vulnerability to social influences ( Steinberg 2004 ), such as those offered through the marketing of tobacco products and the modeling of smoking by attractive role models, as in movies ( Dalton et al. 2009 ), which have especially strong effects on the young. This is also a time in life of heightened sensitivity to normative influences: as tobacco use is less tolerated in public areas and there are fewer social or regular users of tobacco, use decreases among youth ( Alesci et al. 2003 ). And so, as we adults quit, we help protect our children.

Cigarettes are the only legal consumer products in the world that cause one-half of their long-term users to die prematurely ( Fagerström 2002 ; Doll et al. 2004 ). As this epidemic continues to take its toll in the United States, it is also increasing in low- and middle-income countries that are least able to afford the resulting health and economic consequences ( Peto and Lopez 2001 ; Reddy et al. 2006 ). It is past time to end this epidemic. To do so, primary prevention is required, for which our focus must be on youth and young adults. As noted in this report, we now have a set of proven tools and policies that can drastically lower youth initiation and use of tobacco products. Fully committing to using these tools and executing these policies consistently and aggressively is the most straight forward and effective to making future generations tobacco-free.

The 1994 Surgeon General’s Report

This Surgeon General’s report on tobacco is the second to focus solely on young people since these reports began in 1964. Its main purpose is to update the science of smoking among youth since the first comprehensive Surgeon General’s report on tobacco use by youth, Preventing Tobacco Use Among Young People , was published in 1994 ( USDHHS 1994 ). That report concluded that if young people can remain free of tobacco until 18 years of age, most will never start to smoke. The report documented the addiction process for young people and how the symptoms of addiction in youth are similar to those in adults. Tobacco was also presented as a gateway drug among young people, because its use generally precedes and increases the risk of using illicit drugs. Cigarette advertising and promotional activities were seen as a potent way to increase the risk of cigarette smoking among young people, while community-wide efforts were shown to have been successful in reducing tobacco use among youth. All of these conclusions remain important, relevant, and accurate, as documented in the current report, but there has been considerable research since 1994 that greatly expands our knowledge about tobacco use among youth, its prevention, and the dynamics of cessation among young people. Thus, there is a compelling need for the current report.

Tobacco Control Developments

Since 1994, multiple legal and scientific developments have altered the tobacco control environment and thus have affected smoking among youth. The states and the U.S. Department of Justice brought lawsuits against cigarette companies, with the result that many internal documents of the tobacco industry have been made public and have been analyzed and introduced into the science of tobacco control. Also, the 1998 Master Settlement Agreement with the tobacco companies resulted in the elimination of billboard and transit advertising as well as print advertising that directly targeted underage youth and limitations on the use of brand sponsorships ( National Association of Attorneys General [NAAG] 1998 ). This settlement also created the American Legacy Foundation, which implemented a nationwide antismoking campaign targeting youth. In 2009, the U.S. Congress passed a law that gave the U.S. Food and Drug Administration authority to regulate tobacco products in order to promote the public’s health ( Family Smoking Prevention and Tobacco Control Act 2009 ). Certain tobacco companies are now subject to regulations limiting their ability to market to young people. In addition, they have had to reimburse state governments (through agreements made with some states and the Master Settlement Agreement) for some health care costs. Due in part to these changes, there was a decrease in tobacco use among adults and among youth following the Master Settlement Agreement, which is documented in this current report.

Recent Surgeon General Reports Addressing Youth Issues

Other reports of the Surgeon General since 1994 have also included major conclusions that relate to tobacco use among youth ( Office of the Surgeon General 2010 ). In 1998, the report focused on tobacco use among U.S. racial/ethnic minority groups ( USDHHS 1998 ) and noted that cigarette smoking among Black and Hispanic youth increased in the 1990s following declines among all racial/ethnic groups in the 1980s; this was particularly notable among Black youth, and culturally appropriate interventions were suggested. In 2000, the report focused on reducing tobacco use ( USDHHS 2000b ). A major conclusion of that report was that school-based interventions, when implemented with community- and media-based activities, could reduce or postpone the onset of smoking among adolescents by 20–40%. That report also noted that effective regulation of tobacco advertising and promotional activities directed at young people would very likely reduce the prevalence and onset of smoking. In 2001, the Surgeon General’s report focused on women and smoking ( USDHHS 2001 ). Besides reinforcing much of what was discussed in earlier reports, this report documented that girls were more affected than boys by the desire to smoke for the purpose of weight control. Given the ongoing obesity epidemic ( Bonnie et al. 2007 ), the current report includes a more extensive review of research in this area.

The 2004 Surgeon General’s report on the health consequences of smoking ( USDHHS 2004 ) concluded that there is sufficient evidence to infer that a causal relationship exists between active smoking and (a) impaired lung growth during childhood and adolescence; (b) early onset of decline in lung function during late adolescence and early adulthood; (c) respiratory signs and symptoms in children and adolescents, including coughing, phlegm, wheezing, and dyspnea; and (d) asthma-related symptoms (e.g., wheezing) in childhood and adolescence. The 2004 Surgeon General’s report further provided evidence that cigarette smoking in young people is associated with the development of atherosclerosis.

The 2010 Surgeon General’s report on the biology of tobacco focused on the understanding of biological and behavioral mechanisms that might underlie the pathogenicity of tobacco smoke ( USDHHS 2010 ). Although there are no specific conclusions in that report regarding adolescent addiction, it does describe evidence indicating that adolescents can become dependent at even low levels of consumption. Two studies ( Adriani et al. 2003 ; Schochet et al. 2005 ) referenced in that report suggest that because the adolescent brain is still developing, it may be more susceptible and receptive to nicotine than the adult brain.

Scientific Reviews

Since 1994, several scientific reviews related to one or more aspects of tobacco use among youth have been undertaken that also serve as a foundation for the current report. The Institute of Medicine (IOM) ( Lynch and Bonnie 1994 ) released Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths, a report that provided policy recommendations based on research to that date. In 1998, IOM provided a white paper, Taking Action to Reduce Tobacco Use, on strategies to reduce the increasing prevalence (at that time) of smoking among young people and adults. More recently, IOM ( Bonnie et al. 2007 ) released a comprehensive report entitled Ending the Tobacco Problem: A Blueprint for the Nation . Although that report covered multiple potential approaches to tobacco control, not just those focused on youth, it characterized the overarching goal of reducing smoking as involving three distinct steps: “reducing the rate of initiation of smoking among youth (IOM [ Lynch and Bonnie] 1994 ), reducing involuntary tobacco smoke exposure ( National Research Council 1986 ), and helping people quit smoking” (p. 3). Thus, reducing onset was seen as one of the primary goals of tobacco control.

As part of USDHHS continuing efforts to assess the health of the nation, prevent disease, and promote health, the department released, in 2000, Healthy People 2010 and, in 2010, Healthy People 2020 ( USDHHS 2000a , 2011 ). Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of prevention activities. Each iteration of Healthy People serves as the nation’s disease prevention and health promotion roadmap for the decade. Both Healthy People 2010 and Healthy People 2020 highlight “Tobacco Use” as one of the nation’s “Leading Health Indicators,” feature “Tobacco Use” as one of its topic areas, and identify specific measurable tobacco-related objectives and targets for the nation to strive for. Healthy People 2010 and Healthy People 2020 provide tobacco objectives based on the most current science and detailed population-based data to drive action, assess tobacco use among young people, and identify racial and ethnic disparities. Additionally, many of the Healthy People 2010 and 2020 tobacco objectives address reductions of tobacco use among youth and target decreases in tobacco advertising in venues most often influencing young people. A complete list of the healthy people 2020 objectives can be found on their Web site ( USDHHS 2011 ).

In addition, the National Cancer Institute (NCI) of the National Institutes of Health has published monographs pertinent to the topic of tobacco use among youth. In 2001, NCI published Monograph 14, Changing Adolescent Smoking Prevalence , which reviewed data on smoking among youth in the 1990s, highlighted important statewide intervention programs, presented data on the influence of marketing by the tobacco industry and the pricing of cigarettes, and examined differences in smoking by racial/ethnic subgroup ( NCI 2001 ). In 2008, NCI published Monograph 19, The Role of the Media in Promoting and Reducing Tobacco Use ( NCI 2008 ). Although young people were not the sole focus of this Monograph, the causal relationship between tobacco advertising and promotion and increased tobacco use, the impact on youth of depictions of smoking in movies, and the success of media campaigns in reducing youth tobacco use were highlighted as major conclusions of the report.

The Community Preventive Services Task Force (2011) provides evidence-based recommendations about community preventive services, programs, and policies on a range of topics including tobacco use prevention and cessation ( Task Force on Community Preventive Services 2001 , 2005 ). Evidence reviews addressing interventions to reduce tobacco use initiation and restricting minors’ access to tobacco products were cited and used to inform the reviews in the current report. The Cochrane Collaboration (2010) has also substantially contributed to the review literature on youth and tobacco use by producing relevant systematic assessments of health-related programs and interventions. Relevant to this Surgeon General’s report are Cochrane reviews on interventions using mass media ( Sowden 1998 ), community interventions to prevent smoking ( Sowden and Stead 2003 ), the effects of advertising and promotional activities on smoking among youth ( Lovato et al. 2003 , 2011 ), preventing tobacco sales to minors ( Stead and Lancaster 2005 ), school-based programs ( Thomas and Perara 2006 ), programs for young people to quit using tobacco ( Grimshaw and Stanton 2006 ), and family programs for preventing smoking by youth ( Thomas et al. 2007 ). These reviews have been cited throughout the current report when appropriate.

In summary, substantial new research has added to our knowledge and understanding of tobacco use and control as it relates to youth since the 1994 Surgeon General’s report, including updates and new data in subsequent Surgeon General’s reports, in IOM reports, in NCI Monographs, and in Cochrane Collaboration reviews, in addition to hundreds of peer-reviewed publications, book chapters, policy reports, and systematic reviews. Although this report is a follow-up to the 1994 report, other important reviews have been undertaken in the past 18 years and have served to fill the gap during an especially active and important time in research on tobacco control among youth.

Focus of the Report

Young People

This report focuses on “young people.” In general, work was reviewed on the health consequences, epidemiology, etiology, reduction, and prevention of tobacco use for those in the young adolescent (11–14 years of age), adolescent (15–17 years of age), and young adult (18–25 years of age) age groups. When possible, an effort was made to be specific about the age group to which a particular analysis, study, or conclusion applies. Because hundreds of articles, books, and reports were reviewed, however, there are, unavoidably, inconsistencies in the terminology used. “Adolescents,” “children,” and “youth” are used mostly interchangeably throughout this report. In general, this group encompasses those 11–17 years of age, although “children” is a more general term that will include those younger than 11 years of age. Generally, those who are 18–25 years old are considered young adults (even though, developmentally, the period between 18–20 years of age is often labeled late adolescence), and those 26 years of age or older are considered adults.

In addition, it is important to note that the report is concerned with active smoking or use of smokeless tobacco on the part of the young person. The report does not consider young people’s exposure to secondhand smoke, also referred to as involuntary or passive smoking, which was discussed in the 2006 report of the Surgeon General ( USDHHS 2006 ). Additionally, the report does not discuss research on children younger than 11 years old; there is very little evidence of tobacco use in the United States by children younger than 11 years of age, and although there may be some predictors of later tobacco use in those younger years, the research on active tobacco use among youth has been focused on those 11 years of age and older.

Tobacco Use

Although cigarette smoking is the most common form of tobacco use in the United States, this report focuses on other forms as well, such as using smokeless tobacco (including chew and snuff) and smoking a product other than a cigarette, such as a pipe, cigar, or bidi (tobacco wrapped in tendu leaves). Because for young people the use of one form of tobacco has been associated with use of other tobacco products, it is particularly important to monitor all forms of tobacco use in this age group. The term “tobacco use” in this report indicates use of any tobacco product. When the word “smoking” is used alone, it refers to cigarette smoking.

Organization of the Report

This chapter begins by providing a short synopsis of other reports that have addressed smoking among youth and, after listing the major conclusions of this report, will end by presenting conclusions specific to each chapter. Chapter 2 of this report (“The Health Consequences of Tobacco Use Among Young People”) focuses on the diseases caused by early tobacco use, the addiction process, the relation of body weight to smoking, respiratory and pulmonary problems associated with tobacco use, and cardiovascular effects. Chapter 3 (“The Epidemiology of Tobacco Use Among Young People in the United States and Worldwide”) provides recent and long-term cross-sectional and longitudinal data on cigarette smoking, use of smokeless tobacco, and the use of other tobacco products by young people, by racial/ethnic group and gender, primarily in the United States, but including some worldwide data as well. Chapter 4 (“Social, Environmental, Cognitive, and Genetic Influences on the Use of Tobacco Among Youth”) identifies the primary risk factors associated with tobacco use among youth at four levels, including the larger social and physical environments, smaller social groups, cognitive factors, and genetics and neurobiology. Chapter 5 (“The Tobacco Industry’s Influences on the Use of Tobacco Among Youth”) includes data on marketing expenditures for the tobacco industry over time and by category, the effects of cigarette advertising and promotional activities on young people’s smoking, the effects of price and packaging on use, the use of the Internet and movies to market tobacco products, and an evaluation of efforts by the tobacco industry to prevent tobacco use among young people. Chapter 6 (“Efforts to Prevent and Reduce Tobacco Use Among Young People”) provides evidence on the effectiveness of family-based, clinic-based, and school-based programs, mass media campaigns, regulatory and legislative approaches, increased cigarette prices, and community and statewide efforts in the fight against tobacco use among youth. Chapter 7 (“A Vision for Ending the Tobacco Epidemic”) points to next steps in preventing and reducing tobacco use among young people.

Preparation of the Report

This report of the Surgeon General was prepared by the Office on Smoking and Health (OSH), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), USDHHS. In 2008, 18 external independent scientists reviewed the 1994 report and suggested areas to be added and updated. These scientists also suggested chapter editors and a senior scientific editor, who were contacted by OSH. Each chapter editor named external scientists who could contribute, and 33 content experts prepared draft sections. The draft sections were consolidated into chapters by the chapter editors and then reviewed by the senior scientific editor, with technical editing performed by CDC. The chapters were sent individually to 34 peer reviewers who are experts in the areas covered and who reviewed the chapters for scientific accuracy and comprehensiveness. The entire manuscript was then sent to more than 25 external senior scientists who reviewed the science of the entire document. After each review cycle, the drafts were revised by the chapter and senior scientific editor on the basis of the experts’ comments. Subsequently, the report was reviewed by various agencies within USDHHS. Publication lags prevent up-to-the-minute inclusion of all recently published articles and data, and so some more recent publications may not be cited in this report.

Evaluation of the Evidence

Since the first Surgeon General’s report in 1964 on smoking and health ( USDHEW 1964 ), major conclusions concerning the conditions and diseases caused by cigarette smoking and the use of smokeless tobacco have been based on explicit criteria for causal inference ( USDHHS 2004 ). Although a number of different criteria have been proposed for causal inference since the 1960s, this report focuses on the five commonly accepted criteria that were used in the original 1964 report and that are discussed in greater detail in the 2004 report on the health consequences of smoking ( USDHHS 2004 ). The five criteria refer to the examination of the association between two variables, such as a risk factor (e.g., smoking) and an outcome (e.g., lung cancer). Causal inference between these variables is based on (1) the consistency of the association across multiple studies; this is the persistent finding of an association in different persons, places, circumstances, and times; (2) the degree of the strength of association, that is, the magnitude and statistical significance of the association in multiple studies; (3) the specificity of the association to clearly demonstrate that tobacco use is robustly associated with the condition, even if tobacco use has multiple effects and multiple causes exist for the condition; (4) the temporal relationship of the association so that tobacco use precedes disease onset; and (5) the coherence of the association, that is, the argument that the association makes scientific sense, given data from other sources and understanding of biological and psychosocial mechanisms ( USDHHS 2004 ). Since the 2004 Surgeon General’s report, The Health Consequences of Smoking , a four-level hierarchy ( Table 1.1 ) has been used to assess the research data on associations discussed in these reports ( USDHHS 2004 ). In general, this assessment was done by the chapter editors and then reviewed as appropriate by peer reviewers, senior scientists, and the scientific editors. For a relationship to be considered sufficient to be characterized as causal, multiple studies over time provided evidence in support of each criteria.

Four-level hierarchy for classifying the strength of causal inferences based on available evidence.

When a causal association is presented in the chapter conclusions in this report, these four levels are used to describe the strength of the evidence of the association, from causal (1) to not causal (4). Within the report, other terms are used to discuss the evidence to date (i.e., mixed, limited, and equivocal evidence), which generally represent an inadequacy of data to inform a conclusion.

However, an assessment of a casual relationship is not utilized in presenting all of the report’s conclusions. The major conclusions are written to be important summary statements that are easily understood by those reading the report. Some conclusions, particularly those found in Chapter 3 (epidemiology), provide observations and data related to tobacco use among young people, and are generally not examinations of causal relationships. For those conclusions that are written using the hierarchy above, a careful and extensive review of the literature has been undertaken for this report, based on the accepted causal criteria ( USDHHS 2004 ). Evidence that was characterized as Level 1 or Level 2 was prioritized for inclusion as chapter conclusions.

In additional to causal inferences, statistical estimation and hypothesis testing of associations are presented. For example, confidence intervals have been added to the tables in the chapter on the epidemiology of youth tobacco use (see Chapter 3 ), and statistical testing has been conducted for that chapter when appropriate. The chapter on efforts to prevent tobacco use discusses the relative improvement in tobacco use rates when implementing one type of program (or policy) versus a control program. Statistical methods, including meta-analytic methods and longitudinal trajectory analyses, are also presented to ensure that the methods of evaluating data are up to date with the current cutting-edge research that has been reviewed. Regardless of the methods used to assess significance, the five causal criteria discussed above were applied in developing the conclusions of each chapter and the report.

Major Conclusions
Cigarette smoking by youth and young adults has immediate adverse health consequences, including addiction, and accelerates the development of chronic diseases across the full life course.
Prevention efforts must focus on both adolescents and young adults because among adults who become daily smokers, nearly all first use of cigarettes occurs by 18 years of age (88%), with 99% of first use by 26 years of age.
Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults.
After years of steady progress, declines in the use of tobacco by youth and young adults have slowed for cigarette smoking and stalled for smokeless tobacco use.
Coordinated, multicomponent interventions that combine mass media campaigns, price increases including those that result from tax increases, school-based policies and programs, and statewide or community-wide changes in smoke-free policies and norms are effective in reducing the initiation, prevalence, and intensity of smoking among youth and young adults.
Chapter Conclusions

The following are the conclusions presented in the substantive chapters of this report.

Chapter 2. The Health Consequences of Tobacco Use Among Young People

The evidence is sufficient to conclude that there is a causal relationship between smoking and addiction to nicotine, beginning in adolescence and young adulthood.
The evidence is suggestive but not sufficient to conclude that smoking contributes to future use of marijuana and other illicit drugs.
The evidence is suggestive but not sufficient to conclude that smoking by adolescents and young adults is not associated with significant weight loss, contrary to young people’s beliefs.
The evidence is sufficient to conclude that there is a causal relationship between active smoking and both reduced lung function and impaired lung growth during childhood and adolescence.
The evidence is sufficient to conclude that there is a causal relationship between active smoking and wheezing severe enough to be diagnosed as asthma in susceptible child and adolescent populations.
The evidence is sufficient to conclude that there is a causal relationship between smoking in adolescence and young adulthood and early abdominal aortic atherosclerosis in young adults.
The evidence is suggestive but not sufficient to conclude that there is a causal relationship between smoking in adolescence and young adulthood and coronary artery atherosclerosis in adulthood.

Chapter 3. The Epidemiology of Tobacco Use Among Young People in the United States and Worldwide

Among adults who become daily smokers, nearly all first use of cigarettes occurs by 18 years of age (88%), with 99% of first use by 26 years of age.
Almost one in four high school seniors is a current (in the past 30 days) cigarette smoker, compared with one in three young adults and one in five adults. About 1 in 10 high school senior males is a current smokeless tobacco user, and about 1 in 5 high school senior males is a current cigar smoker.
Among adolescents and young adults, cigarette smoking declined from the late 1990s, particularly after the Master Settlement Agreement in 1998. This decline has slowed in recent years, however.
Significant disparities in tobacco use remain among young people nationwide. The prevalence of cigarette smoking is highest among American Indians and Alaska Natives, followed by Whites and Hispanics, and then Asians and Blacks. The prevalence of cigarette smoking is also highest among lower socioeconomic status youth.
Use of smokeless tobacco and cigars declined in the late 1990s, but the declines appear to have stalled in the last 5 years. The latest data show the use of smokeless tobacco is increasing among White high school males, and cigar smoking may be increasing among Black high school females.
Concurrent use of multiple tobacco products is prevalent among youth. Among those who use tobacco, nearly one-third of high school females and more than one-half of high school males report using more than one tobacco product in the last 30 days.
Rates of tobacco use remain low among girls relative to boys in many developing countries, however, the gender gap between adolescent females and males is narrow in many countries around the globe.

Chapter 4. Social, Environmental, Cognitive, and Genetic Influences on the Use of Tobacco Among Youth

Given their developmental stage, adolescents and young adults are uniquely susceptible to social and environmental influences to use tobacco.
Socioeconomic factors and educational attainment influence the development of youth smoking behavior. The adolescents most likely to begin to use tobacco and progress to regular use are those who have lower academic achievement.
The evidence is sufficient to conclude that there is a causal relationship between peer group social influences and the initiation and maintenance of smoking behaviors during adolescence.
Affective processes play an important role in youth smoking behavior, with a strong association between youth smoking and negative affect.
The evidence is suggestive that tobacco use is a heritable trait, more so for regular use than for onset. The expression of genetic risk for smoking among young people may be moderated by small-group and larger social-environmental factors.

Chapter 5. The Tobacco Industry’s Influences on the Use of Tobacco Among Youth

In 2008, tobacco companies spent $9.94 billion on the marketing of cigarettes and $547 million on the marketing of smokeless tobacco. Spending on cigarette marketing is 48% higher than in 1998, the year of the Master Settlement Agreement. Expenditures for marketing smokeless tobacco are 277% higher than in 1998.
Tobacco company expenditures have become increasingly concentrated on marketing efforts that reduce the prices of targeted tobacco products. Such expenditures accounted for approximately 84% of cigarette marketing and more than 77% of the marketing of smokeless tobacco products in 2008.
The evidence is sufficient to conclude that there is a causal relationship between advertising and promotional efforts of the tobacco companies and the initiation and progression of tobacco use among young people.
The evidence is suggestive but not sufficient to conclude that tobacco companies have changed the packaging and design of their products in ways that have increased these products’ appeal to adolescents and young adults.
The tobacco companies’ activities and programs for the prevention of youth smoking have not demonstrated an impact on the initiation or prevalence of smoking among young people.
The evidence is sufficient to conclude that there is a causal relationship between depictions of smoking in the movies and the initiation of smoking among young people.

Chapter 6. Efforts to Prevent and Reduce Tobacco Use Among Young People

The evidence is sufficient to conclude that mass media campaigns, comprehensive community programs, and comprehensive statewide tobacco control programs can prevent the initiation of tobacco use and reduce its prevalence among youth.
The evidence is sufficient to conclude that increases in cigarette prices reduce the initiation, prevalence, and intensity of smoking among youth and young adults.
The evidence is sufficient to conclude that school-based programs with evidence of effectiveness, containing specific components, can produce at least short-term effects and reduce the prevalence of tobacco use among school-aged youth.
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Cite this Page National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2012. 1, Introduction, Summary, and Conclusions.
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1 Introduction, Summary, and Conclusions
Tobacco use is a global epidemic among young people. As with adults, it poses a serious health threat to youth and young adults in the United States and has significant implications for this nation's public and economic health in the future (Perry et al. 1994; Kessler 1995). The impact of cigarette smoking and other tobacco use on chronic disease, which accounts for 75% of American spending ...