Despite decades of anti-smoking education, one in four U.S. high school seniors still smokes. And three in four high school smokers continue to smoke as adults, according to a new report from the U.S. Surgeon General.
"The addictive power of nicotine makes tobacco use much more than a passing phase for most teens," Surgeon General Dr. Regina Benjamin wrote in the 900-page report. "Today, more than 600,000 middle school students and 3 million high school students smoke. We don't want our children to start something now that they won't be able to change later in life."
Cigarette smoking is still the leading cause of preventable death in the U.S., accounting for about one in five deaths each year. For every tobacco-related death, two young people under the age of 26 become addicted.
"Unfortunately, most teenagers don't realize that just a few cigarettes here and there can lead to addiction," said Dr. Richard Hurt, director of the Mayo Clinic's Nicotine Dependence Center in Rochester, Minn. "All it takes is a bit of experimenting, and that's what teens do."
Part of the problem, according to the report, is the nearly $10 billion spent annually on marketing cigarettes and making them more affordable.
"It's a sad commentary that these people sit around in boardrooms thinking of ways to replace their customers," said Hurt. "Cigarettes are the only product I know that, when properly used, kill 60 percent of users. The only way to replenish the customer base is to fill the pipeline with young people."
Hurt said cigarette companies are now marketing to young people through social media.
"The marketing people at tobacco companies are way ahead of the rest of us, and they have been for as long as they've been selling cigarettes -- almost 100 years," he said.
On Monday, the U.S. government appealed a federal judge's decision to block graphic warning labels on cigarette packaging. The judge ruled the labels, which depict the health hazards of smoking, unconstitutional.
"It's a quirk of history, an accident really that cigarettes are a legal product," said Hurt, explaining how tobacco was smoked for centuries before its health effects were learned. "This is a product that kills 450,000 Americans every year -- that's three fully loaded 747s crashing daily, 365 days a year, with no survivors. Does anyone believe that if that were to happen tomorrow any 747s would be flying Saturday? Absolutely not."
Although many Americans try to quit smoking, it's no easy task.
"The cigarette is what I call the holy grail of drug delivery," said Hurt. "It's so sophisticated that it gets nicotine to the brains of unsuspecting teenagers within five heartbeats. Anything you can do to speed up drug delivery makes it more addictive. ... But if you ask a 17-year-old, he'll say, 'I can stop whenever I want. I'm just doing it to hang out with friends.'"
Cigarette smoking costs the U.S. $96 billion in direct medical costs and $97 billion in lost productivity each year, according to the report.
"We have the responsibility to act and do something to prevent our youth from smoking," Health and Human Services Secretary Kathleen Sebelius wrote in a message accompanying the report. "The prosperity and health of our nation depend on it."