Dried tobacco leaves are used to create cigarettes, cigars, pipe tobacco, chewing/dipping tobacco, snuff and hookah.

Tobacco is legal to purchase and consume for adults in the U.S. ages 18 and up. Exceptions to this are Alaska, Alabama, Utah and New Jersey, where the legal purchasing/consumption age is 19.

How does this affect me?

According to the 2014 Monitoring the Future Survey:

  • Only 1.4 percent of 8th graders reported smoking every day in 2014, compared to 2.7 percent in 2009; 3.2 percent of 10th graders reported smoking daily, compared to 4.4 percent in 2013 and 6.3 percent in 2009; and 6.7 percent of high school seniors reported smoking daily in 2014, down from 8.5 percent in 2013 and 11.2 percent in 2009. In 1997, at its peak, nearly a quarter of seniors were daily smokers.
  • Use of e-cigarettes in the past 30 days was reported by 8.7 percent of 8th graders, 16.2 percent of 10th graders, and 17.1 percent of 12th graders.
  • However, other forms of tobacco remain popular. In 2014, past-year hookah use continued to increase among 12th graders to 22.9 percent—the highest rate since 2010 where 20% of 12th graders said they had used a hookah.

The U.S. Department of Health and Human Services reports that, if smoking persists at the current rate among youth in this country, 5.6 million adolescents are projected to die prematurely from a smoking-related illness.

What about Electronic Cigarettes?

Electronic cigarettes (also known as vape pens, e-hookahs, e-cigs) are battery-powered, cigarette-shaped devices in which a nicotine-based liquid is vaporized and inhaled, simulating smoking. Electronic cigarettes have largely been marketed as a safe alternative to smoking or as a way to help current smokers quit. This is due to the fact that e-cigs do not contain many of the carcinogens found in traditional cigarettes. However, the nicotine-based liquid contained in e-cigs contains many toxic chemicals.

A Food and Drug Administration (FDA) review of 18 different studies on e-cig vapor revealed traces of solvents that can cause serious lung irritation.

While more research is needed on the long-term effects of e-cig use, the FDA and the World Health Organization (WHO) do not recommend the use of e-cigs for any purpose.


Tobacco contains the addictive stimulant nicotine. When nicotine reaches the brain, it stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system causing increased blood pressure, heart rate and respiration.

Short-Term Effects

Nicotine causes an increase in dopamine levels. Dopamine is the brain’s “feel-good” neurotransmitter (chemical messenger). Nicotine tricks the brain into feelings of relaxation.

Long-Term Effects

  • Decreased physical performance
  • Increased mucus production
  • Persistent cough
  • Increased heart rate/blood pressure
  • Constricted blood vessels
  • Gastrointestinal issues
  • Lung/heart disease
  • Periodontitis/gum disease
  • Stroke
  • Cancer of the lungs, larynx, esophagus, mouth, bladder, cervix, pancreas and kidneys

Other Effects

  • Bad breath
  • Yellowed fingernails and teeth
  • Premature skin wrinkling
  • Higher every day stress levels
  • Cognitive dysfunction


Is tobacco really that addictive?

Yes! According to, about 70% of smokers say they want to quit and about half try to quit each year, but only 4% to 7% succeed without help. This is because nicotine has a fast-acting effect on the brain. Nicotine causes the release of dopamine, which causes temporary pleasant feelings for tobacco users. It also stimulates the central nervous system, causing a small adrenaline rush. However, after these feelings begin to fade away, smokers are struck with withdrawal symptoms which can include: cravings, headaches, nervousness, irritability, and trouble sleeping. These unpleasant feelings are alleviated by consuming more tobacco. This can make it incredibly difficult for a person to stop using tobacco.

Why do people start smoking?

People start smoking for a variety of different reasons. According to the 2012 Surgeon General’s Report, very few people start smoking after age 25. Nearly 9 out of 10 adult smokers started by age 18, and 99% started by age 26. This means that most adults who smoke actually started smoking as teens. Many smokers had friends or family members who smoked. Some wanted to “look cool” or “fit in.” Additionally, although the 1998 Tobacco Master Settlement Agreement banned cigarette brand placement in movies, cigarettes appeared in every 2 out of 3 box office hits in 2005, with more than one third of these films being youth-rated. Youth who see smoking in the media are more likely to begin smoking.

What is ‘secondhand smoke?’

Secondhand smoke (SHS) is made up of two different components:

  • Sidestream smoke: Smoke from the lit end of a cigarette, cigar, or pipe
  • Mainstream smoke: Smoke exhaled by the smoker

When non-smokers are exposed to SHS, they are taking in nicotine and other toxic chemicals in the same way that smokers do. This is called involuntary or passive smoking. Sidestream smoke has a high concentration of carcinogens (cancer-causing agents). The particles in sidestream smoke are also smaller than those of mainstream smoke, meaning that sidestream particles enter a person’s lungs and cells more easily. This means that individuals who are exposed to other people’s smoke are actually inhaling a greater amount of toxic chemicals! SHS causes:

  • About 3,400 lung cancer deaths in non-smoking adults. The Surgeon General estimates that living with a smoker increased the chance of getting lung cancer by 20% to 30%
  • An estimated 42,000 deaths from heart disease in people who are current non-smokers
  • Worse asthma and asthma-related problems in up to 1 million asthmatic children
  • Between 150,000 and 300,000 lower respiratory tract infections (lung and bronchus) in children under 18 months of age, with 7,500 to 15,000 hospitalizations a year

The only way to fully protect non-smokers from exposure to SHS indoors is to prevent all smoking in that indoor space or building.

Is there any safe way to use tobacco?

No. Regardless of what type of tobacco a person is using, there are still serious health risks involved.

How do people quit smoking?

  • Quitting can be a difficult process. Smokers must not only address their physical cravings for nicotine, but the mental/social need for smoking as well. Nicotine replacement therapy (NRT) is an option for addressing the physical side of nicotine addiction. NRT provides individuals who are trying to quit with lowered levels of nicotine in the form of gums, patches, sprays, etc. This relieves some of the immediate withdrawal symptoms of nicotine addiction and can help smokers to wean themselves off nicotine. Smokers who chose to use NRT should consult with a physician before doing so.
  • Smokers may also find it helpful to join a support group, such as Nicotine Anonymous (NicA). Additionally, the American Cancer Society, the American Lung Association, and local health departments all sponsor classes on smoking cessation. Support from family and friends is also invaluable to individuals trying to quit.

Why should someone quit smoking?

Though quitting can be difficult, the health benefits are almost immediate. According to the Surgeon General:

  • Within 20 minutes of quitting, heart rate and blood pressure drop.
  • Within 12 hours of quitting, carbon monoxide levels in the bloodstream return to normal.
  • Within 2 weeks to 3 months of quitting, circulation improves and lung function increases.
  • Within 1 to 9 months of quitting, coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
  • After 1 year of quitting, the excess risk of coronary heart disease is half that of a continuing smoker’s.
  • After 5 years of quitting, risk of cancer of the mouth, throat, esophagus, and bladder are cut in half. Cervical cancer risk falls to that of a non-smoker. Stroke risk can fall to that of a non-smoker after 2-5 years.
  • After 10 years of quitting, the risk of dying from lung cancer is about half that of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decreases.
  • After 15 years of quitting, the risk of coronary heart disease is that of a non-smoker’s.

Some additional immediate benefits to stopping tobacco use:

  • Your sense of smell returns to normal.
  • Your breath, hair, and clothes smell better.
  • Food will taste better.
  • Your teeth and fingernails stop yellowing.
  • You can be in smoke-free buildings without having to go outside to smoke.
  • Ordinary activities leave you less out of breath (for example, climbing stairs or light housework).

How to Get Help

Talk to a trusted adult or seek out local substance abuse treatment centers in your area. A physician or a counselor can also assist in finding treatment.

  • You can also seek out local self-help groups such as Nicotine Anonymous (NicA). To find out more information about NicA’s services, visit
  • Call Centerstone at 1-888-291-4357 (HELP) to schedule an appointment with a therapist.
  • If you feel like you need immediate help, please call 1-800-681-7444 for 24-hour Crisis Services.