Ask any parent … teenagers are notorious for pushing boundaries and testing limits, oftentimes to their detriment. And while making questionable choices is perhaps just part of growing up, there’s some recent positive news that reflects a decrease in tobacco use among teens.

Still the No. 1 cause of preventable disease and death in the United States, tobacco use is on the downswing among middle school and high school students, according to a recent report from the Centers for Disease Control and Prevention. In 2016, 20.2 percent of surveyed high school students (3.05 million) and 7.2 percent of middle school students (0.85 million) reported tobacco use, with e-cigarettes accounting for the majority (11.3 percent and 4.3 percent of current users, respectively).

While the rate of combustible tobacco use among teenagers declined between 2011 and 2016, overall tobacco use (including cigarettes, cigars, smokeless tobacco, e-cigarettes, hookahs, pipe tobacco and bidis) didn’t change considerably. However, between 2015 and 2016, high school students reported a decrease in use of any tobacco product, combustible products, 2+ tobacco products, e-cigarettes and hookahs. In the same period, the use of e-cigarettes also declined among middle schoolers.

Christopher Blewett, M.D., pulmonologist and critical care physician on the staff at Texas Health Plano, says that while teens may choose e-cigarettes more often, they aren’t necessarily any safer than traditional tobacco products.

“Vaping is a health hazard, because many of the long-term effects are not known,” he explains. “While one may not be inhaling smoke, you are still inhaling [aerosol ED particles] into your lungs, which can still result in harm.

“There are types of lung illnesses, known as hypersensitivity pneumonitis, caused by an immune system reaction to the inhalation of a toxic protein, resulting in damage to the lungs.  It can be relatively silent in the beginning but result in long-term damage to the lungs and airways.”

The new statistics from the CDC have the potential to make a significant impact, as tobacco use predominantly begins during the teenage years, with nine out of 10 cigarette smokers first lighting up by age 18. In fact, every day across the U.S., more than 3,200 kids (ages 18 or younger) smoke their first cigarette, while an additional 2,100 youth and young adults become regular smokers.

Blewett warns that while teens may not see any day-to-day damage from their tobacco use, it’s wreaking havoc in their lungs whether they know it or not.

“Traditional cigarette smoke has both short-term and long-term effects, but much of the damage that causes people to be symptomatic takes years to occur, due to relatively large lung reserve we have.

However, our lung function naturally declines as we age and inhalation of any type of pollutant or toxin, whether in traditional smoke, mist or vapor, has the potential to accelerate that decline. The loss of lung function is often permanent, so the best way to preserve lung function is to cut down and quit as soon as possible.”

According to the CDC, approximately one in 13 Americans under the age of 18, or 5.6 million people, will die prematurely due to a smoking-related illness if tobacco use continues at the current pace. And while those statistics are shocking, tobacco use is a serious health issue for Americans of all ages.

Smoking causes cancer, heart disease, stroke, lung diseases, diabetes and chronic obstructive pulmonary disease, which affect 16 million Americans. The use of cigarettes causes 480,000 deaths per year in the United States, including 41,000 due to secondhand smoke, and close to six million deaths per year worldwide.

Blewett deals with patients of all ages who are struggling with health issues due to smoking. No matter how long they’ve been tobacco users, he says one thing most of them have in common is a sense of regret.

“The younger patients I see with smoking-related issues tend to have increased susceptibility to infections such as bronchitis and chronic issues like cough or exacerbation of underlying asthma,” he says. “Because of the relatively large physiologic reserve with our lungs, it takes a while before the damage results in lifestyle-limiting side effects like shortness of breath with mild activity (walking or walking up stairs).

“Most of my patients will express a sense of regret that they did not quit smoking sooner. Or, if they had known what the physical consequences were going to be, such as [having to use] long-term oxygen, they never would have started.”

Despite the health challenges his patients face, Blewett provides hope.

“Like many things, we need something tangible to motivate us, whether it’s our diet, lack of exercise or smoking,” he says. “We are all human and we all have things that we can do to change to improve our health. The hardest part is the decision to make a change.  Remember that family, friends and your health care providers are here to support you.

“Find a good support group. If you are able to surround yourself with people that do not smoke or who are also trying to quit, then you are much more likely to quit, especially in the beginning. You CAN quit. The hardest part of any journey begins with the first step, and the mightiest waterfall begins with a single drop of water.”

Blewett suggests the following online resources for those looking for more information on smoking cessation:

• The American Lung Association – (www.lung.org)
• American Thoracic Society (ATS) – (www.thoracic.org/patients) – Under Patient Resources there is a fact sheet with topics listed alphabetically, including COPD, smoking, second-hand smoke, pollution, hookah and vaping.
• American College of Chest Physicians (ACCP) – (https://foundation.chestnet.org/patient-education-resources/)