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Cigarette smoking is the leading cause of preventable disease in the U.S., accounting for 20 percent of all deaths (or more than 480,000 deaths) every year. Though current rates of cigarette smoking have declined over the last decade, about 15 percent of U.S. adults aged 18 years or older still smoke. Unfortunately, the rates of cigarette smoking are higher in certain populations including: younger adults (aged 18-24), individuals with lower educational levels, those who live below the poverty level, and certain races and ethnicities.

The tobacco problem has become even more complex with the increasing utilization of e-cigarettes, marijuana, and other cannabis-containing products. For the first time in several decades, the overall nicotine and tobacco use is growing among U.S. high school students. This increase is primarily due to teenagers using e-cigarettes, hookahs, and vaping. The growing popularity of e-cigarettes among teenagers is particularly concerning since they may serve as a gateway to tobacco smoking.

I live in Colorado, a state that recently legalized marijuana and other cannabis-containing products. When traveling, I am always asked about “How has the legalization affected Colorado?” I have watched stores with green crosses (symbolizing that they sell cannabis products) multiply across the state. The percentage of cannabis users has increased steadily since its legalization, and Colorado residents now consume more cannabis per month than any other state in our country. Among adults older than 26 years old, the incidence of cannabis use has increased from 6 to 12 percent, while the incidence among college age students has increased from 22 to 31 percent. As marijuana and other cannabis-containing products are legalized in other states and countries, its increasing utilization will become a worldwide problem.

The ATS is fortunate to have a very active and productive Tobacco Action Committee. The committee organizes and coordinates our tobacco control activities including research, clinical, educational, advocacy and policy efforts with the ultimate goal of minimizing the impact of tobacco on morbidity and mortality worldwide. The committee is also starting to tackle the important and growing issue of e-cigarettes, marijuana, and other cannabis-containing products.

To protect the health and future of our children and younger adults, it's imperative that we work to reduce their exposure to tobacco products.

Flavored tobacco appeals to children. Cigars contain more tobacco; they burn longer, and produce higher amounts of secondhand smoke. Children exposed to second-hand smoke have increased hospitalizations for respiratory issues. The potential harmful effects of e-cigarette and cannabis on the lung cannot be overlooked.

What You Can Do To Help

There are a few actions that we can take as ATS members. There is a growing interest in raising the legal minimum age for tobacco products to 21 years. To date, more than 260 cities and counties in 18 states have adopted this tobacco policy. One city in Massachusetts reported that raising the age for tobacco sales lowered the rate of teenage smoking by almost 50 percent. So, write a letter to the editor of your newspaper in support of raising the minimum age for the sale/purchase of tobacco products. Talk about why we need to raise the minimum age on social media; discuss why we need to do this to protect our children. Contact your local, state, and federal legislators and ask them to support laws that raise the age of purchase for tobacco to 21 years.

Finally, we need to take a stronger stand on e-cigarettes, marijuana, and other cannabis-containing products. We should help spread the message that these products have deleterious effects. The ATS also needs to advocate for more research directed at unraveling the potential harmful pulmonary effects of tobacco, e-cigarettes, marijuana, and other cannabis-containing products .

Please visit the advocacy section of our website for resources on tobacco control.