Providers issue brief: tobacco: youth access to tobacco: year end report-2003.

The use of tobacco products by adolescents concerns advocacy organizations, state departments of public health, state legislatures and tobacco manufacturers. Research conducted by the Centers for Disease Control and Prevention concludes that more than half of all smokers begin smoking before the age of 14, and 90 percent begin by age 19. The average age of first use is between age 13 and age 14. The earlier adolescents use tobacco, the more likely they are to use it as adults and the longer potential time they have to become habitual users. Both the duration and the amount of tobacco use are related to eventual chronic health problems, and these chronic health problems add to the states' medical costs. For instance, the treatment of tobacco-related illnesses collectively cost the states $50 billion to $75 billion annually