The number of teens in the US that are smoking has reached epidemic proportions according to the most recent report from the US Surgeon General's Office. That report marks the first comprehensive youth smoking study done by the agency since 1994. According to its findings, roughly one in every five high school students is a smoker. While the agency agrees that the rate is down from what it has been in other years, the rate of the decline has slowed down dramatically. The majority of the teen smokers will reportedly continue smoking into adulthood.

Over 600,000 middle school students are smokers as are more than three million students at the high school level. According to the Surgeon General, Dr. Regina Benjamin, nearly four thousand new smokers will pick up their first cigarette every day and nearly all of the current smokers started the habit before they reached eighteen. Ninety nine percent of all smokers started the habit before they were in their mid twenties.

Smoking related deaths account for some of the decreases in the numbers but, according to the report there are more than enough new smokers to keep that decrease from becoming significant. In fact, for every one smoker who dies, there are two new smokers to take their place. Those new smokers are typically described as below the age of twenty five.

Smoking cessation and prevention programs are considering ways to target youth including stricter sales in some stores and stiffer penalties for those who sell tobacco to minors. The Surgeon General's office also had harsh wors about the big tobacco companies and their targeting of young people with their marketing and promotional campaigns. By estimate, the tobacco industry spends roughly one million dollars per hour to promote their products. The tobacco industry defended its own actions saying that they are promoting a legal product to age verified people.

In 2009, Congress passed a new law that would urge the Food and Drug Administration to set new standards for cigarette packaging. That mandate allowed the FDA to compel cigarette companies to include large, color labels on each pack of cigarettes, big enough to cover the majority of the front and back panels. Those labels were meant to depict some of the consequences of smoking including rotting teeth, blackened lungs and other health conditions. The major cigarette companies took the case to court and a US Judge's ruling came down on the side of the tobacco industry, saying in part that the requirement was a violation of free speech.