Smoking and Other Drug Use
Teen smoking is an early warning sign for additional substance abuse problems. Youths age
12-17 who smoke are more than 11 times as likely to use illicit drugs and 16 times as likely to
drink heavily as youths who do not smoke.1 As the U.S. Supreme Court noted in 1962, “The first
step toward addiction may be as innocent as a boy's puff on a cigarette in an alleyway.”2
Smoking and Illegal Drugs
Smoking typically precedes other drug use. Among youths who have used both cigarettes
and marijuana by the 12th grade, 65 percent smoked cigarettes before marijuana; and 98 percent
of those who had used both cocaine and cigarettes smoked cigarettes first.3
The earlier a person uses tobacco, the more likely they are to experiment with cocaine,
heroin or other illicit drugs. Those who start smoking as a child are three times more likely to
use marijuana and four times more likely to use cocaine than those who do not smoke as
children.4
In addition, more than half of all persons who start smoking before age 15 use an
illicit drug in their lifetime, compared to only a quarter of those who do not start smoking until they
are beyond age 17 -- with those who start smoking before age 15 are more than three times
more likely to use cocaine. And those who start smoking before age 15 are seven times more
likely to use cocaine than those who never smoke cigarettes at all. 5
The earlier a person uses tobacco, the more likely he or she is to become a regular drug
user as an adult. People who start smoking as children are almost four times more likely to be
regular users of an illicit drug and three times more likely to use cocaine regularly than those
who do not smoke as children.6
Heavy smokers are much more likely to use marijuana or harder drugs. Youths who
smoke more than 15 cigarettes a day are more than twice as likely to use an illicit drug and 16
times more likely to use cocaine than those who smoke less frequently -- and are 10 times more
likely to use an illicit drug and more than 100 times more likely to use cocaine than those who
never smoke. Children who smoke a pack a day are also 13 times more likely to use heroin than
children who smoke less heavily.7 In addition, 12- to 17-year-old daily smokers who smoke daily
are approximately 14 times more likely to have binged on alcohol than those who do not smoke,
more than 100 times more likely to have used marijuana at least ten times, and 32 times more
likely to have used cocaine at least ten times.8
Heavy users of smokeless tobacco are significantly more likely to experiment with or
regularly abuse illegal drugs. High school kids who use spit tobacco 20 to 30 days per
month are nearly four times more likely to currently use marijuana than nonusers, almost three
times more likely to ever use cocaine, and nearly three times more likely to ever use inhalants.9
Increases in cigarette prices reduce the demand for cigarettes and marijuana. Cigarette
and marijuana are not substitutes (users do not increase their use of marijuana to compensate
for smoking less -- or vice versa) and increases in cigarette prices, which reduce smoking, also
reduce marijuana use.10
Smoking and Alcohol