Adolescent tobacco use and cessation.

Over one third of high school students in the United States smoke cigarettes, and close to 10% use spit tobacco. Tobacco use clusters with alcohol use, other substance abuse, and other health risk behaviors among teenagers. Public health and law enforcement policy changes, combined with effective substance use prevention programs in both elementary and middle school, are needed to prevent the early age of onset of tobacco use by youth. Primary care providers can play a key role in identifying children and adolescents who smoke or use spit tobacco and helping them discontinue their tobacco use.