California has made significant progress with its anti-smoking campaigns, but one group has been particularly tough to reach: 18- to 24-year-olds.
They have the highest smoking prevalence of any age group, and their smoking rate has gone up despite widespread attempts to educate them about the dangers of tobacco use.
Smoking rates among young adults rose from 12.3 percent in 2010 to 14.6 percent in 2011, a new state study released Thursday reveals.
People in this age group often leave home and are on their own for the first time and willing to experiment, said Colleen Stevens, branch chief for the state's tobacco control program.
"This is really a vulnerable age," she said.
And while getting started is easy, quitting is not. That's what Cal State East Bay student Max Henderson discovered when he started smoking a decade ago at 16.
"I guess I was one of the youths that got sucked up into thinking it was rebellious and cool, and then I got addicted," said the history and political science major who is trying to ween himself from the habit.
On Thursday, state health officer Dr. Ron Chapman released his department's first wide-ranging report on tobacco use and promotion in California.
Among the findings:
"The economic impact of smoking is a burden for us all, even if you don't smoke," Chapman said.
Not all in the report is gloom and doom, however. It details significant progress since California voters approved a 25-cent tax on cigarettes in 1988 and dedicated the money to smoking prevention programs.
Overall, adult smoking rates have been cut in half, dropping from 23 percent in 1988 to 12 percent in 2011. California has the second-lowest smoking rate in the nation, second only to Utah.
And there are now 1.5 billion fewer cigarette packs sold in the state each year. Sales have plunged from 2.5 billion packs in 1998 to 972,000 in 2011.
Yet many challenges remain, particularly in reaching young adults, Chapman noted.
Several smokers interviewed this week at the Cal State East Bay campus in Hayward said they were aware of, but undeterred by, the health risks, at least when they started the habit.
Brandon Berzman, a 22-year-old business major, began smoking at 17. He had been exposed to it because his parents smoked and said he did not worry about potential health problems.
But a year ago, he tried to quit and discovered he could not. He may try again when he graduates from school and has less stress. In the meantime, he tries to be considerate of others and to limit his smoking around nonsmokers.
"I know people don't like to be smoked around," he said. "I just try to keep people's beliefs in mind while I'm smoking."
Even though the smoking rate for young adults rose in 2011, it remains below the 17 percent rate of 2007 and 2008, and rates that exceeded 20 percent in 2003 and earlier.
As a health science major, 24-year-old Mary Fabriquer does not smoke and has tried to warn some of her friends about the risks but said some don't care.
"At this age, I don't think people think about their future health," she said. "It's usually all about what's happening now."
Sandy Kleffman covers health. Contact her at 510-293-2478. Follow her at Twitter.com/skleffman.