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Reduce and Prevent Youth Smoking in Missouri The Problem: More than 95% of long-term smokers started before age of 21 The primary place underage smokers get tobacco is from their 18 to 20-year-old peers Over 80% of high school seniors are 18 when they graduate Adolescent brains are still developing and are uniquely sensitive to nicotine addiction E-cigarette use among youth in Missouri has more than doubled in recent years E-cigarettes contain nicotine, toxins and carcinogens and are currently available to 18-year-olds Smokers cost up to 40% more than non-smokers in health care costs For private businesses, smoking employees costs $5,816 in excess cost per year on average The Solution: Support for Tobacco 21: 75% of U.S

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Effective strategies include price increases and restricting youth access to tobacco products and exposure to tobacco product marketing