Young people often feel invincible. They may think smoking or vaping causes health problems for adults, but that those same health risks won’t apply to them. According to the CDC, “many children and adolescents do not understand the nature of tobacco addiction and are unaware of or underestimate the important health consequences of tobacco use.⁵ Therefore, they need to be reminded that health consequences of tobacco and nicotine use affect everyone. This activity outlines and explains some of the health consequences caused by cigarettes, vapes and smokeless tobacco. Knowing the facts may prevent students from experimenting or stop them if they’ve already tried tobacco or nicotine. 

The CDC reports each year that more deaths are caused by tobacco use than by all deaths from motor vehicle injuries, illegal drug use, alcohol use, human immunodeficiency virus (HIV), suicides, and murders combined.⁷ Share this statistic with your students.

Ask your health teacher or school nurse to join you for this activity. Have a dictionary or health textbook on hand so students can look up unfamiliar terms and share them with the class.

To introduce this activity, show your students the consequences of tobacco and nicotine use listed below. Display the list on an interactive whiteboard or with a projector, or write the terms on the board.^4,8

Tobacco-Related Health Consequences

• Halitosis (bad breath)
• Throat cancer
• Shortness of breath
• Kidney cancer
• Stained teeth
• Gum disease
• Cracked lips
• Stroke
• Mouth sores/bleeding in the mouth
• Heart disease
• Coughing/wheezing
• Emphysema
• Smelly hair (non-health related)
• Lung cancer
• Oral cancer
• Nicotine addiction
• Tooth loss 

Vaping and Nicotine Use Side Effects 

• Nicotine addiction
• Mood disorders
• Permanent lowering of impulse control
• Impact to attention and learning

Ask the students to review the list. Use the internet to define any unfamiliar terms. Then, ask students which issues on the board they believe are health consequences of tobacco use. Check each one the students suggest. Next, tell them that all of the items on the list are health consequences of tobacco use—and they are real. Some students might be concerned about consequences such as bad breath and the smell, while others may be more concerned about the diseases. 

Share the activity link with your class or open the activity on your interactive whiteboard. Click the thumbnail below for the link. Then, review the information provided in the activity. 

After students complete the activity, take a class poll to see which of the health consequences students were familiar with and which ones they were not. They may be surprised to learn how quickly a young person can be affected by using tobacco and nicotine. 

Before completing this activity, display the health consequences poster, “Look What Tobacco Will Do.” It is included in the “Activity Resources” section below. Read the facts with your students. Remind them that these are real issues that affect people who use tobacco and nicotine. Deciding to be tobacco and nicotine free will help them stay healthy.

As a class, visit the CDC’s website for additional information on health consequences. 

Use the supplemental “Totally Caught” video, in the “Materials” section below, to complement this section. 

Students will discover this fact at the completion of Activity Two: Cigarette smoking is responsible for about one in five deaths in the U.S. per year.⁷ Have students work in teams to research this fact and prepare presentations or reports to encourage people to be tobacco and nicotine free. Along with their presentations or reports, have the students create a digital poster representing what they’ve learned about tobacco and nicotine and its health consequences. The materials for the digital poster are provided below. 

To create their presentations or reports, students might use photos or images, Internet resources, books, or interviews with smokers who quit as their resources, along with their digital posters. They will then create a slideshow, handouts for their peers, or any presentation method of their choice to accompany their digital posters and demonstrate the health consequences of tobacco and nicotine use that generate the statistic above. 

Determine a timeframe that is appropriate for your group. Let students get creative and use whatever aids they find most effective to do their reports/presentations. Schedule each pair/group for a different day during the unit to present its findings so your students have enough time to prepare their projects. Invite other classes in to see the presentations. 

⁴ U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Washington, D.C., 2012. Referenced 2023. http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf 

⁵  CDC. Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. MMWR 1994; Vol. 43, No. RR-2; 1-18. Referenced 2023. http://www.cdc.gov/mmwr/PDF/RR/RR4302.pdf 

⁷ CDC. Smoking & Tobacco Use. Fact Sheet—Health Effects of Cigarette Smoking. Referenced 2017. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm 

⁸ NIDA for Teens. (2016, May). Drug Facts: Tobacco, Nicotine, & E-Cigarettes. Referenced 2023. https://teens.drugabuse.gov/drug-facts/tobacco-nicotine-e-cigarettes 

⁹  https://e-cigarettes.surgeongeneral.gov knowtherisks.html#:~:text=Youth%20and%20young%20adults%20are,permanent%20lowering%20of%20impulse%20control.