A new report out of the U.S. Surgeon General's office this week is calling for increased tobacco taxes to discourage young Americans from picking up the smoking habit.
The report showed nearly one in five high school-aged teens smokes. That's down from earlier decades, but the rate of decline has slowed, the report said.
Calling for an end to the "tobacco epidemic," the report suggested everything from mass media campaigns to new restrictions to tobacco tax hikes in an effort to once again start cutting down on youth tobacco use.
"The evidence shows that increasing tobacco prices is effective at lowering smoking prevalence as well as consumption levels of tobacco products, especially by youth and young adults," the report said.
As the Obama administration pushes to ease the tax burden on the middle class, through a payroll tax cut and other measures, the tobacco tax has been the notable exception.
A 2009 law raised the federal tax on cigarettes to $1.01 per pack. Congress also passed a law allowing the Food and Drug Administration to enforce new standards on the tobacco industry -- a law aimed in large part at curbing youth tobacco use.
States and cities have pursued their own increased taxes. New York City has the highest combined state-and-local tax, at $5.85.
Governments are focusing on higher taxes as part of the arsenal of regulatory tools they have to combat the industry's costly marketing campaigns.
The Surgeon General's report showed tobacco companies spent $9.94 billion on marketing in 2008.
The report said it's important to stop young people from using tobacco because those who start smoking as teenagers can increase their chances of long-term addiction. They also quickly can experience reduced lung function, impaired lung growth, early heart disease and other health problems, such as asthma.
More than 80 percent of smokers begin by age 18, and 99 percent of adult smokers in the U.S. start by age 26, according to the 920-page report, which is the first comprehensive look at youth tobacco use from the Surgeon General's office in nearly two decades.
"We have come a long way since the days of smoking on airplanes and in college classrooms, but we have a long way to go," Secretary of Health and Human Resources Kathleen Sebelius said in a statement accompanying the latest report. "The prosperity and health of our nation depend on it."
In a statement Thursday, Richmond, Va.-based Altria Group, parent company of the nation's largest cigarette maker, Philip Morris USA, which makes the top-selling Marlboro brand, said it agrees that kids shouldn't use tobacco products and that it markets its products to adult tobacco users through age-verified direct communications and at retail stores.
"Underage tobacco use is a difficult issue, and there is not a simple solution," the company said. "We agree there's still more work to be done."
The Associated Press contributed to this report.