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The study of tobacco usage among youth is important, as while smoking rates have declined in the past decade, 80% of adult smokers first try smoking by the age of 18

As of 2017, about 34 million adults smoked cigarettes, and nearly 90 percent of smokers tried their first smoke by age 18

Cigarette smoke affects digestion through multiple mechanisms: Nicotine stimulates the parasympathetic nervous system Inhaled chemicals create an inflammatory response in the gut Carbon monoxide alters blood flow to digestive organs Smoke exposure changes gut microbiome composition Research shows smoking encourages development of certain bowel diseases while potentially deterring others

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Men have a higher incidence of oral cancer than women, and tobacco use is a major contributor to oral cancer [49]