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UVA Health: Cigarette smoking becoming renormalized for Gen Z

UVA Health: Cigarette smoking becoming renormalized for Gen Z

The youth cigarette smoking rate hit a 25-year low in 2024, but an increased normalization of smoking among young people has concerned researchers. Photo: Unsplash


CHARLOTTESVILLE, VA (CVILLE RIGHT NOW) – For many adults, living in an anti-cigarette smoking culture is an established norm. Once a billion-dollar industry, the public health fallout of smoking led to heavy regulation and discouragement of using tobacco. But a shift in this culture may be changing Gen Z’s attitude towards smoking.

Dr. Melissa Little, the director of the Center for Tobacco Prevention and Control Research at the University of Virginia School of Medicine, cited “multiple converging forces” during a UVA Health webinar titled “Why Does Gen Z Think Smoking is Cool?” from new forms of digital endorsement to a sense of pessimism permeating Gen Z’s outlook on their future.

The briefing intended to address a growing renormalization of smoking cigarettes among young people, which is a potential threat to the record low rates at which Gen Z is actually consuming the product.

More young people now perceive their future as compromised,” Little said. “They have this feeling like their whole future is out of their control and everything is so terrible… So, what’s the harm of using tobacco? I’m going to die anyway. I have no control. And that’s this idea of fatalistic risk discounting that we’ve seen before.”

Little also discussed smoking being perceived as a social ritual rooted in pre-digital authenticity, which requires more effort to go outside or join a group rather than use an e-cigarette or vape privately.

The rise of celebrities and social media influencers spotted or posing with cigarettes, which some social media accounts document or aestheticize, has also contributed to a shift for some Gen Zers from the pursuit of “wellness” to a new sense of rebellion and coolness.

“It’s unoptimized, it’s un-curated, it’s this authentic ritual,” Little said. “We see it amplified in fashion and culture, and it’s this nostalgia (for) an earlier, simpler time, when everything else feels a little out of control.”

The observations give an alternative view of what Little called “the most wellness-oriented generation that we’ve ever had,” citing statistics such as 64% of legal age Gen Z young adults do not regularly consume alcohol.

However, tobacco imagery in mainstream media has also been on the rise, with a 41% increase from 2023 to 2024 of tobacco imagery in top box office films, and 85% of young people aged 15 to 24 reporting that they see tobacco use frequently in media content they consume.

But another significant challenge, Little said, has been the focus on vaping and e-cigarettes over the past few decades, which combined with a decline in smoking, led many to take their eye off of combustible tobacco as a longstanding threat to public health.

Some young people addicted to nicotine now view cigarettes as a potential avenue to quit vaping, a reversal that has surprised many public health experts. Messaging in school prevention programs may not be well-equipped to confront this change, with a past anti-cigarette focus lacking the bandwidth to discourage all tobacco and nicotine use.

“I think schools really need to address all forms of nicotine and tobacco,” Little said. “The assumption that teenagers aren’t interested in smoking cigarettes needs to be challenged.”

The popularity of nicotine pouches amongst young people, with brands like ZYN recently being approved by the FDA, also creates an issue – use has nearly doubled from 2021 to 2024, but health experts do not know the long-term effects of the recently developed tobacco product.

Although Little acknowledged that these pouches are different from cigarettes and vapes. With less harmful effects than combustible tobacco, they present a similar scenario to the development of vaping as a substitution for cigarette smoking.

“Theoretically, they are safer than a traditional burnt tobacco,” Little said. “(Nicotine pouches) are a gateway tobacco product, just like how vaping was initially developed to help people quit smoking cigarettes, and it sparked a whole epidemic on its own.”

While an actual substantive increase in cigarette smoking among Gen Z has not occurred yet, with the youth cigarette smoking rate hitting a 25-year low in 2024, Little encouraged vigilance and more public awareness of pervasive tobacco and nicotine imagery and the message behind it. 

“We’re not in the middle of a crisis yet,” Little said. “I think we’re at the start of a trend, and I think we just need to be very aware that … the cultural environment is shifted, and it’s promoting the renormalization of tobacco use.”

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