According to the surgeon general, more work needs to be done to keep young Americans from using tobacco, including creating smoking bans and increasing taxes on tobacco products.
"The burden of tobacco is a burden on society," Surgeon General Dr. Regina Benjamin said. "The numbers are shocking."
It's the first comprehensive look at youth tobacco use from the surgeon general's office in nearly two decades.
The report says it's especially important to stop young people from using tobacco, because those who start smoking as teens can increase their chances of long-term addiction.
"Middle school, or younger actually, is when children are smoking their first cigarette," said Jill Sabo from Tobacco-free St. Joseph County. "That's where we need to be. "
More than 80-percent of smokers begin by age 18, and 99-percent of smokers in the US start by age 26.
"Peer pressure is a big thing in school," high school junior Gabriella Martinez said. "It's a big thing for younger kids."