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and (d) asthma-related symptoms (e.g., wheezing) in childhood and adolescence.1 The evidence is suggestive but not sufficient to conclude that smoking by adolescents and young adults is not associated with significant weight loss, contrary to young peoples belief.1 Through multiple defined mechanisms, the risk and severity of many adverse health outcomes caused by smoking are directly related to the duration and level of exposure to tobacco smoke.3 Sustained use and long-term exposures to tobacco smoke are caused by the powerfully addicting effects of tobacco products, which are mediated by diverse actions of nicotine and perhaps other compounds, at multiple types of nicotinic receptors in the brain.3 Nicotine stimulates the release of multiple neurotransmitters, including dopamine, norepinephrine, acetylcholine, glutamate, serotonin, -endorphin, and -aminobutyric acid.4 Low levels of exposure, including exposures to secondhand tobacco smoke, lead to a rapid and sharp increase in endothelial dysfunction and inflammation, which are implicated in acute cardiovascular events and thrombosis.3 There is insufficient evidence that product modification strategies to lower emissions of specific toxicants in tobacco smoke reduce risk for the major adverse health outcomes.3 Risk Factors Given their developmental stage, adolescents and young adults are uniquely susceptible to social and environmental influences to use tobacco