Most smokers start when they are between 12 and 18 years old—the earlier they start the greater the health risks. Academic risk doubles for students who smoke, and they are more likely to engage in other risky behaviors. Tobacco use is the single most preventable cause of chronic illness and premature death in the U.S., including most cancers and lung disease. More than 6.4 million American adolescents alive today will die prematurely because of tobacco use. In Washington state more than 50 kids start smoking every day.