Pop culture is once again accepting that smoking is cool, and Gen Zers are watching.

Generation Z, made up largely of middle and high school students, reported the lowest smoking rates on record in 2024, according to data from the CDC and FDA, but that trend may be in danger.

“Overall, the decline in smoking in the US, [down] to about 11.9% of the general population, it’s a huge public health success story that’s happened over the last 20 years,” Dr. Neil W. Schluger, dean of the School of Medicine at New York Medical School and a pulmonologist, told News Digital.

Some experts, however, fear that the “cool factor” may be making a comeback, hooking a new generation on smoking.

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There is reportedly a movement in certain populations to re-glamorize cigarette smoking, Schluger said.

An Instagram account, @Cigfluencers, posts photos of celebrities with cigarettes to its more than 83,000 followers.

“VERY HOT!” reads the caption of a provocative image of Sabrina Carpenter smoking over the bathroom sink. “Also, smoking = hot.”

Other celebrities who have been open about their cigarette smoking, and who also appear on @Cigfluencers, include Ben Affleck, Jeremy Allen White, and Natalie Portman, among others.

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“Influencers can be influenced by marketing dollars and can appeal to younger generations, especially if the channels used are popular with younger people, such as social media,” said Judith J. Prochaska, Ph.D., a professor in the Department of Medicine at Stanford University in California, whose research focuses on developing effective treatments for tobacco dependence.

Multiple studies show that teens and young adults who view smoking-related content are more likely to start using tobacco products in the future, but those risks increase when they interact with tobacco content on social media.

“It’s a confusing and dangerous contradiction for young people who take their cues from pop culture and influential celebrities, and are especially vulnerable to believing that smoking is more popular than it really is,” Truth Initiative CEO and President Robin Koval said in a news article on the organization’s website.

In a recent opinion piece published in The BMJ, the author wrote that smoking is experiencing a “pop culture renaissance” that is an “unwelcome setback for public health.”

“This normalization of smoking risks is reigniting a harmful cultural association between cigarettes and coolness, to which young people are particularly vulnerable,” the article says.

Smoking trends among youth

In the mid-to-late 1990s, about a third of high school students smoked cigarettes. Today, that number has dropped to less than 3%, according to the American Lung Association.

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“It’s harder to track trends in youth and young adults, because they tend to be less connected to survey efforts, and behaviors can change quickly,” Dr. Daniel J. Boffa, vice chair of the American College of Surgeons Commission on Cancer and chief of the division of thoracic surgery at Yale School of Medicine, told News Digital.

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“The signals we have suggest that smoking rates are much lower in Generation Z than in some previous generations.”

Boffa noted, however, that about 8 percent of Gen Z teens use e-cigarettes, “which is important because we don’t yet know the long-term effect of e-cigarettes, and some young adults will switch from e-cigarettes to smoking tobacco.”

The United States saw a rise in vaping rates in 2019, largely due to the popularity of the JUUL brand, which resonated with youth due to its high nicotine level, discreet design, kid-friendly flavors and appealing marketing tactics, Prochaska said.

E-cigarettes are also increasing among young adults, in part because teenagers age into young adults, he added.

Health risks of smoking

More than 90 percent of long-term smokers started smoking before age 18, Boffa noted.

“The problem with smoking in adolescence and young adulthood is that the most serious health-related consequences will not appear for a few decades, making it easier to ignore the warnings,” he warned.

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When someone smokes over time, the inhaled burning tobacco and paper damages the small air sacs in the lungs called alveoli, which facilitate the exchange of oxygen and carbon dioxide. This damage could lead to chronic obstructive pulmonary disease, according to the Mayo Clinic.

The habit can also increase the risk of cancer, health experts warn. Humans produce randomly mutated cells that can potentially become cancerous, but a healthy immune system usually eliminates those cells.

However, when someone smokes, toxic substances enter the body and depress the immune system, giving those mutated cells a chance to grow and become cancerous.

Repeated exposure can also increase the risk of oral health problems, pregnancy harm, sexual dysfunction and even mental health effects, Prochaska warned.

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Smoking is also a risk factor for coronary artery diseaseaneurysms in the aorta (the main artery of the heart), peripheral vascular disease, and heart attacks and strokes, according to the FDA.

“Reducing tobacco use in the U.S. is a huge public health advance, and we must be vigilant so we don’t go backwards,” Schluger said.

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To maintain this progress, the doctor advocates banning smoking in public places, increasing tobacco taxes, increasing funding for smoking cessation programs, and cracking down on illegal advertising and sales to minors.