Despite everything that has been said and written about the negative effects of tobacco, new evidence suggests that there are still Americans, including teenagers, who are smoking it.

Smoked Tobacco vs Smokeless Tobacco

Over the years, tobacco has evolved into a variety of different forms. Presently, it can be classified into three groups: smoked tobacco, smokeless tobacco, and the trendy, e-cigarettes.

Smoked tobacco includes the popular menthol and light cigarettes — the most widely used tobacco in the United States — cigars, pipes, bidis (hand-rolled Indian cigarettes wrapped in a tendu or temburni leaf), kreteks or clove cigarettes (contains 60 percent tobacco and 40 percent ground cloves), and hookahs.

Smokeless tobacco products, on the other hand, include chewable tobacco (placed between the cheek and gums), snuff (sniffed if dried), dip (a moist and chewable snuff), snus (powder tobacco pouch placed on the upper lip), and dissolvable tobacco products, such as lozenges, orbs, sticks, and strips.

Contrary to the popular notion that e-cigarettes are healthy and nicotine-free, these battery-operated smoking instruments (sometimes made to look like cigarettes, pipes, or pens) do have nicotine in them along with other unknown chemicals converted into vapor you still inhale.

The PATH Study

According to the latest findings of the Population Assessment of Tobacco and Health (PATH) Study, which was published in the New England Journal of Medicine, more than one in four adults (27.6 percent) and almost one in every four teenagers (8.9 percent) use tobacco.

This conclusion was drawn from the first batch of PATH Study data, involving 32,320 adults and 13,651 teenagers. The research was done from September 2013 to December 2014.

"These findings will serve as the baseline for comparison to future waves of PATH Study data in our effort to understand changes in use of tobacco products over time, including switching among types of products, quitting tobacco, and trajectories of use of multiple products," Karin Kasza, MA, the lead author of the study, explained.

The PATH Study, which was initiated back in 2011, is a massive longitudinal study on a national scale aimed at delving deeper into Americans' tobacco use, which is led by statistical survey research corporation, Westat, based in Rockville, Maryland. It was founded under the joint initiative of the National Institutes of Health's National Institute on Drug Abuse (NIDA) and the U.S. Food and Drug Administration's Center for Tobacco Products (USFDA CTP).

Side Effects of Smoking

Based on the Centers for Disease Control and Prevention (CDC) website, smoking causes more than 480,000 deaths each year in the United States — nearly one in five deaths.

Smoking has been known to heighten the risks of serious diseases, including coronary heart disease, stroke, tuberculosis, emphysema, asthma, and a whole variety of cancer.

It is also connected to infertility, teeth and gum infection, and cataracts (because of the smoke getting into your eyes). In pregnant women, smoking tobacco or mere exposure to second-hand smoke have been found to cause preterm labor, still birth, and birth defects.

Smoking has also been linked to degradation of overall health, increased absenteeism from work, and higher healthcare expenses.

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