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Significant changes in percentages of past month cigarette use and perception of great risk of smoking one or more packs of cigarettes per day among persons aged 12 to 17, by state: 20022003 versus 20122013 The prevalence of cigarette use initiation in childhood or adolescence has prompted the Surgeon General to declare tobacco use to be a pediatric epidemic, affirming the importance of tobacco use prevention and control measures that target youths