According to the Guam State Epidemiological Profile, August 2018:
 

• Lung cancer is now the major cause of cancer mortality on Guam for both males and females. Thus, cancer mortality data highlight the critical importance of further reducing tobacco use among Guam’s people. Because second-hand smoke also raises cancer risk, interventions to curb tobacco use will protect not only the tobacco users, but also all others who would have been exposed to tobacco smoke. 

 

• In 2011, almost 6 out of 10 high school students on Guam have tried smoking tobacco. One in five currently smoke, and 1 in 10 of those who do smoke are heavy smokers. Thirteen percent have been daily smokers at some point in their lives. Seventeen percent smoked their first cigarette before the age of 13 years. In 2015, male high school students in Guam had a significantly higher smoking rate than females with smoking fairly evenly distributed across grades 9 to 12 in Guam. 

 

• The use of smokeless tobacco products with or without betel nut is less prevalent than cigarette smoking among Guam’s youth. However, while the actual number of users are small, the rate of smokeless tobacco use is increasing among both high school and middle school youth. 

 

• Youth are also using electronic vapor products (e-cigarettes and other electronic nicotine delivery systems). Lifetime use of these products was 59.9% among high school and 38.5% among middle school youth. One in three of high school youth and nearly one in four middle school youth reported current use. Males were more likely to report current use compared to their female counterparts.

 

According to the 2017 Guam Youth Tobacco Survey conducted by the Guam Department of Public Health & Social Services, almost 6 in 10 (57.0%) of youth ages 13 to 15 years reported that they noticed anti-tobacco messages in the media. More than 5 in 10 (53.7%) notice tobacco advertisements or promotions when visiting points of sale. And, almost 2 in 10 (18.4%) had something with a tobacco brand logo on it. Interestingly enough, over half of youth (57.5%) surveyed reported that they definitely thought other people’s tobacco smoking is harmful to them. Of these youth surveyed, 39.8% reported that they were exposed to tobacco smoke at home, and 47.1% were exposed to tobacco smoke inside enclosed public places.