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One-third of high school smokers are expected to die prematurely of tobacco-related disease, said Mr. Pechacek, the associate director for science in the agency's Office on Smoking and Health.
"It's going to take a long time to make progress, but we have 40 communities that have banned indoor smoking in public buildings, and the percentage of high school smokers is falling.
One recent study showed that the number of high school smokers tripled from 2013 to 2014, and another showed that teens who vaped also smoked regular cigarettes.
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In recent years, nearly one in five teens leave high school as smokers.
Overall, the study participants who used herbal medicines were having their first child, more often students and less likely to work as healthcare providers, with an educational level other than high school, non-smokers, using both folic acid and alcohol during pregnancy.
One in five adults and high school students are smokers.
When Florida started the Truth campaign, 27.4 percent of its high school students were smokers.
Last year, 18.7 percent of high school seniors were smokers — just about the same as the percentage of teenagers who are obese.
Nonwhite women, those with less than a high school education and smokers were at increased risk of delivering a baby whose growth was impaired, the study found.
In 1997, when 36.5 percent of high school seniors were smokers, a headline in The Washington Post said: "Officials Seek a Path to Cut Into Haze of Youth Smoking — The Bottom Line: No One Knows What Works".
The new study, published this week in the journal Pediatrics, took place in a state with one of the worst teen tobacco problems, West Virginia, where roughly a third of all high school students are smokers.
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