Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Cigarette smoking damages nearly every organ of the body. Secondhand smoke also causes many serious health problems such as heart disease, stroke, and lung cancer in adults and respiratory infections, ear infections and more frequent asthma attacks in children. Besides cigarettes, tobacco is also a key ingredient in smokeless tobacco products, cigars, and electronic vaping devices. All tobacco use poses dangers to youth because all tobacco contains the highly addictive drug, nicotine. Nicotine exposure during adolescence can lead to addiction, may harm brain development, and can lead to long term tobacco product use. Alcohol is the most widely misused substance among America’s youth. Consumption of alcohol by anyone under the age of 21, also known as underage drinking, remains a considerable public health challenge. Youth alcohol use is not an acceptable rite of passage, but a serious threat to adolescent development and health. Medical research shows that the developing adolescent brain may be particularly susceptible to long-term negative consequences of alcohol use.