Tobacco use kills nearly 10,000 Hoosiers annually and costs the state almost $3 billion in health care bills.
Wednesday, students across the state took a stand through a campaign called "Kick Butts Day."
Fifty years ago the Surgeon General released its first report on the dangers of smoking and tobacco use.
Half a century later, Hoosiers are still trying to kick the habit and students at Shortridge High School are telling them why now is the time.
"It's all about getting the kids to understand that it's a choice they have to make, but, to make it clear that the best choice is not to do it at all because of all the negative things that can happen if you do do it," said Christian Jones, 18.
He is among the many who signed a pledge vowing never to smoke. The senior says picking up smoking can lead to other problems for young people.
"What are (cigarettes) like $6 to $7 a pack, or something like that? If you smoke four of five packs a week, that is a lot of money," said Jones. "Especially for a teenager who doesn't have a steady income, it could be major holes in their pockets and that leads to them stealing for money or taking from their parents - a lot of negative things."
Tobacco Health Educator Chris Hawkins spent Wednesday at Shortridge talking to students about the dangers.
He says the key is using extreme examples to drive home the point.
"This is how much tar will be in your lungs. This is how much flem you will cough up. You have to show them and (have them) visualize. Show them the lungs. Show them a good lung. Show them a bad lung. Show them a cigarette that has what a cigarette has in it," said Hawkins. "You have to be up front with them and give them that shock value."
And he says a new challenge is clarifying misconceptions teens have about e-cigarettes.
"Just because there is vapor coming out doesn't mean it's a healthier alternative," he said. "People may call it a harm reduction strategy, but it is still not good for you."
The campaign reports more than 18 percent of Indiana teens smoke and a new Surgeon General’s report released earlier this year predicts if changes aren’t made, more than 150,000 Hoosier children will die prematurely from smoking.