RICHMOND, Va. — More work needs to be done to keep young Americans from using tobacco, including creating smoking bans and increasing taxes on tobacco products, the U.S. Surgeon General’s office said in a report released this morning.

Almost one in five high school-aged teens smokes, down from earlier decades, but the rate of decline has slowed, the report said.

It says it’s particularly important to stop young people from using tobacco because those who start smoking as teenagers can increase their chances of long-term addiction. They also quickly can experience reduced lung function, impaired lung growth, early heart disease and other health problems like asthma.

More than 80 percent of smokers begin by age 18 and 99 percent of adult smokers in the U.S. start by age 26, according to the 920-page report, which is the first comprehensive look at youth tobacco use from the surgeon general’s office in nearly two decades.