For the four leading causes of death in the United States (heart disease, cancer, stroke and chronic respiratory disease), tobacco use is a common risk factor. Tobacco use is responsible for almost 450,000 deaths per year and impacts the health of every member of our society. Tobacco is a gateway drug for substance abuse. That role is critical to revisit and revalidate. From 490 schools, a total of 175,460 students in grades 6-12 participated in an alcohol, tobacco and other drug use survey, the descriptive analyses of the data being stated in a 2007 technical report. The secondary analyses of the data clearly demonstrated that a dose-response relationship pattern of association existed between increasing quantity of cigarette use and the use of alcohol and other drugs. Additionally, logit analysis revealed that selected demographic and other variables were statistically significant predictors of the past month's use of cigarettes. The secondary analyses were replicated for the 2008 survey, in which 152,732 students responded to the same questionnaire. Similar results were obtained. Smoking is a major risk factor to the leading causes of death and sufficient empirical evidence establishes that tobacco is a gateway drug. To combat tobacco use, a comprehensive ecological approach, including tobacco education and cessation, enacting and enforcing smoke-free policies, and increasing taxes on tobacco products, is recommended. (Contains 3 tables and 2 figures.)