Declines in rates of adolescent tobacco use have stagnated in the past few years, prompting the CDC to call for better prevention efforts, according to a recent report.
“Smoking continues to be the leading preventable cause of death and disability in the United States; and among adult established smokers in the United States, more than 80% began smoking before age 18 years,” CDC researchers wrote.
To evaluate behaviors and attitudes toward tobacco use during the critical period of adolescence, the researchers used National Youth Tobacco Survey (NYTS) data collected from 2000 to 2009.
The NYTS, which presents school-based survey responses from a cross-sectional, nationally representative sample of middle school and high school students, gleans information on youth tobacco use; smoking cessation; tobacco-related knowledge and attitudes; access to tobacco; media and advertising and secondhand smoke exposure. The study has been conducted every 2 years since 2000.
From the 205 participating schools, 22,679 students responded. They were polled about any use of, current use of and experimentation with certain tobacco products, including cigarettes, cigars, smokeless tobacco, pipes, bidis and kreteks. Survey questions also investigated students’ willingness to initiate tobacco use.
Results indicated that 8.2% of middle school students and 23.9% of high school students reported current tobacco use in 2009, the researchers said, with 5.2% of middle school and 17.2% of high school students reporting current cigarette use. The researchers also noted that 21.2% of middle school and 24% of high school students were willing to start smoking cigarettes.
Data from 2009 also suggested that, among middle school students, 3.9% currently used cigars; 2.6%, smokeless tobacco; 2.3%, pipes; 1.6%, bidis; and 1.2%, kreteks. A similar distribution of use of these products was noted among high school students, with 10.9% currently using cigars; 6.7%, smokeless tobacco; 3.9%, pipes; 2.4%, kreteks; and 2.4%, bidis.
From 2000 to 2009, decreases occurred among middle school students for current tobacco use, 15.1% to 8.2%; current cigarette use, 11% to 5.2%; and cigarette smoking experimentation, 29.8% to 15%. Overall rates for susceptibility to smoking, however, did not decline. Analysis also indicated that rates of decreases demonstrated no change during this time.
Among high school students, current tobacco use decreased from 34.5% to 23.9% from 2000 to 2009, according to the researchers, with current cigarette use also declining from 28% to 17.2% and rates of experimentation falling from 39.4% to 30.1%. Again, rates of decline did not change.
Prevalence of susceptibility to smoking remained steady for middle school and high school students throughout the study period.
Between 2006 and 2009, however, the willingness to start using tobacco products and current use of cigarettes, cigars, smokeless tobacco, pipes, bidis and kreteks did not change among middle school or high school students. For middle school students, the researchers only noted declines in two subpopulations, with rates of current cigarette use falling from 6.4% to 4.7% among girls and decreasing from 6.5% to 4.3% among white students.
Similarly, from 2006 to 2009, prevalence among high school students only declined in girls for current tobacco use, decreasing from 21.3% to 18.2%, and current cigarette use, with rates falling from 18.4% to 14.8%. Prevalence for current bidi use also declined among white students (2.6% to 1.7%).
“The findings in this report indicate that, from 2000 to 2009, prevalences of current tobacco and cigarette use and experimentation with smoking cigarettes declined for middle school and high school students, but no overall declines were noted for the 2006-2009 period,” the researchers wrote. “The general lack of significant change during the shorter period indicates that the current rate of decline in tobacco use is relatively slow.”
Researchers noted that prevention programs are effective, but they do not receive adequate financial support. “Comprehensive tobacco control programs should be fully funded and implemented, as recommended by the CDC,” they wrote.
The researchers also said better control of cigarette advertisements and more graphic warnings on cigarette packs may help deter adolescents from smoking by altering the general public’s attitudes toward tobacco use.
“Changes in social norms might help reduce youth susceptibility to try cigarettes and other tobacco products and accelerate the decline in tobacco use among youths,” the researchers wrote.