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Decline in Teen Smoking Rate Levels Off

CDC Study Shows 19.5% of High School Students Report Current Cigarette Use

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

July 8, 2010 -- The rate of decline of high school smokers has leveled off or slowed after many years of progress, and more vigorous efforts are needed to reverse this "discouraging" finding, the CDC says in a new report.

Across all racial and ethnic groups, as well as among males and females, there has been either a slowing or leveling off of the rate of decline, study researcher Terry Pechacek, PhD, associate director of CDC's Office on Smoking and Health, tells WebMD.

Because of this slowing trend, "thousands of youths are developing an addiction from which one in three are going to die prematurely," says Pechacek, author of the report in the CDC's Morbidity and Mortality Weekly Report for July 9, 2010.

Because of the slowing rate of decline, he tells WebMD, "we are not going to be able to reach our 2010 objective" of reducing the prevalence of current cigarette use among high school students to 16% or less anytime soon.

Partly to blame has been a decline in concerted antismoking campaigns, he says, and many formerly successful efforts have been stopped by states, mostly for financial reasons, Pechacek says.

CDC Director Thomas R. Frieden, MD, MPH, says in a news release that although four in five high school students don't smoke, "it's discouraging to see that current smoking did not continue to decline more rapidly among youth."

He says that the "slow progress since 2003 tells us that much more needs to be done to reduce youth smoking."

The report finds that:

  • The percentage of students who reported current cigarette use increased from 27.5% in 1991 to 36.4% in 1997, declined sharply to 21.9% in 2003, after which the decline slowed to 19.5% in 2009.
  • The percentage of students who ever smoked cigarettes did not change from 1991 to 1999, declined from 70.4% in 1999 to 58.4% in 2003, then declined more gradually to 46.3% in 2009.
  • The percentage of students who reported current frequent cigarette use increased from 12.7% in 1991 to 16.8% in 1999, declined to 9.7% in 2003, and then slowed to 7.3% in 2009.

Call for New Antismoking Efforts

Pechacek tells WebMD that the latest findings emphasize a need to return teen smoking trends to the more rapid rate of decline seen from the late 1990s through 2003.

Efforts should include expansion of counter-advertising media campaigns, reduction of tobacco advertising, promotions, and availability of cigarettes, and a renewed push for laws mandating tobacco-free environments.

Also, he says, cigarette prices ought to be increased through state excise taxes.

The report, using data from the national Youth Risk Behavior Survey, questioned students in all 50 states and Washington, D.C. "Ever-smoked" was defined as ever trying cigarettes, even a puff or two; "current smoking" was defined as smoking on at least one day during the 30 days prior to the survey. "Current frequent smokers" were those who said they smoked on 20 or more days during the past 30.

Pechacek tells WebMD that the implications of the findings "are that far, far too many youths who could have been prevented from smoking are on the pathway to premature death."

He adds: "We are disappointed at the slowing. We are not surprised because effective prevention efforts have been reduced due to budget cutbacks at the state level, and tobacco use has become less of a priority issue. Complacency set in that we were making progress."

"We know what works," Pechacek tells WebMD. "It's a matter of doing what we know can be effective," including efforts to make smoking less socially acceptable.

"The good news is that four out of five youths are not smoking, and rates of ever-smoking have come down to the lowest levels we have ever seen in the survey," Pechacek says.

"The bad news is, far too many kids are continuing to develop the nicotine addiction, and the rates of 19.5% current smokers are much higher than they could be if we were effectively doing the programs that we know would prevent youth smoking," he says.

SOURCES: News release, CDC.

Morbidity and Mortality Weekly Report, vol 59: pp 797-801.

Terry Pechacek, PhD, associate director, Office on Smoking and Health, CDC.

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