Teen smoking resumes decline
ANN ARBOR— The number of U.S. teens who smoke has shown significant declines in recent years, particularly among those in their early teens. These declines can be seen in their lifetime, 30-day, and daily smoking rates, according to the latest Monitoring the Future study.
Including a further decline this year, the rate of smoking in the prior 30 days is now down by two-thirds among 8th graders to 7 percent from the peak level reached in 1996 of 21 percent.
?That should eventually translate into many fewer illnesses and premature deaths for this generation of young people,? said University of Michigan Distinguished Research Scientist Lloyd Johnston, the study?s principal investigator.
MTF, now in its 33rd year, tracks smoking, drinking, and illicit drug use among the nation?s secondary school students, surveying about 50,000 8th, 10th, and 12th graders in more than 400 secondary schools every year. A separate, accompanying report provides the results relating to illicit drug and alcohol use.
After warning last year of an end to the decline in daily smoking among younger teens, particularly 8th graders, the study found a resumption of that decline this year. Following a decade of substantial improvement, daily smoking among young people in their early and middle teens stopped declining last year, following a deceleration of the decline in the years immediately preceding.
But this year significant declines were observed among the nation?s 8th graders in their lifetime, 30-day, and daily smoking rates; among 10th graders there also was some decline on all of these measures.
?We don?t have a ready explanation for why the declines in smoking resumed in 2007 but whatever the reason, it is an important development, given that cigarette smoking is still the leading preventable cause of death and disease in this country,? Johnston said.
Compared to peak levels in the mid-1990s, past 30-day smoking rates in 2007 are down by 54 percent among 10th graders and 41 percent among 12th graders. The researchers expect that smoking rates among 10th and 12th graders will continue to decline as the current 8th graders, who smoke at lower rates, get older. The rates of past 30-day smoking now stand at 7 percent, 14 percent, and 22 percent across the three grades.
Daily smoking has declined even more sharply during the past decade?by half for 12th graders from recent peak levels and more than two thirds for 8th graders. In 2007, daily smoking is reported by 3 percent of 8th graders, 7 percent of 10th graders, and 12 percent of 12th graders.
Many fewer young teens even try cigarettes today compared to the mid-1990s. In 1996 half (49 percent) of all 8th graders indicated that they had ever smoked a cigarette, whereas in 2007 little more than one fifth of them (22 percent) said they had. But by the end of 12th grade, 46 percent of students in 2007 reported at least trying cigarettes, and 22 percent reported that they were currently smoking.
?Clearly smoking rates are down and experimentation with cigarettes has shifted up in age,? Johnston said. ?That?s all to the good; but it still leaves too many of our young people adopting a habit that will have adverse consequences for them and those around them. The fact that over a fifth of our young people are smoking when they leave high school, given all that is known today about the health consequences, is hardly the basis for complacency.?
Attitudes about smoking
Most young people today understand that there is a considerable risk associated with daily smoking. In grades 8, 10, and 12, respectively, 61 percent, 68 percent, and 77 percent of the 2007 respondents say that they see ?great risk? of harm in being a pack-a-day smoker
This belief increased considerably in earlier years, beginning after 1995, which probably contributed to the downturn in smoking; but it has been quite stable among the younger teens for the last three years. ?It should be noted that the younger teens are least aware of the dangers of smoking, which is unfortunate, since they are at the age when many initiate smoking and begin to develop a smoking habit,? Johnston said.
The large majority of teens today say they disapprove of smoking at the pack-a-day level: 87 percent, 85 percent, and 81 percent of 8th, 10th, and 12th graders, respectively. Disapproval has grown considerably since 1996 and is still continuing to increase in the lower grades.
The great majority of teens today also say that they ?prefer to date people who don?t smoke?: 81 percent, 80 percent, and 77 percent in grades 8, 10, and 12. Nearly two thirds think that ?becoming a smoker reflects poor judgment.?
These attitudes became more widespread after the mid-1990s, but have not grown much over the past few years. Johnston added, ?Despite what cigarette ads have implied for decades, smoking makes you less attractive to the great majority of the opposite sex, not more; and young people need to know that.?
Availability of cigarettes to teens
The proportion of teens who say that they could get cigarettes ?fairly easily? or ?very easily,? if they wanted some, has been declining for some years, particularly among the younger teens. Today, 56 percent of 8th graders?most of whom are 13 or 14 years old?say they could get cigarettes fairly easily. As high as that number is, it is down considerably from 77 percent in 1996. Tenth graders have greater availability, as might be expected, but fewer of them say they could get cigarettes fairly or very easily in 2007 (78 percent) than said that in 1996 (91 percent). This decline in availability is continuing today, with significant drops in both grades this year. It would appear that the efforts of many states and communities to get retail outlets to stop selling to underage smokers is having some success, conclude the investigators, even though the majority of teens still say that they can get cigarettes.
Like cigarettes, the 30-day prevalence of using smokeless or ?spit? tobacco reached a recent peak in the mid-1990s and then declined. All three grade levels have shown a reduction of about one half in their 30-day prevalence rates since those peak levels, but the declines appear to have ended in all grades, and use remained fairly level this year. At present, the prevalence rates for any use of smokeless or ?spit? tobacco in the prior 30 days are 3 percent, 6 percent, and 7 percent in grades 8, 10, and 12. That means that one in every fifteen high school seniors is a current user of smokeless tobacco. However, among boys, who account for almost all smokeless tobacco use, the rates are considerably higher: 5 percent, 10 percent, and 12 percent. In other words, nearly one in eight boys in 12th grade is a current user of smokeless tobacco.
Only a minority of students see great risk in using smokeless tobacco regularly, averaging around 45 percent, without much difference by grade. Perceived risk grew from about 1995 through 2004, likely helping to account for the decline in use in those years, but it has changed little since then.
Kreteks and bidis
In 2000, a single question was introduced into the study about the use of bidis?small flavored cigarettes imported from India?because of rising concern at the time about their growing popularity. In 2001 a single question was introduced for similar reasons about the use of kreteks?clove-flavored cigarettes imported from Indonesia.
Relatively low prevalence rates were observed for both types of specialty cigarettes in the initial years of measurement, and since then use has declined substantially and fairly steadily in all grades. By 2007 the annual prevalence of bidis use was down by three quarters among 12th graders, from 9 percent in 2000 to under 2 percent in 2007, including some further decline this year. Annual prevalence of kretek use among 12th graders is down by one third since 2001, but it did not decline further this year. The investigators conclude that both kreteks and bidis constituted short-term fads that have not caught on with mainstream American youth, making it unlikely that they will become the health menace some had feared. The investigators note, however, that mainstream tobacco companies have themselves introduced flavored cigarettes, which may help to explain the declines in these fringe products.
Monitoring the Future has been funded under a series of competing, investigator-initiated research grants from the National Institute on Drug Abuse, part of the National Institutes of Health (Grant Number R01DA01411). Surveys of nationally representative samples of American high school seniors were begun in 1975, making the Class of 2007 the 33rd such class surveyed. Surveys of 8th and 10th graders were added to the design in 1991, making the 2007 nationally representative samples the 17th such classes surveyed. The sample sizes in 2007 are 16,495 eighth graders in 151 schools, 16,398 tenth graders in 120 schools, and 15,132 twelfth graders in 132 schools, for a total of 48,025 students in 403 secondary schools. The samples are drawn separately at each grade level to be representative of students in that grade in public and private secondary schools across the coterminous United States. Schools are selected with probability proportionate to their estimated class size.
The findings summarized here will be published in the forthcoming volume: Johnston, L. D., O?Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2008). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2007 (NIH Publication No. [to be assigned]). Bethesda, MD: National Institute on Drug Abuse.
The content presented here is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.