NCI Press Office
Changing Adolescent Smoking Prevalence: Where It Is and Why was compiled by over 30 public health experts from throughout the United States. David M. Burns, M.D., of the University of California in San Diego, Calif., was the senior scientific editor of the monograph. The report is the 14th in NCI's Smoking and Tobacco Control Monograph Series and offers the first major update of adolescent smoking behavior since 1994.
The authors of the monograph examine trends in the percentage of young people who smoke, including data showing that initiation rates have declined over time for males at all ages. However, there was little evidence of a decline in initiation for females under 16 years old, and initiation rates increased for females 16 years and older.
The youth smoking rates overall remain relatively high. The latest figures reported in the monograph are from the 2000 Monitoring the Future study, which showed that almost 32 percent of 12th-graders are current smokers (defined as having smoked within the past 30 days). The highest rate of current smoking for 12th-graders in the 1990s occurred in 1997, with almost 37 percent reported as current smokers.
According to Healthy People 2010, the government's comprehensive set of health objectives for the nation, the goal is to reduce the percent of current adolescent smokers to 16 percent by the year 2010. "Much work and continued progress are needed in order to reach that goal," said Scott Leischow, Ph.D., chief of NCI's Tobacco Control Research Branch.
Several chapters in the NCI monograph present data on various racial/ethnic groups, including descriptions and explanations of smoking behavior among African American, Hispanic/Latino, Asian American and Pacific Islander, and American Indian and Alaskan Native adolescents. Smoking rates vary by ethnic group, with American Indian and Alaskan Native adolescents showing the highest rate and African American adolescents showing the lowest. The authors describe protective factors such as religious involvement and participation in high school sports programs that may contribute to lower smoking rates in certain populations, and risk factors such as poverty that might lead to higher smoking rates in others.
The monograph addresses large-scale influences on the smoking behavior of adolescents, including access, marketing, and cost of tobacco products. The data on youth access show that young people continue to obtain cigarettes both from noncommercial sources, such as friends and family members, and from commercial sources, such as convenience stores, even though cigarette sales are prohibited to individuals under the age of 18.
The data on the effect of cost show that youth are more responsive to cigarette price increases than are adults. A 10 percent increase in the price of cigarettes is estimated to reduce youth smoking by 5 percent or more. In addition, evidence exists that youth are more likely to quit smoking as cigarette prices are increased.
Chapters in the monograph also explore the results from statewide tobacco control programs in Massachusetts, California, and Florida. The authors examine the predictors of tobacco use among youth and describe the impact of the programs. In California, for example, following the enactment of Proposition 99 which provided tobacco control groups with funding to launch an aggressive anti-smoking campaign adolescent smoking in California showed a significant decrease compared with the national rates, particularly among adolescent males.
According to Leischow: "The evidence indicates that sustained programs work when they address the full range of influences on youth tobacco use, such as tobacco-free policies, active parent and community involvement, school-based programs, cessation services, and media to
counter tobacco advertising. But the monograph reminds us that there is no easy solution for reducing youth smoking. Tobacco control organizations and researchers must continue to find answers and implement comprehensive policies and programs that are proven effective."