Fewer teens were smoking in 2000 than in 1999, continuing a downward trend in youth cigarette use since an all-time high in 1997, according to the latest National Household Survey on Drug Abuse by the Department of Health and Human Services (HHS).
“The survey also reveals that rural teens are smoking more than their peers in cities,” says Lee Wilson, Director of the Synar Implementation Program for the Center for Substance Abuse and Prevention, part of HHS. Among youths in metropolitan areas, nearly 12 percent reported smoking in the past month, compared with nearly 18 percent for youths in rural, nonmetropolitan areas. “I think this is really significant,” Wilson says. “I think it clearly speaks of a population that may be in greater need [of tobacco control efforts].”
Among the 2000 survey highlights:
• Thirteen percent of youths between 12 and 17 reported smoking cigarettes, as compared with the 1999 survey that found 15 percent in this age group were smokers.
• Among smokers of all ages, two out of three reported smoking daily, while among the 12-to-17 age group, about one out of three were daily smokers.
• The number of teens who start smoking each day has dropped since its recent peak in 1997 at 3,186 new teen smokers each day. In 1999, 2,145 youths between ages 12 and 17 started smoking each day.
• About 1.4 million teens between 12 and 17 started smoking during 1999, compared with 1.9 million in 1997.
• Among all respondents who reported smoking in the past month, almost half were either binge or heavy alcohol drinkers.
• Among smokers, about one out of six reported illicit drug use, compared with less than one out of twenty nonsmokers.
Survey Results Emphasize Tobacco as a Gateway Drug
“The survey adds to the body of evidence that smoking is associated with use of illicit drugs, binge drinking, and heavy regular use of alcohol,” Wilson says. Because of that, he says, the message of tobacco control initiatives designed to convince kids not to start smoking, or to quit if they have started, should speak in broad terms of a healthy lifestyle.
Cigarette Price Hike, State Tobacco Control Efforts Contribute to Decline
“The decline two years in a row is encouraging, but much work remains for health advocates to reduce the number of teens who smoke—and that work must include teens themselves,” says Ron Todd, MSEd, Director of Tobacco Control for the American Cancer Society. Some of that decline, he says, could be attributed to a price increase in cigarettes, which is known to have an effect on youth smoking. Several states have allocated money to reduce teen smoking, and those programs appear to have an effect as well, he notes. Although the national survey results include smokers of all ages, anti-smoking advocates pay close attention to teen smoking because that is the age when 80 percent of all smokers started the habit, he says.
A Cultural Shift Away from Smoking
“If you look at the number of smoke-free areas that have been established in restaurants and public places—that really is a cultural shift,” Todd says. “When you begin to eliminate smoking in public places, it begins to help the public understand that the majority of people don't want to be exposed to tobacco smoke. It sends a good message to young people.”
What's more important, however, is to involve teens in shaping the message, Todd says. “I think there's been more of an effort over the last few years to involve young people,” Todd says. “We're doing things with them rather than preaching to them. We're incorporating their creativity into our efforts, rather than just teaching them not to smoke.”
Kids Have Easy Access to Tobacco
The annual survey is based on a representative sample of the US population age 12 and older. For the 2000 survey, more than 71,000 people were interviewed, according to the federal agency.
The survey also reported:
• Youths have easy access to tobacco despite laws in all 50 states prohibiting the sale of tobacco to anyone under 18. More than half of the surveyed people 17 and younger who smoke reported that they personally bought cigarettes in the last month.
• Approximately one-third of youth smokers reported buying cigarettes from a store with no questions asked. More of these young survey respondents bought them from friends or relatives.
All 50 states have developed goals and plans to improve the enforcement of laws restricting sales of cigarettes, Wilson says, but access to cigarettes through friends and family remains a more challenging obstacle. “One of the things that is kind of confounding to all of us in the tobacco control movement is that youths are getting a large share of their cigarettes from nonretail sources,” Wilson says. “While we have been able to change laws, increase retailer compliance, and increase the price of tobacco, we are still left with having to change the social norms among some people, i.e., those who believe it is all right to share their cigarettes with kids,” Wilson says. “And this may be the hardest effort of all.”