Report Shows Recent Progress in Decreasing Youth Tobacco Use, but Much Work Remains

Adolescent smoking rates increased through much of the
1990s, but a new report released today by the National
Cancer Institute (NCI) shows there has been a promising
decline over the past few years. Despite this recent
progress, there remains a need for more research and for
anti-smoking programs designed both to prevent young people
from starting to smoke and to help them quit. The report
reveals a particular need for research among certain
racial/ethnic groups where smoking trends have not
decreased or, in some cases, continued to increase.

"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."

--To view the complete monograph online, please visit
cancercontrol.cancer.gov/tcrb/nci_monographs.

--To order a copy of the monograph, please visit NCI's
Publications Locator Web site at
www.cancer.gov/publications. or call NCI's Cancer
Information Service (CIS) at 1-800-4-CANCER (1-800-422-
6237). The CIS also offers personalized help to smokers
who want to quit.

--To learn about the monograph series and tobacco control
programs at the NCI, please visit NCI's Tobacco Control
Research Branch at cancercontrol.cancer.gov/tcrb.

--For more information about cancer, please visit NCI's Web
site at cancer.gov.

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