Problem/condition: Tobacco use is the single leading preventable cause of death in the United States, accounting for approximately 430,000 deaths each year. The prevalence of cigarette smoking nationwide among high school students increased during the 1990s, peaking during 1996-1997, then began a gradual decline. Approximately 80% of tobacco users initiate use before age 18 years. If the trend in early initiation of cigarette smoking continues, approximately 5 million children aged <18 years who are living today will die prematurely because they began to smoke cigarettes during adolescence. The economic costs associated with tobacco use ranges from $53 billion to $73 billion per year in medical expenses and $47 billion in lost productivity. Because of these health and economic consequences, CDC has recommended that states establish and maintain comprehensive tobacco-control programs to reduce tobacco use among youth.
Reporting period: January 2000 through December 2000.
Description of the system: To assist states in developing and maintaining their state-based comprehensive tobacco prevention and control programs, CDC developed the Youth Tobacco Surveillance and Evaluation System, which includes international, national, and state school-based surveys of middle school and high school students. Two components of this system are discussed in this report--the National Youth Tobacco Survey and the state Youth Tobacco Surveys. The national survey is representative of students in the 50 states and the District of Columbia; 35,828 students in 324 schools completed questionnaires in the spring of 2000. Twenty-nine state surveys were conducted in the spring and fall of 2000; state sample sizes ranged from 583 to 33,586 students. This report summarizes data from the 2000 national survey and state surveys.
Results and interpretation: Findings from the National Youth Tobacco Survey indicate that current tobacco use ranges from 15.1% among middle school students to 34.5% among high school students. Cigarette smoking is the most prevalent form of tobacco use, followed by cigar smoking and smokeless tobacco use. Approximately one half of current cigarette smokers in middle school and high school report that they usually smoke Marlboro cigarettes. Black students are more likely to smoke Newport cigarettes than any other brand. More than one half of current cigarette smokers in middle school and high school report that they want to stop smoking. Nearly one fourth of middle school and high school students who have never smoked cigarettes are susceptible to initiating cigarette smoking in the next year. Exposure to secondhand smoke (e.g., environmental tobacco smoke) is substantially higher among both middle school and high school students. During the week before the survey, approximately 9 out of 10 current cigarette smokers and one half of never cigarette smokers were in the same room with someone who was smoking cigarettes; and 8 out of 10 current cigarette smokers and 3 out of 10 never cigarette smokers rode in a car with someone who was smoking cigarettes. Approximately 70% of middle school and 57% of high school students who currently smoke cigarettes live in a home where someone smokes cigarettes. Among never cigarette smokers, approximately 3 out of 10 live in a home where someone smokes cigarettes. Approximately 69% of middle school and 58% of high school students aged <18 years who currently smoke cigarettes were not asked to show proof of age when they bought or tried to buy cigarettes. Approximately 8 out of 10 middle school and high school students have seen antismoking commercials. Eight out of 10 middle school students report having seen actors using tobacco on television or in the movies, and approximately 11% of middle school and 16% of high school students who had never used tobacco would wear or use something with a tobacco company name or picture on it. This rate increases to nearly 60% for current tobacco users.
Public health actions: Youth Tobacco Survey data are used by health and education officials to improve national and state programs to prevent and control youth tobacco use. Several states use the data in presentations to their state legislators to demonstrate the need for funding smoking cessation and prevention programs for youth.