Teen smoking continues to decline in 2003, but declines are slowing

December 19, 2003

ANN ARBOR, Mich.---Cigarette use among American adolescents has been falling since the mid-1990s, with smoking rates among younger teens dropping by roughly one-half. The 2003 results from the Monitoring the Future annual series of nationwide surveys, released today by the University of Michigan Institute for Social Research, show that declines in teen smoking continued into 2003, though results also show that the rate of decline is slowing appreciably.

This year's survey is the 29th in an annual series and involves nearly 50,000 eighth-, 10th-, and 12th- grade students in 392 secondary schools nationwide. Among eighth-graders, the prevalence of current smoking (smoking one or more cigarettes in the prior 30 days) fell by only half a percentage point this year, and among 10th-graders the comparable decline was only one percentage point. Neither of these declines is statistically significant, and both are the smallest declines observed in these grades over the past four or five years. The 12th-graders do show a statistically significant 2.3 percentage point decline in their rate of current smoking; but the investigators believe that this decline largely reflects an echo of the declines exhibited earlier when these students were in the lower grades. So far, current smoking has declined since 1997 by one-third (from 37 percent to 24 percent in 2003) among 12th- graders, but the investigators predict a continuation of the decline at this grade level as the lower-smoking 10th-graders from the past two years reach 12th-grade.

"This year's results suggest that the improvements we have been seeing in teen smoking for the past eight years or so may be near an end," said Lloyd Johnston, the study's principal investigator. "While those declines have been substantial and important, it must be remembered that, to a considerable degree, they were simply offsetting the dramatic increases in teen smoking observed in the first half of the '90s. Even with the improvements, we still have a quarter of our young people who are actively smoking by the time that they leave high school, which is an unacceptably high rate for a behavior that so endangers their health and reduces their life expectancy."

The rates of current daily smoking and of current smoking at the half-pack-per-day level also continued their longer-term declines in all three grades this year. None of these one-year changes reached statistical significance. The most promising finding is that the proportions of students who have ever initiated smoking continue to drop significantly in all three grades.

As would be expected, smoking increases with age: 10 percent of the eighth-graders, 17 percent of the 10th-graders, and 24 percent of the 12th-graders surveyed in 2003 said that they had smoked some in the prior 30 days. The proportions that were current daily smokers were 5 percent, 9 percent, and 16 percent, respectively. "We know from our follow-up studies of past graduating senior classes that a number of the non-daily smokers in high school become daily smokers after graduation," state the investigators. "This increase is likely due to the fact that they no longer spend much of the day in school and in their parents' homes, where they usually are prohibited from smoking." In addition to Johnston, the other authors of the forthcoming report are Patrick O'Malley, Jerald Bachman, and John Schulenberg---all research professors at the University of Michigan Institute for Social Research.

The proportion of students who see smoking at a pack-a-day level as dangerous had been rising steadily since 1995, and that strengthened belief may well have contributed to the substantial decline in their smoking rates. In fact, perceived risk, as the investigators call it, began to rise a year prior to the decline in actual smoking (1996 and 1997, respectively), consistent with a causal interpretation. But the increase in perceived risk associated with smoking ended after 2000 in the lower grades and after 2002 in 12th-grade (see Figure 1), possibly contributing to the deceleration of the decline in use by 2003. "This argues for not letting up on anti-smoking efforts," Johnston said.

Students' personal disapproval of smoking also had been rising for some years but showed no further increase this year among eighth-graders and only a small increase among 10th- and 12th-graders (see Figure 1).

Other attitudinal measures seem to be leveling as well, following a period of considerable change in a negative direction. The proportion of 12th-graders, for example, who said that they prefer to date people who do not smoke rose from 64 percent in 1997 to 72 percent in 2002, but remained at 72 percent in 2003. "It is clear that a young person today pays a significant social price for becoming a smoker, with nearly three-quarters of the opposite sex saying that they prefer to date people who do not smoke," Johnston said. "This is just the opposite of what tobacco ads have promised for so many years."

The eighth- and 10th-grade students are asked, "How difficult do you think it would be for you to get cigarettes, if you wanted some?" The proportion of students saying "fairly easy" or "very easy" has been declining quite steadily from 1996 through 2003. In 1996, 77 percent of eighth-graders said it would be easy to get cigarettes, but that proportion is down to 63 percent in 2003. Over the same interval, the proportion of 10th-graders saying they could get cigarettes fairly easily has dropped from 91 percent to 81 percent.

The investigators conjecture that some of this decline could be due to the fact that fewer students have friends who smoke and who may have served as the source of their cigarettes. Also, some of the decline in perceived availability may be due to changes in retailer behavior. Still, even today the majority of these young people, ranging from 13 to 16 years of age, say that they could get cigarettes fairly or very easily.

Cigarette smoking is not the only form of tobacco use that has been in decline in recent years. Chewing or "spit" tobacco, which is primarily used by boys---particularly by boys from rural areas---has been declining since 1994 or 1995 among teens. The declines have been substantial, with the prevalence of any use of smokeless tobacco in the prior 30 days falling by about half in all three grade levels. However, for the first time in recent years the decline halted this year in eighth- and 10th-grades. In other words, there is evidence that the decline in the use of smokeless tobacco may be bottoming out, as well. Since 1995, teenagers have gradually come to see the use of smokeless tobacco as dangerous to the user, and since 1996, they have steadily become more disapproving of its use. Both of these factors may help to explain the long-term decline in their use of smokeless tobacco.
Monitoring the Future has been funded under a series of competing, investigator-initiated research grants from the National Institute on Drug Abuse. Surveys of nationally representative samples of American high school seniors were begun in 1975, making the class of 2003 the 29th such class surveyed. Surveys of eighth- and 10th-graders were added to the design in 1991, making the 2003 nationally representative samples the 13th such classes surveyed. The sample sizes in 2003 are 17,000 eighth-graders located in 141 schools, 16,200 10th-graders located in 129 schools, and 15,200 12th-graders located in 122 schools, for a total of 48,500 students in 392 schools overall. The samples are drawn to be representative of students in private and public secondary schools across the coterminous United States, selected with probability proportionate to estimated class size, to yield separate, nationally representative samples of students from each of the three grade levels.

The findings summarized here will be published in the forthcoming volume: Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2004). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2003. (NIH Publication No. [yet to be assigned].) Bethesda MD: National Institute on Drug Abuse. It and many other publications from the study may be found on the study's Web site, www.monitoringthefuture.org. Study Web site: www.monitoringthefuture.org

University of Michigan

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