Cigarette smoking among U.S. high school students at an all-time low, but e-cigarette use a concern

Cigarette smoking among high school students dropped to the lowest levels since the National Youth Risk Behavior Survey (YRBS) began in 1991, but the use of electronic vapor products, including e-cigarettes, among students poses new challenges according to the 2015 survey results released today by the Centers for Disease Control and Prevention.

Although current cigarette use decreased significantly from 28 percent in 1991 to 11 percent in 2015, new data from the 2015 survey found that 24 percent of high school students reported using e-cigarettes during the past 30 days.

“Current cigarette smoking is at an all-time low, which is great news. However, it’s troubling to see that students are engaging in new risk behaviors, such as using e-cigarettes,” said CDC Director Tom Frieden, M.D., M.P.H. “We must continue to invest in programs that help reduce all forms of tobacco use, including e-cigarettes, among youth.”

In May 2016, the U.S. Food and Drug Administration finalized an important rule extending its authority to all tobacco products, including e-cigarettes. The rule includes, for the first time, a restriction on the sale of these products to minors nationwide.

A wealth of data on teen health-related behaviors

The YRBS provides important data related to student behaviors, such as behaviors that contribute to unintentional injuries and violence.

The 2015 survey findings indicated that youth continue to be at risk by using wireless devices while driving:

• Among high school students who had driven a car or other vehicle during the past 30 days, the percentage of high school students who texted or e-mailed while driving ranged from 26 percent to 63 percent across 35 states and from 14 percent to 39 percent across 18 large urban school districts.
• Nationwide, 42 percent of students who had driven a car or other vehicle during the past 30 days reported texting or e-mailing while driving. This percentage did not change from 2013.

The 2015 survey findings showed encouraging reductions in physical fighting among adolescents.

• The percentage of high school students nationwide who had been in a physical fight at least once during the past 12 months decreased from 42 percent in 1991 to 23 percent in 2015.

However, nationwide, the percentage of students who had not gone to school because of safety concerns is still high.

• Six percent of students missed at least 1 day of school during the past 30 days because they felt they would be unsafe at school or on their way to or from school. The percentage of students not going to school because of safety concerns decreased from 2013 (7 percent) to 2015 (6 percent).

The survey also included questions on prescription drug use.

• Prescription drug use among youth decreased from 20 percent in 2009 to 17 percent in 2015. Nationwide, 17 percent of students had taken prescription drugs (e.g., Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor’s prescription one or more times during their life.

The 2015 YRBS report also included data on youth sexual risk behaviors.

• The percentage of high school students who are currently sexually active (had sexual intercourse during the past three months) has been decreasing since 1991, dropping from 38 percent in 1991 to 30 percent in 2015. Current sexual activity also decreased from 34 percent in 2013 to 30 percent in 2015.

• Among high school students who are currently sexually active, condom use decreased from 63 percent in 2003 to 57 percent in 2015, following more than a decade of increases that peaked in the early 2000s.  Condom use did not change from 2013 (59 percent) to 2015 (57 percent).
• The proportion of currently sexually active students who had drunk alcohol or used drugs before last sexual intercourse decreased from 25 percent in 1999 to 21 percent in 2015, but did not change from 2013 (22 percent) to 2015 (21 percent).
• Nationwide, 10 percent of all students had ever been tested for HIV. This is a decrease from 13 percent in 2011 and 2013.

Trends in dietary and sedentary-related behaviors, such as drinking sugar-sweetened beverages and screen time, have varied in recent years:

• There was a significant decrease in drinking soda one or more times a day from 27 percent in 2013 to 20 percent in 2015.
• From 2003-2015, the percentage of high school students playing video or computer games or using a computer three or more hours per day (for non-school related work) nearly doubled from 22 percent to 42 percent.

“Health risk behaviors among youth vary over time and across the nation, making the YRBS an important tool to better understand youth. The YRBS helps us identify newly emerging behaviors and monitor long-standing youth risk behaviors over time,” said Laura Kann, Ph.D., chief of CDC’s School-Based Surveillance Branch. “While overall trends for the 2015 report are positive, the results highlight the continued need for improvements in reducing risks among teens.”

About the Youth Risk Behavior Surveillance System (YRBSS)

CDC’s YRBSS is the only surveillance system designed to monitor a wide range of priority health risk behaviors among representative samples of high school students at the national, state, and local levels.

National, state, and large urban school district surveys are conducted every two years among high school students throughout the United States. These surveys monitor health risk behaviors including unintentional injuries and violence; sexual behaviors related to unintended pregnancy and sexually transmitted diseases, including HIV infection; tobacco, alcohol, and other drug use; unhealthy dietary behaviors; and physical inactivity. The surveys also monitor obesity and asthma.

More than 15,000 U.S. high school students participated in the 2015 National YRBS. Parental permission was obtained for students to participate in the survey, student participation was voluntary, and responses were anonymous. States and large urban school districts could modify the questionnaire to meet their needs. The 2015 YRBSS report includes National YRBS results and results from surveys conducted in 37 states and 19 large urban school districts.

The National YRBS is one of three HHS-sponsored surveys that provide data on substance abuse among youth nationally. The others are the National Survey on Drug Use and Health (NSDUH), sponsored by the Substance Abuse and Mental Health Services Administration – a primary source of statistics on substance use among Americans age 12 and older (http://www.samhsa.gov/data/population-data-nsduh) – and the Monitoring the Future (MTF) study funded by the National Institute on Drug Abuse/National Institutes of Health and conducted by the University of Michigan’s Institute for Social Research (http://monitoringthefuture.org). The MTF study tracks substance use and related attitudes among students in the 8th, 10th, and 12th grades.

The 2015 YRBS data are available at www.cdc.gov/yrbs.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES