Perspectives in Disease Prevention and Health Promotion Cigarette
Smoking among Public High School Students -- Rhode Island
From July 1983 through December 1984, as part of a health-risk
survey, information was obtained from 11,657 Rhode Island public
high
school students about their cigarette smoking practices. Overall,
22.3% of these students reported that they smoked cigarettes.
Cigarette smoking increased by grade and was more common among
females
(26.5%) than among males (17.5%). The difference between females
and
males was due primarily to a larger proportion of females who
reported
smoking less than one pack per day (Figure 1).
During this period, 19 (63.3%) of the 30 public high schools in
Rhode Island took part in this health-risk assessment program. The
ongoing program provides both prevalence estimates of cigarette
smoking and other health-related behaviors and counseling to
students
with unhealthy behaviors. More than 99% of the students attending
the
19 schools participated in the program. The 11,657 participants
constituted 26.3% of all public high school students in Rhode
Island.
The participating students were demographically similar to all
Rhode
Island public high school students but were somewhat more likely to
be
female, other than white, and from low-income communities (Table
1).
Reported by HD Scott, MD, L Marciano, MEd, R Cabral, PhD, Office of
Health Promotion, Rhode Island Dept of Health; Behavioral
Epidemiology
and Evaluation Br, Div of Health Education, Center for Health
Promotion and Education, CDC.
Editorial Note
Editorial Note: Cigarette smoking is presently the largest single
cause of preventable morbidity and mortality in the United States
(1). The prevalence of smoking has slowly declined over the past 2
decades, and over 30 million Americans have quit smoking since the
first Surgeon General's report on smoking and health was released
in
1964 (2). It has been estimated that, from 1964 to 1978, more than
200,000 premature deaths were prevented because some people stopped
smoking, and others did not start (3). Nevertheless, approximately
one-third of the U.S. adult population still smokes cigarettes, and
there is some evidence that the prevalence of smoking is actually
increasing among young white females (4). In addition, it has been
estimated that at least 12 million people used smokeless tobacco
(snuff and chewing tobacco) in the United States in 1985 (5). Use
is
increasing, especially among male adolescents and young male
adults.
Therefore, continued and even greater efforts to prevent the
initiation of any tobacco use and to assist in the cessation of
tobacco use are needed.
Smoking is an addictive behavior. Experimentation and adoption
of
the habit usually occur during adolescence; therefore, prevention
programs frequently focus on this group. Rhode Island's
data-collection system represents one approach to collecting data
on
smoking habits of teenagers. The data are self-reported and may
underestimate the true prevalence of cigarette smoking. Although
not
a state-wide random sample, the demographic characteristics of the
participants are similar to those of all public high school
students,
and the data probably are a good representation for the state-wide
public school population.
The National Institute on Drug Abuse (NIDA) collects data each
year on a national cross-section of public and private high schools
(6). Among high school seniors in 1983, NIDA estimates a
prevalence
of daily cigarette smoking of 19% for males and 22% for females.
This
gender difference is less than that seen in Rhode Island. However,
the categories of number of cigarettes smoked in the NIDA survey
and
the Rhode Island program are different, so direct comparison is not
possible.
The Rhode Island data confirm that smoking among high school
students is more common among young females than young males.
Continued efforts to prevent the onset of smoking among young
people
are necessary. Because of the growing use of smokeless tobacco
among
children and adolescents (5), these efforts should also be directed
toward preventing the use of smokeless tobacco products in this age
group. The Rhode Island program is an example of one method to
monitor the overall effect of these efforts.
References
Fielding JE. Smoking: health effects and control (1). N Engl
J
Med 1985;313:491-8.
Office on Smoking and Health. Smoking and health. A report of
the Surgeon General. Rockville, Maryland: US Department of
Health, Education, and Welfare, Public Health Service, 1979.
DHEW
publication no. (PHS) 79-50066.
Warner KE, Murt HA. Premature deaths avoided by the
antismoking
campaign. Am J Public Health 1983;73:672-7.
Remington PL, Forman MR, Gentry EM, Marks JS, Hogelin GC,
Trowbridge FL. Current smoking trends in the United States.
The
1981-1983 behavioral risk factor surveys. JAMA
1985;253:2975-8.
Public Health Service. The health consequences of using
smokeless
tobacco. A report of the Advisory Committee to the Surgeon
General. Rockville, Maryland: US Department of Health and
Human
Services, Public Health Service. NIH publication no. 86-2874.
Johnston LD, O'Malley PM, Bachman JG. Drugs and American high
school students, 1975-1983. Rockville, Maryland: National
Institute on Drug Abuse, 1984. DHHS publication no. (ADM)
85-1374.
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