Cigarette Use Among High School Students—United States, 1991–2009

July 9, 2010 / Vol. 59 / No. 26

MMWR Highlights

• For three measures of cigarette use—ever smoked cigarettes, current cigarette use, and current frequent cigarette use—rates among high school students began to decline in the late 1990s, but the rate of decline slowed during 2003–2009.
  • The percentage of students who ever smoked cigarettes did not change during 1991–1999, declined from 70.4% in 1999 to 58.4% in 2003, and then declined more gradually to 46.3% in 2009.
  • The percentage of students who reported current cigarette use (i.e., smoked cigarettes on at least 1 day during the 30 days before the survey) increased from 27.5% in 1991 to 36.4% in 1997, declined to 21.9% in 2003, and then declined more gradually to 19.5% in 2009.
  • The percentage of students who reported current frequent cigarette use (i.e., smoked cigarettes on 20 or more days during the 30 days before the survey) increased from 12.7% in 1991 to 16.8% in 1999, declined to 9.7% in 2003, and then declined more gradually to 7.3% in 2009.
• Since 2003, the rate of decline in current cigarette use slowed or leveled off for all racial/ethnic and sex subgroups except for black female students (for whom current cigarette use declined after 1999).
• As a result of the slow declines in youth smoking, the Healthy People 2010 national health objective to reduce the prevalence of current cigarette use among high school students to 16% or less has not been met.
• Effective, evidence-based efforts are needed to address the slowing declines and further reduce youth smoking rates in the United States. For example:
  • Strategies such as counter-advertising mass media campaigns; higher prices for tobacco products through increases in excise taxes; tobacco-free environments; programs that promote changes in social norms; and comprehensive communitywide and school-based tobacco-use prevention policies will help reduce smoking.
  • Reductions in tobacco advertising, promotions, and commercial availability of tobacco products in combination with other well-documented and effective strategies can compliment and strengthen the impact of traditional tobacco-control interventions.
  • Effectively countering tobacco industry marketing influences will be important in national efforts to reduce youth smoking.