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The prevalence of daily cigarette use among youth declined dramatically in the 2000s; among twelfth-graders, it decreased to less than a quarter of what it had been, from 25 percent in 1997 to 6 percent in 2015. However, in recent years, youth’s use of electronic cigarettes has risen dramatically, and now surpasses their use of any other form of tobacco.

Importance

Cigarette smoking, which usually starts in adolescence, is the leading preventable cause of premature death in the United States.[1] More than 480,000 Americans die each year from tobacco-related illnesses.[2] Smoking rates remain higher than the Healthy People 2020 objective of 12% adult smoking prevalence, and this target is unlikely to be reached by 2020.[3]

Cigarette smoking, according to the U.S. Surgeon General, has immediate negative health effects, including addiction.[4] Youth who smoke are more likely to drink alcohol, and to use marijuana and other illicit drugs.[5] They are also less likely to be physically fit and more likely to suffer from respiratory problems.[6] According to results from the National Youth Tobacco Survey in 2015, 86 percent of youth aged 9 to 17 who attempted to buy tobacco products within the past 30 days were not refused purchase because of their age.[7]

Youths’ involvement in antisocial behaviors, as well as smoking among their parents and peers, were associated with daily smoking among youth who had initiated smoking by eighth grade. Parents’ positive family management was associated with lower likelihood of escalation to daily smoking.[8]

E-cigarettes, or electronic vaporizers, are devices that allow users to inhale a water-based mist of nicotine, rather than tobacco smoke.[9] While the devices do not produce second-hand smoke, as cigarettes do,[10] “vaping” has negative health effects on the user,[11] and adolescent users are more likely to subsequently take up cigarette smoking.[12]

Trends

In 2015, 1 percent of eighth-graders, 3 percent of tenth-graders, and 6 percent of twelfth-graders reported smoking daily, compared with 7, 16, and 23 percent, respectively, in 1999. Twelfth-grade daily smoking peaked in 1997 at 25 percent, while daily smoking peaked in 1995 for eighth- and tenth-graders, at 10 and 18 percent respectively. (Figure 1) Some of the factors that may be associated with these long-term declines in smoking rates are increases in the level of students’ disapproval of, and their perception of risk connected with smoking; adverse publicity on the tobacco industry’s role in promoting addiction; a decline in cigarette advertising reaching youth, together with an increase in antismoking advertising; and substantial price increases for cigarettes.[13]

Although cigarette use is declining, e-cigarette use is on the rise. Between 2011 and 2015, the proportion of high school students who had used e-cigarettes in the past 30 days increased from 2 to 16 percent, while cigarette use in the past 30 days declined from 16 to 9 percent.[14]

Differences by Age

Daily smoking among students increases with age. While only 1 percent of eighth-graders reported daily cigarette use in 2015, 6 percent of twelfth-graders reported the same. (Figure 1) Although use of e-cigarettes in the past 30 days was lower in 2015 among eighth-graders than their older peers, it was similar among tenth- and twelfth-graders (8 percent among eighth-graders, compared with 14 and 16 percent, respectively, among tenth and twelfth-graders). (Appendix 2)

Differences by Race and Hispanic Origin[15]

White students in tenth and twelfth grades are much more likely to smoke than their black and Hispanic peers. In 2015, 4 percent of white tenth-graders smoked daily, compared with 2 percent of both black and Hispanic tenth-graders. In twelfth grade, there was a similar difference, with 7 percent of white students smoking daily, compared with 4 percent of black and Hispanic students. Differences by race and ethnicity among eighth-graders were less pronounced in 2015.  (Figure 2)

Differences by Gender

In 2014, smoking rates at eighth- and tenth-grade were similar for males and females. However, among twelfth-graders, males were more likely to smoke than females, at eight and five percent, respectively.  (Appendix 1)

Teenage boys are more likely to use of e-cigarettes than girls. Among males in 2014, 10 percent of eighth-graders, 19 percent of tenth-graders, and 20 percent of twelfth-graders used e-cigarettes in the past 30 days, compared with 7, 13, and 14 percent of females, respectively. (Appendix 2)

Differences by Parental Education Level

In general, students whose parents have high levels of education are less likely to smoke cigarettes daily than are students whose parents have low levels of education. For example, in 2015, 5 percent, each, of tenth-grade students with a parent who did not complete high school, and students with a parent with only a high school diploma, smoked cigarettes daily, compared with 2 percent of those with a parent who had completed college, and 1 percent of those with a parent who had completed graduate school.(Figure 3)

In 2015, eighth- and tenth-grade students whose parents completed college were less likely than their peers whose parents had less education to have used e-cigarettes in the past 30 days. However, among twelfth-graders, there was no clear pattern of use by parental education. (Appendix 2)

Differences by College Plans

Eighth-grade students who do not plan to complete 4 years of college are roughly 6 times more likely to smoke daily than students who have such plans (1 versus 6 percent, in 2015). At twelfth-grade the relative size of this gap narrows, although those with college plans are still more than 3 times as likely to smoke as their peers without such plans (4 and 14 percent, respectively). (Appendix 1) Patterns are similar for e-cigarette use. (Appendix 2)

State and Local Estimates

2015 estimates for cigarette use are available for select states and cities from the Youth Risk Behavior Survey (YRBS): see Tables 32, 34, 36 and 38.

Estimates of cigarette use in the past month among 12- to 17-year-olds are available for all 50 states for 2012-2013 from the National Survey on Drug Use and Health.

NOTE: Estimates of drug use from the National Household Survey of Drug Abuse (NHSDA), used to generate these state-level estimates, are generally lower than estimates generated by the Monitoring the Future Survey (MTF). Since the MTF was the source of the national estimates presented in this indicator, users should not make direct comparisons of estimates made from the two sources. For information on methodological differences in the surveys that may be causing these differences in estimates, see

Harrison, L. D. (2001). Understanding the differences in youth drug prevalence rates produced by the MTF, NHSDA, and YRBS studies. Journal of Drug Issues, 31(3), 665‐694.

International Estimates

Estimates for youth in European countries are available through the ESPAD Report 2015: Results from the European School Survey Project on Alcohol and Other Drugs, (See Table 3a

)A cross-country comparison of the percentage of youth who report smoking daily is available at: The Global Youth Tobacco Survey Collaborative Group. “Tobacco use among youth: A cross country comparison” Tobacco Control 2002 Sep. 11(3): 252-70.

The percentage of students who report smoking daily is available for 28 countries from the WHO Policy Series: Health policy for children and adolescents, Issue 1. (Data from 1997/1998, page 98).

National Goals

The federal government has set several national goals, through its Healthy People 2020 initiative, to reduce tobacco use among adolescents. One goal is to reduce the percentage of high school students smoking one or more cigarettes in the prior month, from the 2009 level of 19.5 percent, to 16 percent by 2020. Another goal is to reduce the initiation of tobacco use among youth 12 to 17 years. Other related goals are to increase tobacco-free schools, reduce adolescents’ exposure to advertising for tobacco products, and increase enforcement of laws prohibiting sales of tobacco to minors. To reach this goal, the Center for Disease Control and Prevention (CDC) advocates the use of education programs which work to prevent smoking and encourage cessation of smoking.[16]

More information available here.

What Works to Make Progress on This Indicator

The Centers for Disease Control & Prevention provides a list of successful school‐based programs.

Also, see the Child Trends LINKS database (“Lifecourse Interventions to Nurture Kids Successfully”), for reviews of many rigorously evaluated programs, including the following which have been shown to be effective in preventing adolescent tobacco use:

• The Good Behavior Game
• Know Your Body
• Life Skills Training
• Lion’s‐Quest Skills for Adolescence
• Nuestras Familias
• Project Northland
• Project STAR
• Project “TNT”
• School Nurse‐Delivered Adolescent Smoking Cessation Counseling Intervention
• Social Influence Curriculum
• Tobacco Policy Options for Prevention

Related Indicators

• Parental Smoking
• Substance‐Free Youth
• Asthma
• Mothers Who Smoke While Pregnant

Definition

Students are considered daily cigarette smokers if they said that they smoked one or more cigarettes per day in the last 30 days.

Students are considered e-cigarette smokers if they used any e-cigarettes in the past 30 days. The question referred to electronic cigarettes or e-cigarettes.

Data Source

Data for 1976-2015: Source: Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national survey results on drug use, 1975-2015: Volume I, Secondary school students. Ann Arbor, MI: Institute for Social Research, The University of Michigan. Retrieved from http://monitoringthefuture.org/pubs/monographs/mtf-vol1_2015.pdf. Tables 117 to 119, and 4-7

Raw Data Source

The Monitoring the Future Survey

htto://www.monitoringthefuture.org

Appendix 1 – Percentage of Students in Grades 8, 10, and 12 who Report Smoking Daily¹: Selected Years, 1976-2015

Appendix 2 – Percentage of Students in Grades 8, 10, and 12 who Report Smoking E-Cigarettes, or Cigarettes, Any Time in the Past 30 Days: 2015

Endnotes

Suggested Citation:

Child Trends Databank. (2016). Daily cigarette use. Available at: https://www.childtrends.org/?indicators=daily-cigarette-use