Youth Tobacco Surveillance - United States, 1998–1999

Content • National Youth Tobacco Survey (NYTS) • State Youth Tobacco Surveys (YTS) • Best Practices for Comprehensive Tobacco Programs NYTS results by comprehensive tobacco program category: • Surveillance and Evaluation • Community Programs • School Programs • Enforcement • Counter-marketing • Cessation

MMWR Highlights

October 13, 2000 / Vol. 49 / SS 10

National Youth Tobacco Survey (NYTS)

The National Youth Tobacco Survey (NYTS) was conducted September-October 1999 by the American Legacy Foundation in collaboration with the CDC Foundation and with technical assistance from the CDC. The NYTS report provides first-ever national data on the prevalence of current tobacco use among middle school students and documents the emergence of bidis and kreteks among middle and high school students. Approximately 15,000 students in grades 6 through 12 from about 131 public and private schools participated in the NYTS. A previous report focusing on tobacco use prevalence was published in the January 28, 2000 issue of the MMWR.

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State Youth Tobacco Surveys (YTS)

Three states participated in the YTS in 1998 (Florida, Mississippi, and Texas) and 13 states in 1999 (Arkansas, Florida, Georgia, Kansas, Mississippi, Missouri, Nebraska, New Jersey, North Carolina, Oklahoma, South Dakota, Tennessee, and Texas). The data from middle and high school students are organized around seven categories (prevalence of use, knowledge and attitudes, minors’ access to tobacco, media and advertising, smoking cessation, exposure to environmental tobacco smoke, and school curriculum), which will assist states in designing, implementing and evaluating their comprehensive tobacco control program.

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Best Practices for Comprehensive Tobacco Programs

States can use the NYTS and their YTS data to develop, monitor, and evaluate the elements of their comprehensive tobacco control programs as defined in the CDC’s Best Practices For Comprehensive Tobacco Control Programs. Best Practices provides states with recommended strategies and funding levels for effective programs to prevent and reduce tobacco use, eliminate the public’s exposure to secondhand smoke, and identify and eliminate disparities related to tobacco use and its effects among different population groups. There are nine components of comprehensive tobacco control programs of which six components can be measured using YTS data: surveillance and evaluation, community programs to reduce tobacco use, school programs, enforcement, countermarketing, and smoking cessation programs.

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NYTS results by comprehensive tobacco program category:

Surveillance and Evaluation: Monitor tobacco-related behaviors, attitudes, outcomes and influences.

• Any Tobacco Use - 2.8% of middle school students and 34.8% of high school students used some form of tobacco (cigarettes, smokeless, cigars, pipes, bidis, or kreteks) in the past month.
• Cigarette Use - 28.5% of high school and 9.2% of middle school students were current cigarette smokers in 1999.

Among middle school students there was no significant difference in current cigarette smoking by race/ethnicity — whites (8.8%), African Americans (9.0%), and Hispanics (11.0%). However, white (32.9%) and Hispanic (25.8%) high school students were much more likely than African American (15.9%) high schoolers to currently smoke cigarettes.

Among middle school students 2.5% currently smoke bidis and 1.9% kreteks. Among high school students 5.0% currently smoke bidis and 5.8% kreteks.

• Smoking Susceptibility - One in five middle school (22.9%) and high school students (23.7%) who had never smoked cigarettes are susceptible to initiating smoking in the next year.

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Community Programs: Seek to reduce tobacco use initiation, promote cessation, protect from environmental tobacco smoke and eliminate tobacco use disparities among populations.

• Same Room/Home Exposure - Current smokers were almost twice as likely as never smokers to be in the same room with someone who was smoking on one or more days of the past week and were twice as likely as never smokers to live in a home where someone else smokes.

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School Programs: Critical to preventing tobacco use onset.

• Only 40% of middle school and 10% of high school students were taught ways to say "no" to tobacco as part of their school curriculum during the most recent school year.

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Enforcement: Deters the illegal sale of tobacco to minors.

• Proof of age - Nearly three-fourths (72.2 %) of middle school students and more than half (59.3%) of high school students who currently smoke were not asked to show proof of age when purchasing cigarettes.
• Not Refused Purchase – Almost two-thirds of middle (66.2%) and high school (65.3%) students who currently smoke were not refused purchase of cigarettes because of age.

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Counter-marketing: While tobacco advertising stimulates adult consumption and increases the risk of initiation among youth, counter-marketing messages have a powerful influence on public support for tobacco use prevention.

• Smoking on TV or in Movies - A majority of middle (87.2%) and high (91.7%) school students have seen actors smoking on television or in movies.
• Would Wear or Use Tobacco Image - Approximately one in five current tobacco users in middle (22.4%) and high school (21%) would wear or use something with a tobacco company name or picture on it. Of students who never used tobacco, 1.7% of middle school and 2.1% of high school students would wear or use something with a tobacco company name or picture on it.
• Brand Preference - Three brands account for 75% of cigarettes preferred by teens. The most widely used used by current smokers in middle school are Marlboro (42.7%), Newport (25.3%) and Camel (6.9%). For high schoolers: Marlboro (53.6%), Newport (18.8%) and Camel (10.1%).

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Cessation: Successful cessation programs can produce a greater short-term public health benefit than any other element of a comprehensive tobacco control program. Data support the need for youth programs.

• Want to Stop Smoking - More than half of middle (50.9%) and high (54.4%) school students who currently smoke want to stop smoking completely.

• Tried to Quit Smoking - About six in 10 middle (57.9%) and high (55.6%) school students nationwide had seriously tried to quit smoking in the year prior to the survey.

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This page last reviewed March 27, 2003

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