Cigarette Smoking

Narrative

The use of tobacco products, such as cigarettes, can lead to a variety of illnesses and conditions, including cancer, heart disease, and lung disease.1 Smoking is the leading preventable cause of death and disease in the United States, accounting for more than 1,200 deaths each day. Cigarette smoking among adolescents can result in both immediate and long-term damage. Adolescents who smoke face reduced lung function and slowed lung growth, which may increase their risk for chronic obstructive pulmonary disease. The earlier the age of initiation, the more likely individuals will develop nicotine addiction, which prolongs cigarette use. Almost 9 out of 10 cigarette users started smoking by age 18.2

The rate of past month cigarette use among adolescents aged 12–17 years declined by nearly half, from 13.0 to 6.6 percent, between 2002 and 2012 (Figure 1). Current cigarette use in 2012 varied by age, with rates of 13.6 percent among youth aged 16–17 years, compared to 4.6 percent of youth aged 14–15 years and 1.2 percent of youth aged 12–13 years.

While cigarette use rates were similar for adolescent males and females (6.8 and 6.3 percent, respectively), past-month use varied by race and ethnicity. Rates were highest among non-Hispanic American Indian/Alaska Native (11.8 percent), non-Hispanic White (8.2 percent), and non-Hispanic youth of multiple races (7.5 percent) while lowest among non-Hispanic Asian youth (1.7 percent).

past month cigarette use

Figure 1 Source

The rate of past-month cigarette use was greater in nonmetro counties (9.0 percent) than in both large metro (5.6 percent) and small metro counties (7.1 percent; Figure 2).

past month cigarette use by residence

Figure 2 Source

The rate of past year initiation of cigarette use among adolescents was 4.1 percent. Rates of past year initiation have only recently started to decline, with rates falling from 4.9 percent in 2010 to 4.1 percent in 2012.

Prevention strategies must focus on reducing initiation and continuation of cigarette use as well as promoting cessation. More than 80 percent of smokers under 18 years of age used cigarettes from the top three most advertised brands.3 Health communication interventions have been shown to effectively decrease tobacco use initiation and prevalence as well as increase cessation, especially as part of a set of comprehensive tobacco control measures.4 Successful messages used emotional appeal through personal testimonials or graphic images of harms caused by tobacco and also provided cessation services information.7 Smoke-free policies have been shown to effectively reduce tobacco-related morbidity and mortality,8 in addition to reducing tobacco use initiation and prevalence and increasing cessation. Smoking may be restricted to designated outdoor locations or even completely banned. Initiation, prevalence, and intensity of cigarette smoking can be reduced by increasing tobacco prices.5 In addition, clinicians can play a role in promoting cessation as part of comprehensive pediatric care. Adolescents should be screened for tobacco use at every clinical encounter, and receive appropriate guidance regarding the risks of tobacco use and benefits of tobacco cessation.6

Data Sources

Figure 1. Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: detailed tables. NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013. Accessed March 7, 2014.

Figure 2. Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: detailed tables. NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013. Accessed March 7, 2014.

Endnotes

1 U.S. Department of Health and Human Services. Healthy People 2020 topics & objectives: tobacco use. Accessed March 7, 2014.

2 U.S. Department of Health and Human Services. Preventing tobacco use among youth and young adults: a report of the Surgeon General, 2012. Fact sheet. Accessed March 14, 2014.

3 Centers for Disease Control and Prevention. Youth and tobacco use. CDC fact sheets. Accessed March 14, 2014.

4 U.S. Department of Health and Human Services. Preventing tobacco use among youth and young adults: a report of the Surgeon General, 2012. Fact sheet. Accessed March 14, 2014.

5 Guide to Community Preventive Services. Reducing tobacco use and secondhand smoke exposure. Accessed March 18, 2014.

6 American Academy of Pediatrics. Tobacco as a Substance of Abuse. Accessed February 16, 2015.

7 Guide to Community Preventive Services. Reducing tobacco use and secondhand smoke exposure: Mass-reach health communication interventions. Accessed February 16, 2015.

8 Guide to Community Preventive Services. Reducing tobacco use and secondhand smoke exposure: Smoke-free policies. Accessed February 16, 2015.

Data

Statistical Significance Test

Calculate the difference between two estimates:

Calculated Z-Test Result 0.9567433 Not statistically significant

We follow statistical conventions in defining a significant difference by a p-value less than 0.05 where there is a less than 5% probability of observing a difference of that magnitude or greater by chance alone if there were really no difference between estimates. The 95% confidence interval includes a plausible range of values for the observed difference; 95% of random samples would include the true difference with fewer than 5% of random samples failing to capture the true difference.

This website allows comparisons between two estimates using the independent z-test for differences in rates or proportions. This test is appropriate for comparing independent populations across years (e.g., 2011 versus 2012) or subgroups (e.g., Male versus Female) on corresponding measures. To the extent possible, the functionality of this application has limited estimate comparisons based on appropriate use of the independent z-test. However, some tables present subgroup categories within broader categories that will allow comparisons between non-independent populations (e.g., low birth weight and very low birth weight). Users should exercise caution when interpreting these test results, which will frequently overstate statistical significance.

For some tables, the website does not allow for comparisons between two estimates, even though the data represent independent populations. Generally, this is because the standard errors were not publicly available at the time this website was created.

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