Trends in Cigarette Smoking Among United States Adolescents

Authors

Maria C Mejia
Adedamola Adele
Robert S Levine
Charles H Hennekens
Panagiota Kitsantas

Publication Date

1-1-2023

Journal

Ochsner Journal

DOI

10.31486/toj.23.0113

PMID

38143546

PMCID

PMC10741819

PubMedCentral® Posted Date

12-1-2023

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Adolescent, cigarette smoking, smoking

Abstract

Background: Cigarette smoking remains the leading avoidable cause of premature death in the United States, accounting for approximately 500,000, or 1 in 5, deaths annually. We explored trends in cigarette smoking among US adolescents.

Methods: We used data for adolescents in grades 9 through 12 from 1991 to 2021 from the Youth Risk Behavior Survey provided by the US Centers for Disease Control and Prevention. We explored trends overall as well as by sex, race/ethnicity, and school grade.

Results: All cigarette use—assessed as ever, occasional, frequent, or daily—among adolescents declined markedly from 1991 to 2021. Specifically, ever use significantly decreased from 70.1% in 1991 to 17.8% in 2021 (P<0.05), an almost 4-fold decline. Occasional use significantly decreased from 27.5% in 1991 to 3.8% in 2021 (P<0.05), a greater than 7-fold decline. Frequent use significantly decreased from 12.7% to 0.7%, a greater than 18-fold decline. Daily use declined from 9.8% in 1991 to 0.6% in 2021, a greater than 16-fold decline. Cigarette smoking significantly decreased from 1999 to 2021 across sex, race/ethnicity, and school grade (P<0.05). In 2021, daily use was higher in boys vs girls; Hispanic/Latino and White youth vs Black and Asian youth; and 12th graders vs 9th, 10th, and 11th graders.

Conclusion: These data show large and significant decreases in cigarette use among US adolescents in high school grades 9 through 12 from 1991 to 2021. Nonetheless, the data also suggest residual clinical and public health challenges that will require targeted interventions.