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April 12, 2012

Trends in Cigarette Use among Adolescents and Young Adults

In Brief
  • The percentages of adolescents aged 12 to 17 and young adults aged 18 to 25 reporting past month cigarette use decreased from 2004 to 2010; the percentages were similar in 2008 and 2009 but decreased between 2008 and 2010 (from 9.1 to 8.3 percent for those aged 12 to 17 and from 35.7 to 34.2 percent for those aged 18 to 25)
  • The percentage of adolescents who smoked daily in the past month decreased from 3.3 percent in 2004 to 2.0 percent in 2008, then remained relatively stable; the percentage of young adults who smoked daily decreased from 20.4 percent in 2004 to 17.2 percent in 2008, then declined further between 2008 and 2010 to 15.8 percent
  • Between 2004 and 2008, the percentage of daily smokers aged 18 to 25 who smoked 26 or more cigarettes per day (about one and a half packs or more) remained relatively stable at about 5 to 6 percent; from 2008 to 2010, this percentage decreased from 6.0 to 3.4 percent
  • About 25 percent of daily smokers aged 18 to 25 smoked 5 or fewer cigarettes per day between 2004 and 2008; from 2008 to 2010, this percentage increased from 24.7 to 28.6 percent

Smoking remains the Nation's leading cause of preventable illness and death.1 Antismoking efforts have been undertaken to address this problem, and many of these efforts place particular emphasis on adolescents and young adults because most adult smokers initiate cigarette use before the age of 25.2 Schools offer health education programs targeting cigarette use, and antismoking campaigns educate young people about the dangers of smoking. States have increased enforcement of the Synar Amendment, which requires States to have and enforce laws prohibiting the sale and distribution of tobacco products to persons younger than 18.3 In addition, because higher prices can make cigarette use cost prohibitive for young people, the Federal government and many States have recently enacted substantial increases in cigarette taxes in an effort to reduce the number of young people who smoke and to reduce consumption among those who continue to smoke.4 Monitoring trends in cigarette use among adolescents and young adults can help further refine educational and enforcement efforts.

The National Survey on Drug Use and Health (NSDUH) can be used to examine trends in smoking behavior over time. NSDUH asks persons aged 12 or older if they smoked part or all of a cigarette in the past 30 days. Respondents who answered affirmatively were asked about the number of days they smoked during the past month and the number of cigarettes they smoked per day.5 This issue of The NSDUH Report examines trends since 2004, with a particular focus on recent trends from 2008 to 2010, in cigarette use among adolescents aged 12 to 17 and among young adults aged 18 to 25. These trends include use in the past month, daily use in the past month, and number of cigarettes smoked per day among daily smokers.


Trends in Cigarette Use among Adolescents Aged 12 to 17

During the 7-year period between 2004 and 2010, the percentage of adolescents aged 12 to 17 reporting past month cigarette use decreased from 11.9 to 8.3 percent (Figure 1). Recent trends show that past month cigarette use was similar in 2008 (9.1 percent) and 2009 (8.9 percent), but decreased between 2008 and 2010 (from 9.1 to 8.3 percent).

Figure 1. Past Month Cigarette Use among Persons Aged 12 to 17: 2004 to 2010
This is a line graph comparing past month cigarette use among persons aged 12 to 17: 2004 to 2010. Accessible table located below this figure.

Figure 1 Table. Past Month Cigarette Use among Persons Aged 12 to 17: 2004 to 2010
Cigarette Use 2004 2005 2006 2007 2008 2009 2010
Past Month Use 11.9% 10.8% 10.4%   9.8%   9.1%   8.9%   8.3%
Less than Daily Use   8.6%   8.0%   7.6%   7.2%   7.1%   6.8%   6.5%
Daily Use   3.3%   2.8%   2.8%   2.6%   2.0%   2.1%   1.9%
Source: 2004 to 2010 SAMHSA National Surveys on Drug Use and Health (NSDUHs).

Past month smokers can be divided into two groups—those who smoke daily and those who smoke less than daily. The percentage of adolescents who smoked daily in the past month decreased from 3.3 percent in 2004 to 2.0 percent in 2008, then remained relatively stable.


Trends in Cigarette Use among Young Adults Aged 18 to 25

Between 2004 and 2010, the percentage of young adults aged 18 to 25 reporting past month cigarette use decreased from 39.5 to 34.2 percent (Figure 2). Recent trends show overall past month cigarette use was similar in 2008 (35.7 percent) and 2009 (35.8 percent), but decreased between 2008 and 2010 (from 35.7 to 34.2 percent).

Figure 2. Past Month Cigarette Use among Persons Aged 18 to 25: 2004 to 2010
This is a line graph comparing past month cigarette use among persons aged 18 to 25: 2004 to 2010. Accessible table located below this figure.

Figure 2 Table. Past Month Cigarette Use among Persons Aged 18 to 25: 2004 to 2010
Cigarette Use 2004 2005 2006 2007 2008 2009 2010
Past Month Use 39.5% 39.0% 38.4% 36.2% 35.7% 35.8% 34.2%
Less than Daily Use 19.1% 19.4% 19.7% 18.3% 18.5% 19.5% 18.5%
Daily Use 20.4% 19.5% 18.7% 17.8% 17.2% 16.3% 15.8%
Source: 2004 to 2010 SAMHSA National Surveys on Drug Use and Health (NSDUHs).

The percentage of young adults who smoked daily in the past month decreased from 20.4 percent in 2004 to 17.2 percent in 2008, then declined further to 15.8 percent in 2010.


Trends in Number of Cigarettes Smoked among Daily Smokers

The number of cigarettes smoked per day among adolescent daily smokers remained relatively stable over time (Figure 3); however, changes were seen among 18- to 25-year-olds (Figure 4). Between 2004 and 2008, the percentage of daily smokers in this age group who smoked 26 or more cigarettes per day (about one and a half packs or more) remained relatively stable at about 5 to 6 percent. However, this percentage decreased to 4.0 percent in 2009 and 3.4 percent in 2010. On the other end of the spectrum, about 25 percent of daily smokers aged 18 to 25 smoked 5 or fewer cigarettes per day between 2004 and 2008; from 2008 to 2010, this percentage increased from 24.7 to 28.6 percent.

Figure 3. Number of Cigarettes Smoked per Day among Daily Smokers Aged 12 to 17: 2004 to 2010
This is a line graph comparing number of cigarettes smoked per day among daily smokers aged 12 to 17: 2004 to 2010. Accessible table located below this figure.

Figure 3 Table. Number of Cigarettes Smoked per Day among Daily Smokers Aged 12 to 17: 2004 to 2010
Number Smoked 2004 2005 2006 2007 2008 2009 2010
5 or Less 37.3% 36.3% 37.4% 37.8% 41.9% 46.1% 42.9%
6 to 15 43.2% 43.5% 44.4% 43.2% 39.5% 36.0% 40.2%
16 to 25 15.9% 15.6% 15.5% 14.6% 15.2% 14.5% 14.2%
26 or More   3.5%   4.5%   2.2%   3.9%   3.2%   3.4%   2.4%
Source: 2004 to 2010 SAMHSA National Surveys on Drug Use and Health (NSDUHs).

Figure 4. Number of Cigarettes Smoked per Day among Daily Smokers Aged 18 to 25: 2004 to 2010
This is a line graph comparing number of cigarettes smoked per day among daily smokers aged 18 to 25: 2004 to 2010. Accessible table located below this figure.

Figure 4 Table. Number of Cigarettes Smoked per Day among Daily Smokers Aged 18 to 25: 2004 to 2010
Number Smoked 2004 2005 2006 2007 2008 2009 2010
5 or Less 24.4% 22.4% 24.1% 25.3% 24.7% 27.3% 28.6%
6 to 15 40.6% 40.6% 41.4% 41.5% 43.1% 42.9% 43.5%
16 to 25 28.9% 31.8% 28.5% 27.9% 26.1% 25.7% 24.3%
26 or More   6.0%   5.1%   6.0%   5.1%   6.0%   4.0%   3.4%
Source: 2004 to 2010 SAMHSA National Surveys on Drug Use and Health (NSDUHs).


Discussion

Reducing cigarette smoking is a major public health goal, and the findings in this report suggest that efforts to reduce cigarette use among adolescents and young adults are effective. The percentage of adolescents and young adults smoking cigarettes generally showed decreases over the 7-year period between 2004 and 2010, including decreases in more recent years between 2008 and 2010. There were also reductions in the percentage of young adults who reported smoking daily and in the numbers of cigarettes smoked by young adult daily users.

Despite prevention efforts, laws prohibiting the sale of cigarettes to persons younger than 18, and tax increases, this report shows that in 2010, 1 in 12 adolescents and 1 in 3 young adults smoked in the past month. Given the lifetime health and economic burden from cigarette use, these findings illustrate the need for ongoing efforts to reduce cigarette use and to monitor changes in use over time.


End Notes
1 Centers for Disease Control and Prevention. (2011). Tobacco use: Targeting the Nation's leading killer. At a glance 2011. Retrieved from http://www.cdc.gov/chronicdisease/resources/publications/AAG/osh.htm#aag
2 Liang, L., Chaloupka, F., Nichter, M., & Clayton, R. (2003). Prices, policies and youth smoking. Addiction, 98(Suppl. 1), 105-122.
3 Substance Abuse and Mental Health Services Administration. (2011, January 14). Synar program factsheet. Retrieved from https://www.samhsa.gov/prevention/synarFactsheet.aspx
4 Centers for Disease Control and Prevention. (2010). State cigarette excise taxes—United States, 2009. MMWR, 59(13), 385-388.
5 Current cigarette smokers were asked to report the total number of days (i.e., 1 to 30 days) in the past month that they smoked part or all of a cigarette. If respondents did not know or refused to answer the question, they were asked for their best estimate of the number of days they smoked.


Suggested Citation
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (April 12, 2012). The NSDUH Report: Trends in Cigarette Use among Adolescents and Young Adults. Rockville, MD.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The combined 2004 to 2010 data used in this report are based on information obtained from 157,524 persons aged 12 to 17 and 158,794 persons aged 18 to 25. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on the most recent NSDUH is available in the following publication:

Center for Behavioral Health Statistics and Quality. (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of national findings (NSDUH Series H-41, HHS Publication No. SMA 11-4658). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: https://www.samhsa.gov/data/.

The NSDUH Report is published periodically by the Center for Behavioral Health Statistics and Quality (formerly the Office of Applied Studies), Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Center for Behavioral Health Statistics and Quality are available online: https://www.samhsa.gov/data/. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.

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