Jun. 12 2014
WASHINGTON, DC – In terrific news for America’s health, the CDC’s National Youth Risk Behavior Survey (YRBS) released today shows that the smoking rate among high school students dropped to 15.7 percent in 2013, the lowest level since this survey began in 1991. The high school smoking rate fell from 18.1 percent in 2011 and has declined by a remarkable 57 percent since peaking at 36.4 percent in 1997.
These survey results are a powerful reminder that the fight against tobacco is an entirely winnable battle, but the job is still far from done. These results should spur elected officials at all levels to do more – not less – to accelerate progress and create a tobacco-free generation. It is within our reach to win the fight against the nation’s number one cause of preventable death if there is the political will to fully implement proven solutions. These include higher tobacco taxes, strong smoke-free laws in every state, well-funded tobacco prevention and cessation programs that include mass media campaigns, and effective regulation of all tobacco products by the Food and Drug Administration.
Despite our progress, the new survey is full of reminders that the fight against tobacco is far from over and must remain a national priority. It is unacceptable that 15.7 percent of America’s high school students – 2.7 million young people – still smoke.
There are also troubling disparities in smoking rates among the states. Some states, including West Virginia (19.6 percent) and Kentucky (17.9 percent), have much higher smoking rates, putting kids in those states at greater risk of premature death from lung cancer, heart disease and the many other diseases caused by smoking. On the positive side, 14 states in this survey, from Alaska to Florida to New York, have smoking rates under 12 percent, showing that much greater progress is possible nationally and in every state. Not surprisingly, there is a correlation between state smoking rates and whether they have implemented strong policies to reduce tobacco use. The 10 states with the lowest youth smoking rates in this survey have an average state cigarette tax of $2.18 per pack, and 7 of the 10 have smoke-free laws that include restaurants and bars. In contrast, the 10 states with the highest youth smoking rates have an average cigarette tax of just 76 cents per pack and only 2 have smoke-free restaurants and bars.
Use of other tobacco products also remains a serious problem:
High school boys now smoke cigars at the same rate as cigarettes (16.5 percent for cigars and 16.4 percent for cigarettes), and an alarming 23 percent of male high school seniors smoke cigars (compared to 19.6 percent who smoke cigarettes). Among all high school students, 12.6 percent were current (past-month) cigar smokers in 2013, with little change in recent years.
Rates of smokeless tobacco use have not declined since 1999. In 2013, 8.8 percent of all high school students and 14.7 percent of high school boys were current users of smokeless tobacco.
These high rates of youth cigar smoking underscore why the FDA must quickly finalize its proposed rule to assert jurisdiction over all tobacco products, including all cigars, and reject proposals to exempt “premium cigars” from its oversight. Congress must also reject legislation that would exempt some cigars from FDA oversight. Tobacco companies would exploit such loopholes by modifying their products so they qualify for the exemption and can be marketed to kids without oversight. Tobacco companies have done this before. They circumvented a 2009 ban on candy and fruit-flavored cigarettes by marketing similarly-flavored cigars, which were not subject to the flavor ban.
The lack of progress in reducing cigar and smokeless tobacco use isn’t surprising given how these products have been marketed to kids. Tobacco companies have exploited tax and regulatory loopholes to market an array of cheap, sweet and colorfully packaged cigars, many of which look and are smoked just like cigarettes. Led by Grizzly, the most popular smokeless brand among youth, smokeless tobacco continues to be heavily advertised in magazines with large youth readerships, often with a message telling teen boys they can’t be real men without smokeless tobacco. Marketing for smokeless tobacco totaled $451.7 million in 2011, more than three times the amount spent in 1998.
While big challenges remain, it is very encouraging that youth smoking rates are falling again after several years in which they were nearly stagnant. President Obama and his Administration deserve credit for taking strong actions to reinvigorate the fight against tobacco. The Administration’s accomplishments include the landmark 2009 law granting the FDA authority over tobacco products, which cracked down on tobacco marketing and sales to kids; a large 62-cents per pack cigarette tax increase in 2009; expansion of coverage for tobacco cessation treatments under the Affordable Care Act; and launch of unprecedented national media campaigns to reduce tobacco use (the CDC’s Tips from former Smokers campaign launched in 2012 and the FDA’s The Real Cost campaign launched earlier this year – the latter after this survey was conducted). The YRBS results are further evidence that these actions are having an impact.
To continue making progress, both the federal government and the states must redouble efforts to implement what we know works. As the United States marks the 50th anniversary of the first Surgeon General’s report on smoking and health, there is no better time for a national commitment to end the tobacco epidemic for good. The latest Surgeon General’s report, issued in January, reminded us how much is at stake: Tobacco kills 480,000 Americans and costs the nation at least $289 billion in health care bills and economic losses each year.
Our nation’s progress against tobacco is a remarkable public health success story. But we cannot declare victory until every child is tobacco-free and we have eliminated the death and disease caused by tobacco. It must not take another 50 years to achieve these goals.