1991-2015 Trends of Adolescent Smoked First Whole Cigarette Before Age 13 in the U.S.

Saturday, 29 July 2017

Yu-ku Chen, BSN
Yu-han Zheng, BSN
Jiunn-Jye Sheu, PhD, MSPH
School of Population Health, University of Toledo, Toledo, OH, USA


The Youth Risk Behavior Survey (YRBS) has been established to monitor tobacco use trends among adolescents. Most reports had reported adolescent's current smoking prevalence trends by either sex, race/ethnicity, or grade separately. This study took a more holistic view and identified the disparity by sex-grade-race/ethnicity specific rate trends of a first whole cigarette smoked before age 13.


The longitudinal prevalence trends of a first whole cigarette smoked before age 13 stratified by more than 2 demographic variables have not been extensively investigated. The published studies are either of lack of national sampling representation, small in sample size, cross-sectional design, or reported prevalence trends by only one or two demographic variables from participant’s grade, gender, or race/ethnicity.


This study described the 24 years longitudinal prevalence trends of a first whole cigarette smoked before age 13, compared them in the specific grades, genders, and major races/ethnicities, and suggested nursing intervention.


The Centers for Disease Control and Prevention (CDC) established this biennial Youth Risk Behavior Surveillance System (YRBSS) in 1991 to display health-risk behaviors amongst youth at national, state, and local levels. The YRBSS surveys adolescents in grades levels 9-12 from sampled schools across the United States. Therefore this offers the maximum representative data for youth health risk behaviors. The CDC designed YRBSS to see the health-risk behaviors among high school students. This assesses whether these behaviors increase, decrease, or stay the same over time. YRBSS focuses only on youth health-risk behaviors.


The trends in adolescent’s smoking a whole cigarette before the age of 13 changed by each grade progression. Across 24 years, males of Hispanic in grades 9th and 12th and African Americans in the 9th grade had higher proportions of smoking a whole cigarette before the age of 13. There was not a clear distinction among male and female White 9th-12th graders, Hispanics grades 10th and 11th, and African Americans 10th, 11th and 12th.


Resources that are distributed and policies established should be made based on scientific evidence with sufficient stratification. Especially when public health budgets and resources are limited, priorities should be given to the higher risk groups identified by such analysis.