Smoking figures show decrease in heavy smokers but rise in teenage and light smokers

By Dr. Ananya Mandal, MDAug 8 2011

A new study reveals that American high school students are unlikely to be heavy smokers, but casual and occasional smoking is on the rise. The study warns that even light smoking may be injurious to health.

Researchers found that occasional smoking among teens rose from 67.2 percent in 1991 to 79.4 percent in 2009, while heavy smoking fell from 18 percent to 7.8 percent. Dr. Terry Pechachek, a study co-author from the Centers for Disease Control said, “We're seeing a broad national phenomenon. With fewer cigarettes, the price effect, smoke-free policies and a change in the broad public awareness of risk, the heaviest patterns of use are becoming very rare.”

He added in warning, “It is important to note that light and intermittent smoking still has significant health risks…We think there may be an emerging pattern. We may be creating a new type of smoker that may be more durable, that are adapting to smoke-free environments and to changing social norms.”

Pechacek said that the high percentage of intermittent teenage smokers is unacceptable. Teachers and parents should not downplay the risks. “It's still a very risky behavior. We want to get across to people that although this is a positive trend, it's very unacceptable to have so many children exposing themselves to something so addictive. The greatest danger is minimizing the risk.”

The study, which is published in the American Journal of Preventive Medicine, defined heavy smokers as people who smoke 11 or more cigarettes a day. Moderate smoking was defined as between 6 and 10 cigarettes a day, while light smoking was from one and five cigarettes a day.

Between 14,000 and 16,000 students a year participated in the study by answering a national survey about their smoking and health habits. The percentage of Hispanic high school students who are heavy smokers rose from 3.1 percent to 6.4 percent, which Pechachek said could be a by-product of Hispanic families assimilating to American culture. Pechachek said, “I don't think we fully understand that…The U.S. Hispanic population has been lighter smokers in general, but it's possible that as more Hispanics are moving forward in the middle class, Hispanics are becoming more like everybody else. It's not proven, but that is something we are looking at.”

In California however rates of adult smoking have dropped sharply over the last two decades, reaching its lowest level on record, largely because of aggressive tobacco control campaigns by state and local governments, officials said.

Last year, 11.9% of Californians said they smoked, down from 25.9% in 1984, the earliest data available, according to the California Department of Public Health. Only one other state had a lower smoking rate last year: Utah with 9.1%.

Smoking rates also have dropped nationally, but California still remains far below U.S. levels, saving lives and billions of dollars in avoided healthcare costs, state health officials say. The officials point out that middle school and high school students are smoking less, but say that much of California’s drop is because of declining cigarette use among young adults ages 18 to 24.

Experts credit California’s 22-year-old tobacco control program, the longest running in the country, for shaping that type of attitude. With money from a 1988 voter-approved tobacco tax, the program has run media and school campaigns and funded other efforts to spotlight the dangers of smoking. Over the last two decades, meanwhile, California has moved to ban smoking in bars, restaurants, in-state flights and most enclosed workplaces. “We have changed the social norms,” said Colleen Stevens, chief of the state health department’s tobacco control branch. “Younger people are growing up in an environment where there is very little smoking.”

According to the CDC, smoking cigarettes has contributed to an estimated 443,000 deaths annually. Nearly one of every five deaths in the U.S. are related to smoking. Tobacco causes more deaths per year than Human Immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.