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CDC Telebriefing Transcript
Teen Smoking Rates Decline Significantly
May 16, 2002
CDC MODERATOR: Good afternoon and welcome to today's telebriefing. Today,
Dr. Terry Pechacek will be discussing the article entitled "Trends in
Cigarette Smoking Among High School Students--United States, 1991 through
2001" that is appearing in today's "Mortality and Morbidity Weekly Report."
Dr. Pechacek will open with comments, followed by questions and answers.
Dr. Pechacek, are you ready to begin?
DR. PECHACEK: Yes. Good morning.
We are very pleased to report today that our analysis of the youth risk
behavior surveillance system data from the Youth Risk Behavior Survey, which
is conducted nationwide every two years, since 1991, has indicated that
rates of smoking among high school students are declining significantly.
As many of you are aware, during the 1990's, we were very concerned about
the fact that smoking rates among students in several surveys, several
national surveys, have been showing that the rates were continuing to
This increase continued into the late 1990's. This survey, the Youth Risk
Behavior Survey, is the tracking survey on which the national health
objectives are based and is our primary surveillance for progress we're
making in this leading health indicator of smoking rates among teens.
This rate of smoking among teens, and the YRBS had increased from 1991
through 1997, and rates have increased from 27.5 percent in 1991 up to 36.4
percent in 1991 [sic. – The accurate date is 1997].
We're very pleased to see that now that rates have declined in 2001 down to
28.5. So the increase that we saw throughout the 90's is being reversed, and
the pattern that we're seeing in 1991 and in 2001 indicate that if this
downward trend continues, the U.S. could reach its 2010 national health
objective of reducing current smoking rates among teenage students to 16
percent or less, which is our national objective.
This could have major health implications and we are encouraged by this
decline through 2001, but we also think it's important to focus on the fact
that continued reduction in cigarette smoking among youth will require us to
maximize our current efforts, and continue our current efforts at the state,
federal, and local level to ensure that comprehensive programs are being
We feel like that we're making a lot of progress, but a few things cause us
to be of continuing concern. One of the facts, we are seeing a decline
across all groups, and that is good, but we're seeing that the rates of
smoking are still highest among white and Hispanic students, and that the
rates among black students are lower, but that the rate of decline is less
in the, particularly the black females.
They start starting to tend down, but in several groups we see the increase
continuing on through 1999. So that the progress is much more recent in some
This is all the types of indicators that indicate to us that while we're
making progress, and while the rates are starting to turn down, that we need
continued effort both in increasing price, in countermarketing, in limiting
the exposure of youth to advertising, but particularly in school programs
and school policies, where we feel like that we're starting to make progress
but we want to see more progress.
So this is what the good news is and as well as what we see as the challenge
for the future.
CDC MODERATOR: Thank you, Dr. Pechacek. We're now ready to take questions.
AT&T OPERATOR: Thank you. Ladies and gentlemen, if you wish to ask a
question please press one on your touchtone phone. You will hear a tone
indicating you've been placed in queue, and you may remove yourself from
queue at any time by pressing the pound key.
If using a speaker-phone, please pick up your handset before pressing the
Once again, if you do have a question or a comment, please press the one on
your touchtone phone at this time.
Our first question will come from the line of Adam Marcus at HealthScout.
Please go ahead.
MR. MARCUS: Hi. Thanks for holding the briefing. I had a question about the
relationship, if any, between tobacco use among adolescents and the overall
economic picture, and whether the downturn in the economy might be expected
to lead to any changes in teen smoking rates?
DR. PECHACEK: Well, we don't specifically measure a number of those
variables in this survey. What we know from the general literature is that
price has a very large effect on youth and that price did increase during
this period between December '97 and 2001, spring 2001. There was about a
70-percent increase in their average retail price of cigarettes.
In this survey, we do not monitor youth disposable income. Some other
studies have suggested that youth disposable income is related to levels of
smoking. And therefore, as the employment picture becomes a little tighter
or there may be less disposable income, and at the same time price of
cigarettes are increasing, the other data would suggest that that could be
one of the factors related to this decline in smoking.
QUESTION: Thank you.
CDC MODERATOR: Thanks, Adam.
Could we have our next question?
AT&T OPERATOR: Our next question will come from the line of Steve Mitchell
at United Press. Please go ahead.
QUESTION: Hi. My question concerns price. That seems to be one of the major
factors for the downturn here. Is that something that we can continue to
increase or is that going to, at some point, reach a threshold?
The other thing is can you sort of elaborate on what might explain the
DR. PECHACEK: Question No. 1, with respect to price, we do have a national
health objective to increase the average excise tax on cigarettes to $2 by
the year 2010. Now we are currently about 84 cents, so that that other
health objective, if we continue to make progress toward higher average
excise tax, would suggest that price could remain a factor.
We do know that in a large number of states that excise taxes have been
increased since 2001 over this last legislative cycle, and other states are
considering it, and that the average retail price of cigarettes continues to
go up. In fact, there was news from the Consumer Price Index today about the
fact that cigarettes continue to increase in price.
We are cautious about the effect that--how much we can expect price to be a
primary contributing factor on our continuing decline, and that's why we're
stressing the need for sustained, comprehensive program efforts.
A couple of the factors that we feel like have contributed beyond price are
the fact that effective countermarketing campaigns are much more available
to youth in recent years, both state campaigns in many of the large states,
such as California and Florida, Texas, as well as Arizona, Massachusetts,
Oregon, but also the American Legacy has now had a national truth campaign
to focus on youth smoking preventions since February 2000. We need to
maintain those kinds of countermarketing campaigns to offset the large
multi-billion-dollar advertising campaigns of the tobacco industry.
Additionally, we have seen school programs increasing in recent years, both
in the teaching of tobacco use prevention, as well as the increase of
tobacco-free policies, and we feel like those are very important types of
environments that reach all youth of the target ages, middle and high school
programs and policies.
So there's a variety of things that we feel like are necessary.
Now, with respect to the racial/ethnic differences, there's been a variety
of analyses, and no definitive conclusion, as to why the African American
rates were lower and dropped in the 1980s, and then were lower coming into
the '90s. Unfortunately, the African American rates did continue to
increase, from a lower point, but they were increasing as rapidly or more
rapidly on a percentage basis than in white and Hispanic.
This increase cut back on much of the success we had seen in the early '90s
in the African American--we know that there were, from the basic research
being done, that there were some broad cultural differences in how parents,
and families, and social groups were treating tobacco. Specifically, African
American families tended to treat nicotine as any other drug. In other
words, nicotine was as bad as marijuana, as bad as cocaine, and was treated
as a dangerous drug. Whereas, the non-Hispanic white families tended to put
tobacco in a bad, but not as bad-type category. In other words, my
adolescent is smoking, but at least he's not using cocaine. And that type of
difference I think may be one of the factors that's important.
CDC MODERATOR: Thanks, Steve.
AT&T OPERATOR: The next question will come from the line of Aaron McClean at
Associated Press. Please go ahead.
QUESTION: Hi. Thanks very much. I was wondering, first of all, if you could
give me the sample size for the 2001 survey. I don't see it in the report.
Secondly, I was talking to a tobacco industry spokesman earlier today, and
he said that it's his belief that raising the cigarette tax doesn't really
cut down on smoking, the teens just go and look for cheaper cigarettes and
keep on smoking.
I was wondering if you have had good data that shows a direct link between
raising the price and a decrease in the smoking rate.
DR. PECHACEK: Well, first of all, on the sample size, the sample size in
2001 was 13,601. The sample sizes across the years 1991 through 2001 have
varied from about 11,000 up to 16,000, and response rates, the overall
response rate in 2001 was 63 percent and has been over 60 percent for all of
With respect to the efficacy of price preventing youth smoking, there is a
very large literature base. What the health economists who carefully looked
at this have found is that the increase in price does impact youth smokers.
It particularly impacts those smokers who are at risk for transitioning from
occasional smoking to regular or more frequent smoking. "Frequent" we define
as 20 or more days in the past 30 days. Some other people would define it as
daily smoking or almost daily smoking.
And that transition is where price particularly impacts youth. Youth will
tend to find cigarettes for experimentation by borrowing, stealing it from
parents, from friends, so that that might be less price sensitive. But once
they're forced into regularly buying their own cigarettes, they are, in
fact, more price sensitive than adults, the research finds.
While there has been this suggestion by some that they would go to cheaper
cigarettes, in fact, when we are tracking the brands of cigarettes that they
buy, they continue to buy the premium brands of cigarettes. The image of
which brand they are smoking is very important, and it's very rare, less
than 5 percent of youth, are smoking the generic-type-brand cigarettes. It's
almost none are smoking the discount brands of cigarettes.
QUESTION: Thank you.
CDC MODERATOR: Thanks, Aaron.
Next question, please?
AT&T OPERATOR: Once again, ladies and gentlemen, if you do have a question
or comment, please press the one at this time.
We have nobody queuing up at this time. Please continue with your
CDC MODERATOR: Well, since we have no more questions, we'd certainly like to
thank everybody for joining us on the telebriefing. The transcript will be
available on-line this afternoon at www.cdc.gov on the media relations page.
Also, please, for more information on the CDC's tobacco control activities,
please visit the CDC's OSH website at www.cdc.gov/tobacco.