NIDCR/CDC
Dental, Oral and Craniofacial
Data Resource Center

Oral Health, U.S. 2002 Annual Report

Section 12: TOBACCO

Despite extensive antitobacco public health campaigns, tobacco use continues and in 2000 was reported to be increasing among adolescents (US DHHS, 2000). The percentage of high school students reporting cigarette use increased between 1993 (30.5%) and 1999 (34.8%) (CDC, 1995; CDC, 2000a). The increase was seen in both males and females and in all racial/ethnic groups. In the 1998–1999 National Youth Tobacco Survey, 12.8% of U.S. middle school students and 34.8% of U.S. high school students reported being current users of tobacco products (CDC, 2000b). Cigarettes were the most prevalent form of tobacco used for both groups, followed by cigars. In contrast, the prevalence of cigarette smoking among adults declined from 25.0% to 23.5% between 1993 and 1999 (CDC, 2001).

Smokeless tobacco use among high school students decreased between 1993 and 1999. In 1993, 11.5% of high school students reported using smokeless tobacco products, compared with 7.8% in 1999 (CDC, 1995; CDC, 2000a). This decrease was reported by both males and females and by all racial/ethnic groups. However, its use by young men aged 18 to 24 years increased dramatically over the past two decades from 2.2% in 1970 to 8.9% in 1991 (Giovino et al., 1994). In 1991, 2.9% of U.S. adults were current smokeless tobacco users (CDC, 1993). Usage was higher among males and persons with lower levels of education.

Cigar use increased nearly 50% between 1993 and 1997 (Gerlach et al., 1998). Data from the Youth Risk Behavior Surveillance System indicate that 17.7% of all adolescents reported cigar use as did over one-quarter (25.4%) of all adolescent males in 1999 (CDC, 2000).

SOURCES OF DATA
Analyses reported here are based on MMWR Surveillance Summaries from the 1993, 1995, 1997, and 1999 Youth Risk Behavior Surveillance System, Centers for Disease Control and Prevention (see references) and data from the 1996 and 1999 Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention.

• Adolescents
• All three race/ethnicity groups of high school students display an increased prevalence of current cigarette smoking between 1993 and 1997 and a slight decrease in prevalence from 1997 to 1999 (Figure 12.2.1).
• The percentage of male current smokers increased between 1993 and 1997 then decreased in 1999. Among females, current smoking increased sharply between 1993 and 1995 (Figure 12.2.2).

• Adults
• Trends in current cigarette smoking from 1993 to 1999 are shown in Figure 12.2.3. The level of current cigarette smoking in 1999 is significantly decreased when compared with that in 1993. Other differences are not statistically significant.
• Hispanics report lower current smoking levels than non-Hispanic blacks or whites from 1993 to 1999.
• Females have lower current smoking levels than males from 1993 to 1999.
• Those with more than a high school education have lower current smoking levels than those with lower educational levels from 1993 to 1999.

Bullets reference data that can be found in Tables 12.2.1 and 12.2.2..

REFERENCES
Centers for Disease Control and Prevention. Use of smokeless tobacco among adults-United States, 1991. MMWR 1993;45(14):263-66.

Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 1993. MMWR Surveillance Summaries 1995;44(SS-1):1-55.

Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 1999. MMWR Surveillance Summaries 2000a;49(SS-5):1-96.

Centers for Disease Control and Prevention. Youth tobacco surveillance-United States, 1998-1999. MMWR Surveillance Summaries 2000b;49(SS-10):1-93.

Centers for Disease Control and Prevention. Cigarette smoking among adults-United States, 1999. MMWR 2001;50(40):869-73.

Gerlach KK, Cummings KM, Hyland A, Gilpin EA, Johnson MD, Pierce JP. Trends in cigar consumption and smoking prevalence. In: National Cancer Institute. Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph 9. Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, 1998. NIH pub. no. 98-4302.

Giovino GA, Schooley MW, Zhu BP, Chrismon JH, Tomar SL, Peddicord JP, Merritt RK, Husten CG, Eriksen MP. Surveillance for selected tobacco use behaviors-United States, 1900-1994. MMWR 1994;43(SS-3):1-43.

U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.

Figure 12.2.1. Trends in prevalence of current cigarette smoking among U.S. high school students by race/ethnicity

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Data sources: 1993, 1995, 1997, and 1999 Youth Risk Behavior Surveillance System, Centers for Disease Control and Prevention.

Figure 12.2.2. Trends in prevalence of current cigarette smoking among U.S. high school students by gender

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Data sources: 1993, 1995, 1997, and 1999 Youth Risk Behavior Surveillance System, Centers for Disease Control and Prevention.

Figure 12.2.3. Trends in prevalence of current cigarette smoking among U.S. adults

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Data sources: 1993, 1995, 1997, and 1999 National Health Interview Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention.

Department of Health and Human Services
National Institute of Dental And Craniofacial Research (NIDCR)	CDC Division of Oral Health
National Institutes of Health

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