Teen smoking resumes decline

Transcription

1 December 11, 2007 Contacts: Patti Meyer, (734) or Joe Serwach, (734) or Study Web site: EMBARGOED FOR RELEASE AFTER 11 A.M. EST, TUESDAY, DEC. 11, 2007 EDITORS: Results of this year s Monitoring the Future survey are being released at the White House by the President. The National Institute on Drug Abuse, which sponsors the study, and the University of Michigan, which designed and conducted the study, will be available for follow-up briefings for the media at the National Press Club. Participants will include the director of the White House Office of National Drug Control Policy (ONDCP), John Walters; the director of the National Institute on Drug Abuse (NIDA), Nora Volkow; and the principal investigator of the study, Lloyd Johnston. For further information, contact Johnston at (734) Teen smoking resumes decline ANN ARBOR, Mich.----The number of U.S. teens who smoke has shown significant declines in recent years, particularly among those in their early teens. These declines can be seen in their lifetime, 30-day, and daily smoking rates, according to the latest Monitoring the Future (MTF) study. Including a further decline this year, the rate of smoking in the prior 30 days is now down by two thirds among 8 th graders to 7 percent from the peak level reached in 1996 of 21 percent. That should eventually translate into many fewer illnesses and premature deaths for this generation of young people, said University of Michigan Distinguished Research Scientist Lloyd Johnston, the study s principal investigator. MTF, now in its 33 rd year, tracks smoking, drinking, and illicit drug use among the nation s secondary school students, surveying about 50,000 8 th, 10 th, and 12 th graders in more than 400 secondary schools every year. A separate, accompanying report provides the results relating to illicit drug and alcohol use.

2 After warning last year of an end to the decline in daily smoking among younger teens, particularly 8 th graders, the study found a resumption of that decline this year. Following a decade of substantial improvement, daily smoking among young people in their early and middle teens stopped declining last year, following a deceleration of the decline in the years immediately preceding. But this year significant declines were observed among the nation s 8 th graders in their lifetime, 30-day, and daily smoking rates; among 10 th graders there was also some decline on all of these measures. We don t have a ready explanation for why the declines in smoking resumed in 2007, but whatever the reason, it is an important development, given that cigarette smoking is still the leading preventable cause of death and disease in this country, Johnston said. Compared to peak levels in the mid-1990s, past 30-day smoking rates in 2007 are down by 54 percent among 10 th graders and 41 percent among 12 th graders. The researchers expect that smoking rates among 10 th and 12 th graders will continue to decline as the current 8 th graders, who smoke at lower rates, get older. The rates of past 30-day smoking now stand at 7 percent, 14 percent, and 22 percent across the three grades. Daily smoking has declined even more sharply during the past decade by half for 12 th graders from recent peak levels and more than two thirds for 8 th graders. In 2007, daily smoking is reported by 3 percent of 8 th graders, 7 percent of 10 th graders, and 12 percent of 12 th graders. Many fewer young teens even try cigarettes today compared to the mid-1990s. In 1996 half (49 percent) of all 8 th graders indicated that they had ever smoked a cigarette, whereas in 2007 little more than one fifth of them (22 percent) said they had. But by the end of 12 th grade, 46 percent of students in 2007 reported at least trying cigarettes, and 22 percent reported that they were currently smoking. Clearly smoking rates are down and experimentation with cigarettes has shifted up in age, Johnston said. That s all to the good; but it still leaves too many of our young people adopting a habit that will have adverse consequences for them and those around them. The fact that over a fifth of our young people are smoking when they leave high school, given all that is known today about the health consequences, is hardly the basis for complacency. Attitudes about Smoking Most young people today understand that there is a considerable risk associated with daily smoking. In grades 8, 10, and 12, respectively, 61 percent, 68 percent, and 77 percent of the 2007 respondents say that they see great risk of harm in being a pack-a-day smoker This belief increased considerably in earlier years, beginning after 1995, which probably contributed to the downturn in smoking; but it has been quite stable among the younger teens for the last three years. It should be noted that the younger teens are least aware of the dangers of 2

3 smoking, which is unfortunate, since they are at the age when many initiate smoking and begin to develop a smoking habit, Johnston said. The large majority of teens today say they disapprove of smoking at the pack-a-day level: 87 percent, 85 percent, and 81 percent of 8 th, 10 th, and 12 th graders, respectively. Disapproval has grown considerably since 1996 and is still continuing to increase in the lower grades. The great majority of teens today also say that they prefer to date people who don t smoke : 81 percent, 80 percent, and 77 percent in grades 8, 10, and 12. Nearly two thirds think that becoming a smoker reflects poor judgment. These attitudes became more widespread after the mid-1990s, but have not grown much over the past few years. Johnston added, Despite what cigarette ads have implied for decades, smoking makes you less attractive to the great majority of the opposite sex, not more; and young people need to know that. Availability of Cigarettes to Teens The proportion of teens who say that they could get cigarettes fairly easily or very easily, if they wanted some, has been declining for some years, particularly among the younger teens. Today, 56 percent of 8 th graders most of whom are 13 or 14 years old say they could get cigarettes fairly easily. As high as that number is, it is down considerably from 77 percent in Tenth graders have greater availability, as might be expected, but fewer of them say they could get cigarettes fairly or very easily in 2007 (78 percent) than said that in 1996 (91 percent). This decline in availability is continuing today, with significant drops in both grades this year. It would appear that the efforts of many states and communities to get retail outlets to stop selling to underage smokers is having some success, conclude the investigators, even though the majority of teens still say that they can get cigarettes. Smokeless Tobacco Like cigarettes, the 30-day prevalence of using smokeless or spit tobacco reached a recent peak in the mid-1990s and then declined. All three grade levels have shown a reduction of about one half in their 30-day prevalence rates since those peak levels, but the declines appear to have ended in all grades, and use remained fairly level this year. At present, the prevalence rates for any use of smokeless or spit tobacco in the prior 30 days are 3 percent, 6 percent, and 7 percent in grades 8, 10, and 12. That means that one in every fifteen high school seniors is a current user of smokeless tobacco. However, among boys, who account for almost all smokeless tobacco use, the rates are considerably higher: 5 percent, 10 percent, and 12 percent. In other words, nearly one in eight boys in 12 th grade is a current user of smokeless tobacco. Only a minority of students see great risk in using smokeless tobacco regularly, averaging around 45 percent, without much difference by grade. Perceived risk grew from about 1995 through 2004, likely helping to account for the decline in use in those years, but it has changed little since then. 3

4 Kreteks and Bidis In 2000, a single question was introduced into the study about the use of bidis small flavored cigarettes imported from India because of rising concern at the time about their growing popularity. In 2001 a single question was introduced for similar reasons about the use of kreteks clove-flavored cigarettes imported from Indonesia. Relatively low prevalence rates were observed for both types of specialty cigarettes in the initial years of measurement, and since then use has declined substantially and fairly steadily in all grades. By 2007 the annual prevalence of bidis use was down by three quarters among 12 th graders, from 9 percent in 2000 to under 2 percent in 2007, including some further decline this year. Annual prevalence of kretek use among 12 th graders is down by one third since 2001, but it did not decline further this year. The investigators conclude that both kreteks and bidis constituted short-term fads that have not caught on with mainstream American youth, making it unlikely that they will become the health menace some had feared. The investigators note, however, that mainstream tobacco companies have themselves introduced flavored cigarettes, which may help to explain the declines in these fringe products. # # # Monitoring the Future has been funded under a series of competing, investigator-initiated research grants from the National Institute on Drug Abuse, part of the National Institutes of Health (Grant Number R01DA01411). Surveys of nationally representative samples of American high school seniors were begun in 1975, making the Class of 2007 the 33 rd such class surveyed. Surveys of 8 th and 10 th graders were added to the design in 1991, making the 2007 nationally representative samples the 17 th such classes surveyed. The sample sizes in 2007 are 16,495 eighth graders in 151 schools, 16,398 tenth graders in 120 schools, and 15,132 twelfth graders in 132 schools, for a total of 48,025 students in 403 secondary schools. The samples are drawn separately at each grade level to be representative of students in that grade in public and private secondary schools across the coterminous United States. Schools are selected with probability proportionate to their estimated class size. The findings summarized here will be published in the forthcoming volume: Johnston, L. D., O Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2008). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2007 (NIH Publication No. [to be assigned]). Bethesda, MD: National Institute on Drug Abuse. The content presented here is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. 4

5 FIGURE 1 Cigarettes: Trends in 30-Day Use, Risk, Disapproval, and Availability Grades 8, 10, and Use % who used in past 30 days 100 Risk % seeing great risk in smoking a pack or more per day 12th Grade 80 10th Grade 8th Grade 80 PERCENT PERCENT '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 0 '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 YEAR YEAR 100 Disapproval % disapproving of smoking a pack or more per day 100 Availability % saying fairly easy or very easy to get PERCENT '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 YEAR 5PERCENT Source. The Monitoring the Future study, the University of Michigan '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 YEAR

6 FIGURE 2 Smokeless Tobacco: Trends in 30-Day Use, Risk, and Disapproval Grades 8, 10, and Use Risk % who used in past 30 days % seeing great risk in using regularly th Grade 10th Grade 8th Grade 80 PERCENT PERCENT '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 0 '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 YEAR YEAR Disapproval Availability % disapproving of using regularly % saying fairly easy or very easy to get PERCENT '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 YEAR 6PERCENT Source. The Monitoring the Future study, the University of Michigan. (no data) '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03 '05 '07 YEAR

7 TABLE 1 Trends in Prevalence of Use of Cigarettes for Eighth, Tenth, and Twelfth Graders Lifetime 8th Grade th Grade th Grade Thirty-Day 8th Grade th Grade th Grade Daily 8th Grade th Grade th Grade /2 Pack+ per Day 8th Grade th Grade th Grade Approximate Ns: 8th Grade 17,500 10th Grade 14,800 12th Grade 9,400 15,400 17,100 17,800 15,500 15,900 17,500 17,700 16,300 15,900 16,000 15,200 16,300 16,300 16,700 15,200 15,000 Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. Cont. 7

8 TABLE 1 (cont.) Trends in Prevalence of Use of Cigarettes for Eighth, Tenth, and Twelfth Graders change Lifetime 8th Grade ss 10th Grade th Grade Thirty-Day 8th Grade ss 10th Grade th Grade Daily 8th Grade s 10th Grade th Grade /2 Pack+ per Day 8th Grade th Grade th Grade Approximate Ns: 8th Grade 18,600 18,300 17,300 17,500 17,800 18,600 18,100 16,700 16,700 16,200 15,100 16,500 17,000 16,800 16,500 16,100 10th Grade 14,800 15,300 15,800 17,000 15,600 15,500 15,000 13,600 14,300 14,000 14,300 15,800 16,400 16,200 16,200 16,100 12th Grade 15,800 16,300 15,400 15,400 14,300 15,400 15,200 13,600 12,800 12,800 12,900 14,600 14,600 14,700 14,200 14,500 Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. 8

9 TABLE 2 Trends in Availability and Attitudes about Smoking One or More Packs of Cigarettes per Day for Eighth, Tenth, and Twelfth Graders Perceived Risk a th Grade th Grade th Grade Disapproval b 8th Grade th Grade th Grade Availability c 8th Grade 10th Grade Approximate Ns: 8th Grade 17,500 10th Grade 14,800 12th Grade 2,800 2,900 3,100 3,800 3,300 3,200 3,600 3,600 3,300 3,300 3,300 3,000 3,300 3,300 2,800 2,600 2,600 Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. Cont. 9

10 TABLE 2 (cont.) Trends in Availability and Attitudes about Smoking One or More Packs of Cigarettes per Day for Eighth, Tenth, and Twelfth Graders change Perceived Risk a 8th Grade th Grade th Grade Disapproval b 8th Grade th Grade th Grade Availability c 8th Grade ss 10th Grade s Approximate Ns: 8th Grade 18,600 18,300 17,300 17,500 17,800 18,600 18,100 16,700 16,700 16,200 15,100 16,500 17,000 16,800 16,500 16,100 10th Grade 14,800 15,300 15,800 17,000 15,600 15,500 15,000 13,600 14,300 14,000 14,300 15,800 16,400 16,200 16,200 16,100 12th Grade 2,700 2,800 2,600 2,600 2,400 2,600 2,500 2,300 2,100 2,100 2,200 2,400 2,400 2,500 2,400 2,400 a The question text was: How much do you think people risk harming themselves (physically or in other ways) if they smoke one or more packs of cigarettes per day? Answer alternatives were: (1) No risk, (2) Slight risk, (3) Moderate risk, (4) Great risk, and (5) Can t say, drug unfamiliar. The percentage saying great risk is shown. For 8th and 10th graders: Beginning in 1999, perceived risk data based on two of four forms; N is two thirds of N indicated. b The question text was: Do you disapprove of people smoking one or more packs of cigarettes per day? Answer alternatives were: (1) Don t disapprove, (2) Disapprove, and (3) Strongly disapprove. For 8th and 10th graders, there was another category Can t say, drug unfamiliar which was included in the calculation of these percentages. The percentage saying they disapprove or strongly disapprove is shown. For 8th and 10th graders: Beginning in 1999, disapproval data based on two of four forms; N is two thirds of N indicated. c The question text was: How difficult do you think it would be for you to get cigarettes, if you wanted some? Answer alternatives were: (1) Probably impossible, (2) Very difficult, (3) Fairly difficult, (4) Fairly easy, (5) Very easy, and (8) Can t say, drug unfamiliar (included in the calculation of these percentages). The percentage saying cigarettes are fairly easy or very easy to get is shown. In 1992 only, availability data based on one of two forms; N is one half of N indicated. The question was not asked of 12th graders. 10

11 TABLE 3 Trends in Various Attitudes Towards Cigarette Use Among Eighth, Tenth, and Twelfth Graders Percentage who report "mostly agree" or "agree" I prefer to date people who don't smoke 8th Grade th Grade th Grade Smoking is a dirty habit 8th Grade th Grade th Grade I think that becoming a smoker reflects poor judgment 8th Grade th Grade th Grade I strongly dislike being near people who are smoking 8th Grade th Grade th Grade I personally don't mind being around people who are smoking 8th Grade th Grade th Grade The harmful effects of cigarettes have been exaggerated 8th Grade th Grade th Grade Smokers know how to enjoy life more than nonsmokers 8th Grade th Grade th Grade Notes: For 8th graders: N s range from 6,604 to 8,005. For 10th graders: N s range from 6,398 to 7,807. For 12th graders: N s range from 1,795 to 3,

12 TABLE 4 Trends in Prevalence of Use of Smokeless Tobacco for Eighth, Tenth, and Twelfth Graders Lifetime 8th Grade th Grade th Grade change Thirty-Day 8th Grade th Grade th Grade Daily 8th Grade th Grade th Grade Approximate Ns: 8th Grade 17,500 18,600 18,300 17,300 17,500 17,800 18,600 18,100 16,700 16,700 16,200 15,100 16,500 17,000 16,800 16,500 16,100 10th Grade 14,800 14,800 15,300 15,800 17,000 15,600 15,500 15,000 13,600 14,300 14,000 14,300 15,800 16,400 16,200 16,200 16,100 12th Grade 15,200 16,300 16,300 16,700 15,000 15,800 16,300 15,400 15,400 14,300 15,400 15,200 13,600 12,800 12,800 12,900 14,600 14,600 14,700 14,200 14,500 Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. For 8th and 10th graders: Data based on one of two forms for and on two of four forms beginning in 1997; N is one half of N indicated. For 12th graders: Data based on one form; N is one fifth of N indicated in and one sixth of N indicated beginning in The prevalence of use of smokeless tobacco was not asked of 12th graders in 1990 and Prior to 1990 the prevalence-of-use question on smokeless tobacco was located near the end of one 12th-grade questionnaire form, whereas after 1991 the question was placed earlier and in a different form. This shift could explain the discontinuities between the corresponding data. 12

13 TABLE 5 Trends in Attitudes about Regular Smokeless Tobacco Use for Eighth, Tenth, and Twelfth Graders Perceived Risk a change 8th Grade th Grade th Grade Disapproval b 8th Grade th Grade Approximate Ns: 8th Grade 17,500 18,600 18,300 17,300 17,500 17,800 18,600 18,100 16,700 16,700 16,200 15,100 16,500 17,000 16,800 16,500 16,100 10th Grade 14,800 14,800 15,300 15,800 17,000 15,600 15,500 15,000 13,600 14,300 14,000 14,300 15,800 16,400 16,200 16,200 16,100 12th Grade 3,000 3,300 3,300 2,800 2,600 2,600 2,700 2,800 2,600 2,600 2,400 2,600 2,500 2,300 2,100 2,100 2,200 2,400 2,400 2,500 2,400 2,400 Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. a The question text was: How much do you think people risk harming themselves (physically or in other ways) if they use smokeless tobacco regularly? Answer alternatives were: (1) No risk, (2) Slight risk, (3) Moderate risk, (4) Great risk, and (5) Can t say, drug unfamiliar. The percentage saying great risk is shown. b The question text was: Do you disapprove of people using smokeless tobacco regularly? Answer alternatives were: (1) Don t disapprove, (2) Disapprove, and (3) Strongly disapprove. For 8th and 10th graders, there was another category Can t say, drug unfamiliar which was included in the calculation of these percentages. The percentage saying they disapprove or strongly disapprove is shown. This question was not asked of 12th graders. 13

14 TABLE 6 Cigarettes: Trends in Thirty-Day Prevalence of Use by Subgroups for Eighth Graders Percentage who used in last thirty days Approximate N = 17,500 18,600 18,300 17,300 17,500 17,800 18,600 18,100 16,700 16,700 16,200 15,100 16,500 17,000 16,800 16,500 16,100 Total ss Gender: Male Female ss College Plans: None or under 4 years Complete 4 years sss Region: Northeast s North Central South s West Population Density: Large MSA s Other MSA Non-MSA Parental Education: a change (Low) s (High) ss Race (2-year average): b White Black Hispanic Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. a Parental education is an average score of mother s education and father s education. See Appendix B for details. b To derive percentages for each racial subgroup, data for the specified year and the previous year have been combined to increase subgroup sample size and thus provide more stable estimates. For the data beginning in 2005, see the race/ethnicity note at the end of Appendix D. 14

15 TABLE 7 Cigarettes: Trends in Thirty-Day Prevalence of Use by Subgroups for Tenth Graders Percentage who used in last thirty days Approximate N = 14,800 14,800 15,300 15,800 17,000 15,600 15,500 15,000 13,600 14,300 14,000 14,300 15,800 16,400 16,200 16,200 16,100 Total Gender: Male Female s College Plans: None or under 4 years Complete 4 years Region: Northeast North Central South West Population Density: Large MSA Other MSA Non-MSA ss Parental Education: a change (Low) (High) Race (2-year average): b White Black Hispanic Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. a Parental education is an average score of mother s education and father s education. See Appendix B for details. b To derive percentages for each racial subgroup, data for the specified year and the previous year have been combined to increase subgroup sample size and thus provide more stable estimates. For the data beginning in 2005, see the race/ethnicity note at the end of Appendix D. 15

16 TABLE 8 Cigarettes: Trends in Thirty-Day Prevalence of Use by Subgroups for Twelfth Graders Percentage who used in last thirty days Class of: Approximate N = 9,400 15,400 17,100 17,800 15,500 15,900 17,500 17,700 16,300 15,900 16,000 15,200 16,300 16,300 16,700 15,200 15,000 Total Gender: Male Female College Plans: None or under 4 years Complete 4 years Region: Northeast North Central South West Population Density: Large MSA Other MSA Non-MSA Parental Education: a (Low) (High) Race (2-year average): b White Black Hispanic Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. Cont. 16

17 TABLE 8 (cont.) Cigarettes: Trends in Thirty-Day Prevalence of Use by Subgroups for Twelfth Graders Percentage who used in last thirty days Class of: Approximate N = 15,800 16,300 15,400 15,400 14,300 15,400 15,200 13,600 12,800 12,800 12,900 14,600 14,600 14,700 14,200 14,500 Total Gender: Male Female College Plans: None or under 4 years Complete 4 years Region: Northeast North Central South West Population Density: Large MSA Other MSA Non-MSA Parental Education: a change (Low) (High) Race (2-year average): b White Black Hispanic a Parental education is an average score of mother s education and father s education. See Appendix B for details. b To derive percentages for each racial subgroup, data for the specified year and the previous year have been combined to increase subgroup sample size and thus provide more stable estimates. For the data beginning in 2005, see the race/ethnicity note at the end of Appendix D. 17

18 TABLE 9 Smokeless Tobacco: Trends in Thirty-Day Prevalence of Use by Subgroups for Eighth Graders Percentage who used in last thirty days Approximate N = 17,500 18,600 18,300 17,300 17,500 17,800 18,600 18,100 16,700 16,700 16,200 15,100 16,500 17,000 16,800 16,500 16,100 Total Gender: Male Female College Plans: None or under 4 years Complete 4 years Region: Northeast North Central South West Population Density: Large MSA Other MSA Non-MSA Parental Education: a change (Low) (High) Race (2-year average): b White Black Hispanic Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. Data based on one of two forms in and on two of four forms beginning in 1997; N is one half of N indicated. a Parental education is an average score of mother s education and father s education. See Appendix B for details. b To derive percentages for each racial subgroup, data for the specified year and the previous year have been combined to increase subgroup sample size and thus provide more stable estimates. For the data beginning in 2005, see the race/ethnicity note at the end of Appendix D. 18

19 TABLE 10 Smokeless Tobacco: Trends in Thirty-Day Prevalence of Use by Subgroups for Tenth Graders Percentage who used in last thirty days Approximate N = 14,800 14,800 15,300 15,800 17,000 15,600 15,500 15,000 13,600 14,300 14,000 14,300 15,800 16,400 16,200 16,200 16,100 Total Gender: Male Female College Plans: None or under 4 years Complete 4 years Region: Northeast North Central South West Population Density: Large MSA Other MSA Non-MSA Parental Education: a change (Low) (High) Race (2-year average): b White Black Hispanic Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. Data based on one of two forms in and on two of four forms beginning in 1997; N is one half of N indicated. a Parental education is an average score of mother s education and father s education. See Appendix B for details. b To derive percentages for each racial subgroup, data for the specified year and the previous year have been combined to increase subgroup sample size and thus provide more stable estimates. For the data beginning in 2005, see the race/ethnicity note at the end of Appendix D. 19

20 TABLE 11 Smokeless Tobacco: Trends in Thirty-Day Prevalence of Use by Subgroups for Twelfth Graders Percentage who used in last thirty days Class of: a Approximate N = 15,200 16,300 16,300 16,700 15,800 16,300 15,400 15,400 14,300 15,400 15,200 13,600 12,800 12,800 12,900 14,600 14,600 14,700 14,200 14,500 Total Gender: Male Female College Plans: None or under 4 years Complete 4 years Region: Northeast North Central South West Population Density: Large MSA Other MSA Non-MSA Parental Education: b change (Low) (High) Race (2-year average): c White Black Hispanic Notes: Level of significance of difference between the two most recent classes: s = 0.05, ss = 0.01, sss = " " indicates data not available. Any apparent inconsistency between the change estimate and the prevalence-of-use estimates for the two most recent classes is due to rounding error. Data based on one of six forms; N is one sixth of N indicated. Caution: Limited sample sizes (see Notes above). Use caution in interpreting subgroup trends. a The prevalence of use of smokeless tobacco was not asked of 12th graders in 1990 and Prior to 1990 the prevalence-of-use question on smokeless tobacco was located near the end of one 12th-grade questionnaire form, whereas after 1991 the question was placed earlier and in a different form. This shift could explain the discontinuities in the data. b Parental education is an average score of mother s education and father s education. See Appendix B for details. c To derive percentages for each racial subgroup, data for the specified year and the previous year have been combined to increase subgroup sample size and thus provide more stable estimates. For the data beginning in 2005, see the race/ethnicity note at the end of Appendix D. 20