Itemization Of Changing Teen Behaviors: Sex, Drugs, Violence, TV Viewing, Texting

Teens: Smoking and TV Lose Appeal

Published: Jun 12, 2014 | Updated: Jun 12, 2014

By Michael Smith, North American Correspondent, MedPage Toda

Current cigarette smoking among high school students is at its lowest level in more than 2 decades, the CDC is reporting.

In the 2013 National Youth Risk Behavior Survey, just 15.7% of participants reported they had smoked a cigarette in the 30 days before filling in the questionnaire, according to CDC Director Tom Frieden, MD.

It's the first time the proportion has been that low since the survey started in 1991, Frieden said, and it meets the objective of the Healthy People 2020 plan to get the rate under 16%.

"That's good news," Frieden told reporters in a telephone briefing on the survey results,published in Morbidity and Mortality Weekly Report

But, in general, the survey findings are a mixture of good news and bad news.

"We're encouraged to see that high school students are making better choices in some areas, like smoking, fighting, and alcohol use," Frieden said.

Nonetheless, other areas are concerning, he said, including the amount of time students spend glued to a screen instead of being active and a relatively new worry -- texting or emailing while driving.

The survey is conducted every 2 years and in 2013 involved 13,583 students. As well, the report includes data from 42 states and 21 large urban school districts that conducted their own version of the survey, to which they could add or remove questions.

Some key findings:

• The 15.7% of students who reported current smoking represents a 10-percentage point drop since 1991, but a decline of more than 20 percentage points since the 36.4% peak in 1997.
• Daily smoking followed the same pattern: 9.8% in 1991, rising to 12.8% in 1999, and then falling to 4.0% in 2013.
• Use of smokeless tobacco, however, has not changed significantly over the past 14 years, remaining at 8.8% in 2013.
• The proportion of students who reported current alcohol use also fell, from 50.8% in 1991 to 34.9% in 2013.
• On the other hand, current marijuana smoking is at 23.4%, up from 14.7% in 1991, but slightly down from the peak of 25.3% in 1995.
• Fewer students -- some 34% -- reported current sexual activity, defined as intercourse within 3 months of the survey date. That's down significantly since 1991, when 37.5% reported current sexual activity.
• Nearly one student in four -- 24.7% -- reported being in a physical fight in the year before the survey. That's down from 42.5% in 1991, and also a decline from 2011, when the rate was 32.8%.

A worrisome finding is that more than two in five of the 64% of students who reported driving in the 30 days before the survey also said they had been texting or emailing while behind the wheel, according to Stephanie Zaza, MD, director of the agency's Division of Adolescent and School Health.

"This puts them and other drivers at risk," she said.

The question is a new one, Zaza said, so there is no information about trends.

Zaza also noted that TV-watching has fallen out of favor -- 32.5% of students reported watching three or more hours of television on an average school day, down from 42.8% in 1999.

That's a "pretty dramatic drop," she told MedPage Today.

But 41.3% of students reported playing video or computer games or using a computer for nonschool work for 3 or more hours on an average school day, up from 22.1% in 2003.

Students might be "replacing" the TV time with hours spent on other devices, including tablets and smartphones, she said.

"We are concerned by the amount of screen time -- it cuts into time for physical activity, it cuts in time for sleep, it cuts into time for interacting in a healthy way with friends and learning," Frieden said.

"It's a whole lot of time being inactive and that's a concern," he told MedPage Today. On the other hand, Frieden added later, computers and similar devices also offer opportunities for learning.