Teens are more likely to turn down tobacco now than they were a decade ago, but rates of decline have slowed, government researchers said.
Between 2000 and 2011, use of tobacco among high schoolers fell from about 34% to 23%, and from 15% to 7% among middle schoolers, Rene Arrazola, MPH, of the CDC, and colleagues reported in the August 10 issue of Morbidity & Mortality Weekly Report.
But that downturn was nowhere near as dramatic as the one seen between 1997 and 2003, which saw a 40% decline, the researchers wrote.
"This report is further evidence that we need to do more to prevent our nation's youth from establishing a deadly addiction to tobacco," CDC director Tom Frieden, MD, MPH, said in a statement, adding that most long-term tobacco use is established in adolescence.
That's a challenge, however, as states continue to face drastic budgetary cuts, which has played a role in the underfunding of tobacco control programs.
Cigarette smoking was the most common form of tobacco use, with a prevalence of 15.8% among high schoolers and 4.3% among middle schoolers.
Cigars were the second most common form of tobacco use among both groups (11.6% and 3.5%, respectively), and their use rose among black high schoolers between 2009 and 2011, from 7.1% to 11.7%, the researchers noted.
"This finding is similar to prevalence trends found using other national data, with increases in cigar smoking observed among black female high school students," they wrote.
They added that cigar use among high school boys is more than twice as high as it is among high school girls (15.7% versus 7.4%) and is comparable to the use of cigarettes among high school boys (17.7%).
But a wider gender gap exists among high schoolers for smokeless tobacco, the use of which among boys is eight times that of girls (12.9% versus 1.6%).
Arrazola and colleagues warned that cigars can be taxed at lower rates than cigarettes and aren't subject to FDA regulation. Manufacturers can also add flavorings and can label their products with "misleading descriptors such as 'light' or 'low tar,'" they wrote.
The data come from the National Youth Tobacco Survey, which involved 178 schools and 18,866 students.
The researchers cautioned that the data may be limited by recall bias, and they didn't distinguish between infrequent tobacco users and heavy users.
The researchers reported no conflicts of interest.
Morbidity & Mortality Weekly ReportSource Reference: Arrazola RA, et al "Current tobacco use among middle and high school students -- United States, 2011" MMWR 2012; 61:581-585.