Youth Risk Behavior Surveillance --- United States, 2009

MMWR Surveillance Summaries

June 4, 2010 / 59(SS05);1-142

Danice K. Eaton, PhD, Laura Kann, PhD, Steve Kinchen, Shari Shanklin, MS, James Ross, MS, Joseph Hawkins, MA, William A. Harris, MM, Richard Lowry, MD, Tim McManus, MS, David Chyen, MS, Connie Lim, MPA, Lisa Whittle, MPH, Nancy D. Brener, PhD, Howell Wechsler, EdD1

Abstract

Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable.

Reporting Period Covered: September 2008--December 2009.

Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and local school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2009 national survey, 42 state surveys, and 20 local surveys conducted among students in grades 9--12.

Results: Results from the 2009 national YRBS indicated that many high school students are engaged in behaviors that increase their likelihood for the leading causes of death among persons aged 10--24 years in the United States. Among high school students nationwide, 9.7% rarely or never wore a seat belt when riding in a car driven by someone else. During the 30 days before the survey, 28.3% of high school students rode in a car or other vehicle driven by someone who had been drinking alcohol, 17.5% had carried a weapon, 41.8% had drunk alcohol, and 20.8% had used marijuana. During the 12 months before the survey, 31.5% of high school students had been in a physical fight and 6.3% had attempted suicide. Substantial morbidity and social problems among youth also result from unintended pregnancies and STDs, including HIV infection. Among high school students nationwide, 34.2% were currently sexually active, 38.9% of currently sexually active students had not used a condom during their last sexual intercourse, and 2.1% of students had ever injected an illegal drug. Results from the 2009 YRBS also indicated that many high school students are engaged in behaviors associated with the leading causes of death among adults aged ≥25 years in the United States. During 2009, 19.5% of high school students smoked cigarettes during the 30 days before the survey. During the 7 days before the survey, 77.7% of high school students had not eaten fruits and vegetables five or more times per day, 29.2% had drunk soda or pop at least one time per day, and 81.6% were not physically active for at least 60 minutes per day on all 7 days. One-third of high school students attended physical education classes daily, and 12.0% were obese.

Interpretation: Since 1991, the prevalence of many health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of morbidity and mortality. The prevalence of most risk behaviors does not vary substantially among cities and states.

Public Health Action: YRBS data are used to measure progress toward achieving 15 national health objectives for Healthy People 2010 and three of the 10 leading health indicators, to assess trends in priority health-risk behaviors among high school students, and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth.

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Tobacco Use

Ever Smoked Cigarettes

Nationwide, 46.3% of students had ever tried cigarette smoking (even one or two puffs) (i.e., ever smoked cigarettes) (Table 26). The prevalence of having ever smoked cigarettes was higher among Hispanic male (54.5%) than Hispanic female (47.6%) students. Overall, the prevalence of having ever smoked cigarettes was higher among Hispanic (51.0%) than black (43.5%) students and higher among Hispanic male (54.5%) than white male (45.2%) and black male (43.5%) students. Overall, the prevalence of having ever smoked cigarettes was higher among 10th-grade (44.0%), 11th-grade (50.0%), and 12th-grade (55.5%) than 9th-grade (37.7%) students; higher among 11th-grade (50.0%) and 12th-grade (55.5%) than 10th-grade (44.0%) students; higher among 12th-grade (55.5%) than 11th-grade (50.0%) students; higher among 10th-grade female (44.0%), 11th-grade female (50.0%), and 12th-grade female (54.8%) than 9th-grade female (37.4%) students; higher among 11th-grade female (50.0%) and 12th-grade female (54.8%) than 10th-grade female (44.0%) students; higher among 12th-grade female (54.8%) than 11th-grade female (50.0%) students; higher among 10th-grade male (44.0%), 11th-grade male (50.0%), and 12th-grade male (56.1%) than 9th-grade male (37.9%) students; and higher among 11th-grade male (50.0%) and 12th-grade male (56.1%) than 10th-grade male (44.0%) students. Prevalence of having ever smoked cigarettes ranged from 23.5% to 59.0% across state surveys (median: 48.8%) and from 35.0% to 51.0% across local surveys (median: 42.9%) (>Table 27).

Ever Smoked Cigarettes Daily

Nationwide, 11.2% of students had ever smoked at least one cigarette every day for 30 days (i.e., ever smoked cigarettes daily) (Table 26). The prevalence of having ever smoked cigarettes daily was higher among black male (5.4%) than black female (3.1%) students. Overall, the prevalence of having ever smoked cigarettes daily was higher among white (13.7%) than black (4.3%) and Hispanic (8.6%) students; higher among Hispanic (8.6%) than black (4.3%) students; higher among white female (13.8%) than black female (3.1%) and Hispanic female (7.7%) students; higher among Hispanic female (7.7%) than black female (3.1%) students; higher among white male (13.7%) than black male (5.4%) and Hispanic male (9.4%) students; and higher among Hispanic male (9.4%) than black male (5.4%) students. Overall, the prevalence of having ever smoked cigarettes daily was higher among 11th-grade (13.0%) and 12th-grade (16.3%) than 9th-grade (7.7%) and 10th-grade (8.9%) students; higher among 12th-grade (16.3%) than 11th-grade (13.0%) students; higher among 11th-grade female (11.7%) and 12th-grade female (15.5%) than 9th-grade female (7.7%) and 10th-grade female (8.3%) students; higher among 12th-grade female (15.5%) than 11th-grade female (11.7%) students; higher among 11th-grade male (14.2%) and 12th-grade male (17.1%) than 9th-grade male (7.8%) and 10th-grade male (9.3%) students; and higher among 12th-grade male (17.1%) than 11th-grade male (14.2%) students. Prevalence of having ever smoked cigarettes daily ranged from 5.0% to 20.0% across state surveys (median: 11.5%) and from 3.3% to 9.3% across local surveys (median: 5.9%) (Table 27).

Current Cigarette Use

Nationwide, 19.5% of students had smoked cigarettes on at least 1 day during the 30 days before the survey (i.e., current cigarette use) (Table 28). The prevalence of current cigarette use was higher among 9th-grade female (15.2%) than 9th-grade male (12.1%) students and higher among 12th-grade male (28.1%) than 12th-grade female (22.4%) students. Overall, the prevalence of current cigarette use was higher among white (22.5%) than black (9.5%) and Hispanic (18.0%) students; higher among Hispanic (18.0%) than black (9.5%) students; higher among white female (22.8%) than black female (8.4%) and Hispanic female (16.7%) students; higher among Hispanic female (16.7%) than black female (8.4%) students; and higher among white male (22.3%) and Hispanic male (19.4%) than black male (10.7%) students. Overall, the prevalence of current cigarette use was higher among 10th-grade (18.3%), 11th-grade (22.3%), and 12th-grade (25.2%) than 9th-grade (13.5%) students; higher among 11th-grade (22.3%) and 12th-grade (25.2%) than 10th-grade (18.3%) students; higher among 12th-grade (25.2%) than 11th-grade (22.3%) students; higher among 10th-grade female (18.7%), 11th-grade female (20.6%), and 12th-grade female (22.4%) than 9th-grade female (15.2%) students; higher among 12th-grade female (22.4%) than 10th-grade female (18.7%) students; higher among 10th-grade male (17.8%), 11th-grade male (23.9%), and 12th-grade male (28.1%) than 9th-grade male (12.1%) students; and higher among 11th-grade male (23.9%) and 12th-grade male (28.1%) than 10th-grade male (17.8%) students. Prevalence of current cigarette use ranged from 8.5% to 26.1% across state surveys (median: 18.2%) and from 5.9% to 15.4% across local surveys (median: 11.5%) (Table 29>).

Current Frequent Cigarette Use

Nationwide, 7.3% of students had smoked cigarettes on 20 or more days during the 30 days before the survey (i.e., current frequent cigarette use) (Table 28). Overall, the prevalence of current frequent cigarette use was higher among male (8.0%) than female (6.4%) students; higher among black male (2.9%) and Hispanic male (5.2%) than black female (1.4%) and Hispanic female (3.2%) students, respectively; and higher among 11th-grade male (9.5%) and 12th-grade male (13.5%) than 11th-grade female (7.1%) and 12th-grade female (8.9%) students, respectively. Overall, the prevalence of current frequent cigarette use was higher among white (9.5%) than black (2.1%) and Hispanic (4.2%) students; higher among Hispanic (4.2%) than black (2.1%) students; higher among white female (9.0%) than black female (1.4%) and Hispanic female (3.2%) students; higher among Hispanic female (3.2%) than black female (1.4%) students; higher among white male (10.0%) than black male (2.9%) and Hispanic male (5.2%) students; and higher among Hispanic male (5.2%) than black male (2.9%) students. Overall, the prevalence of current frequent cigarette use was higher among 11th-grade (8.3%) and 12th-grade (11.2%) than 9th-grade (4.7%) and 10th-grade (5.7%) students; higher among 12th-grade (11.2%) than 11th-grade (8.3%) students; higher among 11th-grade female (7.1%) and 12th-grade female (8.9%) than 9th-grade female (4.4%) students; higher among 12th-grade female (8.9%) than 10th-grade female (5.6%) students; higher among 11th-grade male (9.5%) and 12th-grade male (13.5%) than 9th-grade male (4.9%) and 10th-grade male (5.8%) students; and higher among 12th-grade male (13.5%) than 11th-grade male (9.5%) students. Prevalence of current frequent cigarette use ranged from 2.6% to 12.0% across state surveys (median: 7.4%) and from 1.5% to 6.4% across local surveys (median: 3.4%) (Table 29).

Smoked More than 10 Cigarettes per Day

Among the 19.5% of students nationwide who currently smoked cigarettes, 7.8% of students had smoked more than 10 cigarettes per day on the days they smoked during the 30 days before the survey (Table 30). Overall, the prevalence of having smoked more than 10 cigarettes per day was higher among male (11.1%) than female (4.1%) students; higher among white male (11.0%) than white female (4.3%) students; and higher among 9th-grade male (12.4%), 10th-grade male (9.7%), 11th-grade male (11.7%), and 12th-grade male (10.8%) than 9th-grade female (3.7%), 10th-grade female (2.7%), 11th-grade female (3.9%), and 12th-grade female (5.4%) students, respectively. The prevalence of having smoked more than 10 cigarettes per day was higher among white female (4.3%) than black female (1.3%) students. The prevalence of having smoked more than 10 cigarettes per day ranged from 4.0% to 17.6% across state surveys (median: 9.5%) and from 1.6% to 15.2% across local surveys (median: 7.9%) (Table 31).

Tried to Quit Smoking Cigarettes

Among the 19.5% of students nationwide who currently smoked cigarettes, 50.8% had tried to quit smoking cigarettes during the 12 months before the survey (Table 30). Overall, the prevalence of having tried to quit smoking cigarettes was higher among female (54.2%) than male (48.0%) students and higher among 9th-grade female (53.5%) and 11th-grade female (51.6%) than 9th-grade male (43.6%) and 11th-grade male (42.1%) students, respectively. The prevalence of having tried to quit smoking cigarettes was higher among white male (47.0%) and Hispanic male (52.2%) than black male (36.5%) students. Overall, the prevalence of having tried to quit smoking cigarettes was higher among 10th-grade (54.0%) and 12th-grade (54.0%) than 11th-grade (46.5%) students and higher among 12th-grade male (53.6%) than 11th-grade male (42.1%) students. The prevalence of having tried to quit smoking cigarettes ranged from 38.8% to 67.4% across state surveys (median: 53.2%) and from 36.9% to 65.0% across local surveys (median: 51.5%) (Table 31).

Bought Cigarettes in a Store or Gas Station

Among the 15.7% of students nationwide who currently smoked cigarettes and were aged <18 years, 14.1% usually obtained their own cigarettes by buying them in a store (i.e., convenience store, supermarket, or discount store) or gas station during the 30 days before the survey (Table 32). Overall, the prevalence of having bought their own cigarettes in a store or gas station was higher among male (18.3%) than female (9.6%) students; higher among white male (19.0%) than white female (8.8%) students; and higher among 9th-grade male (11.0%), 10th-grade male (16.8%), 11th-grade male (18.8%), and 12th-grade male (32.7%) than 9th-grade female (3.5%), 10th-grade female (9.8%), 11th-grade female (12.0%), and 12th-grade female (14.9%) students, respectively. Overall, the prevalence of having bought their own cigarettes in a store or gas station was higher among 10th-grade (13.4%), 11th-grade (15.8%), and 12th-grade (23.8%) than 9th-grade (7.1%) students; higher among 12th-grade (23.8%) than 10th-grade (13.4%) and 11th-grade (15.8%) students; higher among 10th-grade female (9.8%), 11th-grade female (12.0%), and 12th-grade female (14.9%) than 9th-grade female (3.5%) students; higher among 10th-grade male (16.8%), 11th-grade male (18.8%), and 12th-grade male (32.7%) than 9th-grade male (11.0%) students; and higher among 12th-grade male (32.7%) than 10th-grade male (16.8%) and 11th-grade male (18.8%) students. Prevalence of having bought their own cigarettes in a store or gas station ranged 4.5% to 26.1% across state surveys (median: 14.5%) and from 10.9% to 34.5% across local surveys (median: 16.8%) (Table 33).

Current Smokeless Tobacco Use

Nationwide, 8.9% of students had used smokeless tobacco (e.g., chewing tobacco, snuff, or dip) on at least 1 day during the 30 days before the survey (i.e., current smokeless tobacco use) (Table 32). Overall, the prevalence of current smokeless tobacco use was higher among male (15.0%) than female (2.2%) students; higher among white male (20.1%), black male (5.2%), and Hispanic male (7.5%) than white female (2.3%), black female (1.3%), and Hispanic female (2.6%) students, respectively; and higher among 9th-grade male (10.7%), 10th-grade male (13.9%), 11th-grade male (18.9%), and 12th-grade male (18.1%) than 9th-grade female (3.2%), 10th-grade female (1.8%), 11th-grade female (2.0%), and 12th-grade female (1.7%) students, respectively. Overall, the prevalence of current smokeless tobacco use was higher among white (11.9%) than black (3.3%) and Hispanic (5.1%) students; higher among Hispanic (5.1%) than black (3.3%) students; higher among Hispanic female (2.6%) than black female (1.3%) students; and higher among white male (20.1%) than black male (5.2%) and Hispanic male (7.5%) students. Overall, the prevalence of current smokeless tobacco use was higher among 11th-grade (10.7%) and 12th-grade (10.0%) than 9th-grade (7.2%) students; higher among 11th-grade (10.7%) than 10th-grade (8.1%) students; higher among 9th-grade female (3.2%) than 12th-grade female (1.7%) students; higher among 10th-grade male (13.9%), 11th-grade male (18.9%), and 12th-grade male (18.1%) than 9th-grade male (10.7%) students; and higher among 11th-grade male (18.9%) and 12th-grade male (18.1%) than 10th-grade male (13.9%) students. Prevalence of current smokeless tobacco use ranged from 4.9% to 16.2% across state surveys (median: 9.1%) and from 2.4% to 9.2% across local surveys (median: 3.8%) (Table 33).

Current Cigar Use

Nationwide, 14.0% of students had smoked cigars, cigarillos, or little cigars on at least 1 day during the 30 days before the survey (i.e., current cigar use) (Table 34). Overall, the prevalence of current cigar use was higher among male (18.6%) than female (8.8%) students; higher among white male (21.0%) and Hispanic male (15.8%) than white female (8.0%) and Hispanic female (9.5%) students, respectively; and higher among 9th-grade male (11.3%), 10th-grade male (16.6%), 11th-grade male (22.4%), and 12th-grade male (26.8%) than 9th-grade female (7.6%), 10th-grade female (9.5%), 11th-grade female (8.6%), and 12th-grade female (9.7%) students, respectively. The prevalence of current cigar use was higher among black female (11.5%) than white female (8.0%) students; and higher among white male (21.0%) than black male (13.9%) and Hispanic male (15.8%) students. Overall, the prevalence of current cigar use was higher among 10th-grade (13.2%), 11th-grade (15.8%), and 12th-grade (18.5%) than 9th-grade (9.6%) students; higher among 12th-grade (18.5%) than 10th-grade (13.2%) and 11th-grade (15.8%) students; higher among 10th-grade male (16.6%), 11th-grade male (22.4%), and 12th-grade male (26.8%) than 9th-grade male (11.3%) students; and higher among 11th-grade male (22.4%) and 12th-grade male (26.8%) than 10th-grade male (16.6%) students. Prevalence of current cigar use ranged from 6.8% to 18.1% across state surveys (median: 14.4%) and from 5.9% to 17.0% across local surveys (median: 10.6%) (Table 35).

Current Tobacco Use

Nationwide, 26.0% of students had reported current cigarette use, current smokeless tobacco use, or current cigar use (i.e., current tobacco use) (Table 34). Overall, the prevalence of current tobacco use was higher among male (29.8%) than female (21.8%) students; higher among white male (35.1%) and Hispanic male (23.6%) than white female (24.9%) and Hispanic female (18.1%) students, respectively; and higher among 10th-grade male (26.8%), 11th-grade male (35.4%), and 12th-grade male (40.4%) than 10th-grade female (21.9%), 11th-grade female (22.9%), and 12th-grade female (25.7%) students, respectively. Overall, the prevalence of current tobacco use was higher among white (30.3%) than black (16.2%) and Hispanic (20.8%) students; higher among Hispanic (20.8%) than black (16.2%) students; higher among white female (24.9%) than black female (14.5%) and Hispanic female (18.1%) students; higher among white male (35.1%) than black male (17.8%) and Hispanic male (23.6%) students; and higher among Hispanic male (23.6%) than black male (17.8%) students. Overall, the prevalence of current tobacco use was higher among 10th-grade (24.5%), 11th-grade (29.3%), and 12th-grade (33.1%) than 9th-grade (19.0%) students; higher among 11th-grade (29.3%) and 12th-grade (33.1%) than 10th-grade (24.5%) students; higher among 12th-grade (33.1%) than 11th-grade (29.3%) students; higher among 10th-grade female (21.9%), 11th-grade female (22.9%), and 12th-grade female (25.7%) than 9th-grade female (17.6%) students; higher among 12th-grade female (25.7%) than 10th-grade female (21.9%) students; higher among 10th-grade male (26.8%), 11th-grade male (35.4%), and 12th-grade male (40.4%) than 9th-grade male (20.2%) students; higher among 11th-grade male (35.4%) and 12th-grade male (40.4%) than 10th-grade male (26.8%) students; and higher among 12th-grade male (40.4%) than 11th-grade male (35.4%) students. Prevalence of current tobacco use ranged from 10.7% to 33.5% across state surveys (median: 25.3%) and from 10.2% to 21.8% across local surveys (median: 15.5%) (Table 35).

Note: Full text PDF of MMWR Surv Summ freely available from link immediately above.


Edited 1 time by JohnPolito Jun 4 10 11:47 PM.