Cigarette smoking rates among high school students have dropped to the lowest levels since the National Youth Risk Behavior Survey (YRBS) began in 1991, according to the 2013 results released today by the Centers for Disease Control and Prevention (CDC).

By achieving a teen smoking rate of 15.7 percent, the United States has met its national Healthy People 2020 objective of reducing adolescent cigarette use to 16 percent or less.

Not all good news

Despite this progress, reducing overall tobacco use remains a significant challenge. For example, other national surveys show increases in hookah and e-cigarette use. In the YRBS, no change in smokeless tobacco use was observed among adolescents since 1999, and the decline in cigar use has slowed in recent years, with cigar use now at 23 percent among male high school seniors.

“It’s encouraging that high school students are making better health choices such as not fighting, not smoking, and not having sex,” said CDC Director Tom Frieden, M.D., M.P.H.  “Way too many young people still smoke and other areas such as texting while driving remain a challenge.  Our youth are our future.  We need to invest in programs that help them make healthy choices so they live long, healthy lives.”

Fewer fights

The YRBS provides data related to behaviors that contribute to unintentional injuries and violence. The 2013 survey found encouraging reductions in physical fighting among adolescents:  

• The percentage of high school students nationwide who had been in a physical fight at least once during the past 12 months decreased from 42 percent in 1991 to 25 percent in 2013.

• Fights on school property have been cut in half during the past 20 years. Sixteen percent of high school students were in at least one physical fight on school property during the 12 months before the survey in 1993, compared to 8 percent in 2013.

For the first time, the surveys conducted by states and large urban school districts gathered information on texting and e-mailing by adolescents while driving. The survey’s findings indicate that the use of technology while driving continues to put youth at risk:

Texting while driving: 61percent

• Among high school students who had driven a car or other vehicle during the past 30 days, the percentage of high school students who texted or e-mailed while driving ranged from 32 percent to 61 percent across 37 states and from 19 percent to 43 percent across 15 large urban school districts.
• Nationwide, 41 percent of students who had driven a car or other vehicle during the past 30 days reported texting or emailing while driving.

Youth sexual risk behaviors

• The percentage of high school students who are currently sexually active (had sexual intercourse during the past three months) has declined from 38 percent in 1991 to 34 percent in 2013. 
• Among the high school students who are currently sexually active, condom use also has declined from 63 percent in 2003 to 59 percent in 2013. This decline follows a period of increased condom use throughout the 1990s and early 2000s. 

Computers, TV and soda

The report also indicates varied trends in obesity-related behaviors in recent years, such as excessive screen time and drinking sugar-sweetened beverages like soda.

• From 2003−2013, the percent of high school students using a computer three or more hours per day (for non-school related work) nearly doubled from 22 percent to 41 percent.
• The percentage of high school students who watch three or more hours of TV on an average school day decreased since 1999 (from 43 percent to 32 percent).
• There was a significant decrease in drinking soda (or pop) one or more times per day from 34 percent in 2007 to 27 percent in 2013.

“The Youth Risk Behavior Survey is an important tool for understanding how health risk behaviors among youth vary across the nation and over time,” said Laura Kann, Ph.D., chief of CDC’s School-Based Surveillance Branch. “We can use these data to help schools, communities, families, and students reduce youth risk behaviors that are still prevalent and to monitor those that are newly emerging.”

About the Youth Risk Behavior Surveillance System (YRBSS)

 CDC’s YRBSS is the only surveillance system designed to monitor a wide range of priority health risk behaviors among representative samples of high school students at the national, state, and local levels.