Teen alcohol use, sexual activity, and smoking decreasing, CDC finds

Being a teenager in America is becoming less of a risky business.

In the past few decades, the percentages of teens smoking and getting into fights at school have been cut by at least half. Numbers have also gone down for sexual activity, alcohol and drug use, and a range of health-related factors such as soda drinking.

“It’s encouraging that high school students are making better health choices such as not fighting, not smoking, and not having sex,” said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), in a statement, adding, “We need to invest in programs that help them make healthy choices so they live long, healthy lives.”

The CDC released the latest National Youth Risk Behavior Survey Thursday afternoon. It’s conducted every two years with a national sample of about 13,000 high-schoolers.

Out of 13 indicators the survey tracks on teen tobacco use, 11 showed a decrease over the past few decades. The percentage of students who had smoked cigarettes at least once in the past 30 days (current smokers) was 15.7 percent, the lowest figure since tracking began in 1991. At the peak in 1997, 36.4 percent of teens were current smokers.

Since the late 1990s, there have also been dramatic reductions in trying cigarettes and in the percentage who smoke daily.

Experts on teen smoking attribute the progress to several factors in the late 1990s: the removal of Joe Camel as a marketing image and the settlement agreement with tobacco companies in 1998 after many state attorneys general sued. The agreement stopped other marketing directed at kids and resulted in a hike in cigarette prices, because the companies had to pay for health costs attributed to addiction. States also enhanced enforcement of laws against selling cigarettes to minors.

“In the past, people always said,... ‘Kids will always smoke. You can’t do anything about it.’ But now we see you can,” says Joseph DiFranza, a professor at the University of Massachusetts Medical School in Worcester. “It’s not natural to smoke, and if you remove those things like cartoon advertising ... and make it difficult for kids to buy it, you can discourage 75 to 80 percent of would-be smokers from starting.”

The downward trend in teen smoking should continue because “you have fewer smoking role models and you have fewer older siblings supplying cigarettes,” Dr. DiFranza says. “It’s a nice virtuous cycle.”

That doesn’t mean policymakers can let down their guard, however. The top concern among antismoking advocates now is that e-cigarettes are being marketed to youths with tactics that cigarette companies used to employ – including candy flavors and celebrity endorsements.

Some studies have suggested e-cigarettes help people quite smoking, but others raise the alarm that as the number of youths using them increases, so could the rate of nicotine addiction.

The percentage of high-schoolers using alcohol has also declined – from 81 percent saying they had used it at some point in their life in the 1999 survey to 66 percent in 2013. About one-third of students are current drinkers, down from 50 percent in the 1990s.

Another area of concern in recent years has been illegal prescription drug use and heroin use, but both have declined slightly since 2011: 2.2 percent say they’ve used heroin at some point, and 17.8 percent have used prescription drugs without a prescription.

As for sexual activity, the percentage who have had intercourse in the past three months declined from 38 percent in 1991 to 34 percent in 2013. 

Trends were also positive on 7 out of 11 violence-related factors traced over time. The percentage of high-schoolers in a physical fight at least once during the past 12 months decreased from 42 percent in 1991 to 25 percent in 2013. And those engaged in fights on school property dropped from 16 percent in 1993 to 8 percent in 2013.

Not all the trends are moving away from risky behaviors, however.

Since the mid-1990s, nearly one-quarter of students have reported current marijuana use, up from about 15 percent in 1991.

The percentage of high-schoolers who made a suicide plan had declined from 18.6 percent in 1991 to 10.9 percent in 2009, but then went up again and now stands at 13.6 percent.

Another area of concern: Forty-one percent of students who had driven in the past 30 days reported texting or e-mailing while driving. “Teen drivers need to avoid any task that takes their attention away from driving,” said Stephanie Zaza, director of the CDC’s Division of Adolescent and School Health, in a conference call with media. “Parents can play an active role ... by close monitoring, frequent discussions, parent-teen driving agreements, and acting as a role model of good driving habits.”