Tobacco use trends and correlates among students in the Madison Metropolitan School District

Trends in cigarette use among students in grades 7-12 in the Madison Metropolitan School District were examined using data from the Dane County Youth Survey, which has been conducted every 5 years since 1980. Past year use of smoking tobacco among these students declined from 40% to 45% through 1995 to 32% in 2000. Past month cigarette use declined from 27% in 1995 to 18% in 2000; daily smoking dropped from 15% in 1990 to 8% in 2000. Among 12th grade students, 1999 national data show that 35% smoked in the past month, compared to 30% of Madison 12th graders. Bivariate analyses show significant socio-economic and race/ethnic disparities in cigarette smoking rates. Hispanic, Native American and white students reported higher rates of smoking than Asian and African American students. Students whose parents had more education were less likely to smoke, as were those students who themselves were academically successful and who had college plans. Students who smoked were far more likely than non-smokers to engage in other risky behaviors, including use of alcohol and marijuana, and to be sexually active. Parental monitoring and supervision, support in one's neighborhood, and participation in volunteer and leadership activities were associated with lower rates of smoking. Risk factors associated with increased rates of smoking included other drug use, aggressive behavior, less family disapproval of risky behavior, and self-concerns about one's own behaviors. These data can assist in targeting prevention and cessation efforts for Wisconsin adolescents. Physicians and other care providers should consider cigarette smoking as a sentinel event that signals the need for screening for potential substance abuse, sexually transmitted diseases (STDs) and contraceptive care. School-based preventive efforts should be continued, particularly at the middle school level, with cessation programs added at the high school level.