Access to and use of tobacco among Tennessean youth

Tobacco use is a leading cause of death. Youth tobacco use is particularly worrisome, as it is associated with long-term use and poor health outcomes.

This study examined access to and patterns of tobacco use among middle school students in Tennessee; and analyzed trends in tobacco use over time.

Data were derived from the Tennessee Youth Risk Behavior Survey for 2003, 2004, and 2006. Ten diverse middle school districts participated in the survey, as part of the Coordinated School Health program.

A total of 7,446, 10,314, and 9,176 middle school students completed the survey in 2003, 2004, and 2006, respectively. In 2006, 1 in 3 students reported ever trying cigarettes, and 1 in 5 had smoked a whole cigarette before the age of 13. Prevalence of daily cigarette smoking exceeded 10%. One in 10 students reported using chewing tobacco, snuff, or dip on one or more of the past 30 days. Only about one-third of respondents had been asked to show identification when purchasing cigarettes. Tobacco use increased with age and was common among male, female, White, and Black students. Cigarette smoking was overall lower in 2006 relative to 2003 and 2004. Yet, access to cigarettes and use of other tobacco products had not declined.

The downward trend in prevalence of cigarette smoking among middle school students is re-assuring. However, the easy access to tobacco and high use rates are alarming. We discuss the implications for health education and promotion, particularly evidence-based policies and interventions to limit access to tobacco.