Survey finds decline in teen smokers; state's ban, tax are working, officials say

Smoking among Minnesota teenagers has declined for eight-straight years, according to the latest statewide survey, and the state's smoking ban appears to have had a profound impact on middle schoolers' attitudes toward tobacco.

That's the good news.

The state's survey of 12,000 students in sixth through ninth grade also showed some troubling trends that had health officials scratching their heads. For the first time since the state began tracking teen smoking rates in 2000, high school girls are smoking less than boys. The popularity of menthol cigarettes is up sharply. And doctors are not asking their teenage patients about tobacco use.

Overall, however, the trend has been relentlessly down. In the past eight years, smoking dropped by 63 percent among middle school students and 41 percent among high school students. Use of any tobacco product dropped by 45 percent among middle school students and 30 percent among high school students. Today, 85,000 teenagers are using tobacco, 12,000 fewer than three years ago.

The declines occurred even though the tobacco industry now spends about $228 million a year on marketing in Minnesota, up from about $170 million eight years ago.

Health officials say the state's tobacco tax and the statewide smoking ban clearly have affected youth smoking rates, especially among middle-schoolers. But they expressed concern that the decline among high school students has slowed, mirroring national trends.

In fact, among boys the smoking rate stayed flat at about 33 percent. Among high school girls, it dropped from 26 to 19.5 percent.

"That's different than the trends we used to see before 2005, said Pete Rode, the research scientist with the Minnesota Department of Health who conducted the survey.

Rode and other experts said they could not explain the difference between boys and girls, though the same trend is occurring nationally.

The gender split may be temporary, said Meg Riordan, director of policy research for the Campaign for Tobacco Free Kids, a national antitobacco advocacy group. In the past year the tobacco industry has begun targeting younger women and girls with marketing campaigns that advertise tobacco brands on cell phone covers, little gadgets and other products designed with their tastes in mind, she said.

"We haven't seen the impact of those campaigns on smoking rates yet," she said.

Jean Forster, a University of Minnesota professor who studies youth smoking, said the lower rates among girls may also reflect their sensitivity to social norms.

"They may be responding to the clean indoor air law," she said.

Middle-schoolers seem to be responding as well. Nearly 90 percent said they believe that smoking should never be allowed inside their homes, in their cars or at work, compared with a range of 71 to 81 percent among high-schoolers.

It was the first time the survey asked their opinion of indoor smoking, so it's not possible to compare the response to previous years, Rode said. "But I suspect they would not have been this strong in the past."

The difference between the older and younger kids is significant, and may reflect a major cultural shift in smoking attitudes, Forster said.

"They may have gotten that message before they started to smoke," she said. That means they are less likely to start smoking as they move into their teenage years.

Rode said he was also surprised by the popularity of menthol cigarettes among teenagers. From 2005 to 2008, the percentage of high school smokers who usually smoke menthols rose from 27 to 39 percent. Since 2000, preference for menthols has doubled.

For years, the tobacco industry marketed menthol cigarettes primarily to blacks. Now, campaigns are being directed at young people in part because the menthol may mask the harsh taste of tobacco for new users, he said.

"The tobacco industry has been doing research, trying to get the right level of menthol so it's attractive to different target groups," he said.

Rode said the survey also makes it clear that health care providers are not stepping up as often as they could with young patients. Less than half of students said they had been asked if they smoke by a doctor, dentist or nurse.

"I think we will be having some conversations with the medical community about this," he said.

Josephine Marcotty • 612-673-7394