Fewer Minnesota teens are smoking, but health care leaders worry that complacency -- combined with new tobacco marketing on social media -- could reverse more than a decade of progress on one of the state's most important public health issues.

The number of high school students who had used a tobacco product in the past month declined from 27 percent in 2008 to 25.8 percent this year, the Minnesota Department of Health reported Monday. Among middle-school students, the rate dropped from 6.9 percent to 5.6 percent. But officials noted that the rate of decline has slowed, and that tobacco use remains more common among high school students than among Minnesota's adults.

"We are failing our youth when you consider that they use tobacco at higher rates than adults and are still being exposed to secondhand smoke," said Dr. Ed Ehlinger, state health commissioner. "We are setting them up for a future of tobacco-related illness and premature death."

In a sign that the heavily regulated tobacco industry may be adopting new marketing tactics, the survey documented, for the first time, that a quarter of high school students see clips on YouTube or related video sites in which people are smoking, and that one-fifth of them have been on pro-tobacco pages on Facebook or other social media sites.

One Facebook fan page for Camel Snus, a smokeless tobacco, included regular appeals to a young audience: "When playing COD: Black Ops, having SEX or typing a paper, DON'T FORGET TO SNUS!!!!"

Health officials are concerned that smokeless tobacco products can lead to cigarettes and lifetime tobacco usage, which can increase the risks of lung cancer, chronic pulmonary disease and other severe illnesses. The survey showed that 14 percent of high school students had tried a snus product at least once.

The decline in overall tobacco use continued a trend that began in 2000, when the high school smoking rate was 38.7 percent. But Health Department officials noted that the decline since 2008 was slight, and was within the survey's margin of error.

The survey also found a significant drop in the share of high school students who had recently seen anti-smoking advertisements (48.4 percent in 2008 to 36 percent this year).

Targeting youth?

Websites and social media are a new frontier for tobacco advertising, said Andy Berndt of Catalyst, an organization created with support from Blue Cross Blue Shield of Minnesota to prevent youth smoking.

"They're always going to be searching for that next way to target young people,'' he said.

Berndt said advocates have relaxed a bit on anti-tobacco campaigns, especially after the passage of state legislation in 2007 that banned smoking in indoor public places and offices in Minnesota. The decline in teens seeing anti-smoking ads reflects that, he said.

His own organization has turned more of its attention to preventing obesity in young adults, and hasn't been as focused on the tobacco message.

The new marketing trends could "undermine progress" against youth tobacco usage, said Pete Rode, a research scientist at the state Health Department. Sites such as Facebook have restrictions on corporate use and self-promotion, but he said they can be easily skirted by having individual employees or contractors create fan pages.

Rode said the survey data found a vast majority of teens who live in homes where smoking isn't allowed, and who don't allow smoking in their vehicles. So it's possible they won't be as swayed by tobacco marketing. But that is only today's teens, he said.

"The one thing we have to be aware of is there is a new group of young people coming every year, and they may not necessarily be as aware of the [no smoking] messages unless they've been given them at home," he said. "We kind of have to keep at it."

Jeremy Olson • 612-673-7744