Changes in Youth Cigarette Use and Intentions Following Implementation of a Tobacco Control Program

CONTEXT: Many states are developing tobacco use prevention and reduction programs, and current data on tobacco use behaviors and how these change over time in response to program activities are needed for program design, implementation, and evaluation. OBJECTIVES: To assess changes in youth cigarette use and intentions following implementation of the Florida Pilot Program on Tobacco Control. DESIGN, SETTING, AND PARTICIPANTS: Self-administered survey conducted prior to program implementation (1998), and 1 and 2 years (1999, 2000) later among a sample of Florida public middle school and high school students who were classified as never users, experimenters, current users, and former users of cigarettes based on survey responses. MAIN OUTCOME MEASURES: Changes in cigarette use status, intentions, and behaviors among students over a 2-year period. RESULTS: Surveys were completed by 22,540, 20,978, and 23, 745 students attending 255, 242, and 243 Florida public middle and high schools in 1998, 1999 and 2000, respectively. Response rates for the 3 survey years ranged from 80% to 82% and 72% to 82% for the middle school and high school surveys, respectively. After 2 years, current cigarette use dropped from 18.5% to 11.1% (P<.001) among middle school students and from 27.4% to 22.6% (P =.01) among high school students. Prevalence of never use increased from 56.4% to 69. 3% (P<.001) and from 31.9% to 43.1% (P =.001) among middle school and high school students, respectively. Prevalence of experimenting decreased among middle school and high school students from 21.4% to 16.2% (P<.001) and from 32.8% to 28.2% (P<.001), respectively. Among never users, the percentage of committed nonsmokers increased from 67.4% to 76.9% (P<.001) and from 73.7% to 79.3% (P<.001) among middle school and high school students, respectively. Among experimenters, the percentage of students who said they will not smoke again increased from 30.4% to 42.0% (P<.001) in middle school and from 44.4% to 51.0% (P<.001) in high school. CONCLUSIONS: Progress toward reduction of youth tobacco use was observed in each of the 2 years of Florida's Pilot Program on Tobacco Control. Our results suggest that a comprehensive statewide program can be effective in preventing and reducing youth tobacco use. JAMA. 2000;284:723-728