Temporal Trends of Sources of Cigarettes Among US High School Students: 2001–2015

Abstract

INTRODUCTION\nRestricting the supply of cigarettes to youth plays an important role in reducing youth smoking.\n\n\nMETHODS\nThe study included data from 8 years of the national Youth Risk Behavior Survey (YRBS) from 2001 to 2015 with 99572 high school students less than 18 years old. Data were weighted to provide national estimates of the temporal trends of cigarette sources. Each cigarette source was analyzed by a separate multivariable logistic regression model and the linear trend odds ratio (aOR) was adjusted by age, sex, race/ethnicity, and smoking frequency.\n\n\nRESULTS\nThe current smoking prevalence among US high school students less than 18 years of age declined from 26.9% in 2001 to 9.9% in 2015. Among current smokers, we found an overall downward trend of buying cigarettes in a store (aOR = 0.98, confidence interval [CI] = [0.96-1.00]) and an overall upward trend of getting them some other way (aOR = 1.03, CI = [1.01-1.05]). The prevalence of purchasing cigarettes in a store significantly declined among smokers aged 16-17, male smokers, white smokers, and daily smokers, but not among other categories. The prevalence of getting cigarettes some other way significantly increased across all groups except Hispanic smokers and medium-level or daily smokers.\n\n\nCONCLUSIONS\nThe proportion of high school students reporting that they bought cigarettes from a store has been declining over the years, while the proportion of high schoolers reporting that they got cigarettes some other way has been increasing. The temporal trends also varied by age, sex, race/ethnicity, and smoking frequency.\n\n\nIMPLICATIONS\nPatterns of high school student access to cigarettes have changed from 2001 to 2015, with access from some other way becoming more prevalent. The differences in cigarette acquisition by age, sex, race/ethnicity, and smoking frequency highlight the importance of implementing tailored policies and interventions to reduce youth access to cigarettes and prevent youth from smoking.