Changes at the high end of risk in cigarette smoking among US high school seniors, 1976-1995

Objectives. This study identified high school seniors at low, moderate, and high risk for cigarette use to examine changes in the prevalence of daily smoking within risk groups from 1976 to 1995. Methods. Data were taken from the Monitoring the Future Project's national surveys of high school seniors. Risk classification was based on grade-point average, truancy, nights out per week, and religious commitment. Logistic regression models were used to estimate trends for all seniors and separately for White (n = 244 221), African American (n = 41 005), and Hispanic (n = 18 457) male and female subgroups. Results. Risk group distribution (low = 45%, moderate = 30%, high = 25%) changed little over time. Between 1976 and 1990, greater absolute declines in smoking occurred among high-risk students (17 percentage points) than among low-risk students (6 percentage points). Particularly large declines occurred among high-risk African Americans and Hispanics. Smoking increased in all risk groups in the 1990s. Conclusions. Among high school seniors, a large part of the overall change in smoking occurred among high-risk youth. Policies and programs to reduce smoking among youth must have broad appeal, especially to those at the higher end of the risk spectrum.