While tobacco use among Hawaii’s public middle and high school students has declined, use of nontraditional tobacco products, such as e-cigarettes, water pipes and self-rolled cigarettes, are on the rise, the Hawaii Department of Health says.
“Tobacco use is the leading preventable cause of death in our Islands. As a state we have made great progress to reduce tobacco use among youth, but we are seeing alarming trends in the use of non-traditional tobacco products that we need to monitor vigilantly,” said Lila Johnson, manager of the DOH Tobacco Prevention and Education Program.
The 2013 Hawaii Youth Tobacco Survey results, which were released this week, indicate that while the use of traditional tobacco products, such as cigarettes, cigars, smokeless tobacco and pipes and exposure to secondhand smoke, has declined, more youth are experimenting with and currently using new types of tobacco products.
Lifetime traditional cigarette use (smoking a cigarette even once) has decreased among high school students from 63.3 percent in 2000 to 29.9 percent in 2013, according to the survey. Among middle schoolers, lifetime traditional cigarette use decreased from 21.1 percent in 2003 to 15.1 percent in 2013.
The percentage of students currently smoking also dropped among high school students from 24.5 percent in 2000 to 6.7 percent in 2013. The percent of middle school students currently smoking has also dropped from 5.3 percent in 2003 to 3.6 percent in 2013.
Lifetime e-cigarette use among high school students, however, tripled from 5.1 percent in 2011 to 17.6 percent in 2013, according to the survey. E-cigarette use quadrupled among middle school students from 1.8 percent to 7.9 percent during the same period.
During the 30 days leading up to the survey, 10 percent of high school students reported using e-cigarettes while 5.5 percent of middle schoolers said they had used an e-cigarette. As for any new tobacco products, which includes e-cigarettes, self-rolled cigarettes and water pipes, among others, 15.9 percent of high school students and 12.6 percent of middle school students reported they had used such products.
“Evidence suggests that e-cigarettes are being used by students who are not cigarette smokers,” said Tonya Lowery St. John, Epidemiologist for DOH’s Chronic Disease Prevention and Health Promotion. “More than a third of middle school students and almost a third of high school students who currently smoke e-cigarettes have never even tried a traditional cigarette.”
Among high school current e-cigarette users, 31.7 percent have never smoked a traditional cigarette, 31.6 percent have tried them but have not smoked one in the past 30 days, and 36.7 percent have smoked both e-cigarettes and traditional cigarettes in the past 30 days. Among middle school e-cigarette users, 33.2 percent have never smoked a traditional cigarette, 38.4 percent have tried traditional cigarettes but not in the past 30 days, and 28.4 percent have smoked both e-cigarettes and traditional cigarettes in the past 30 days.
Compared with national youth tobacco survey results, Hawaii’s youth are using e-cigarettes more than their mainland counterparts.
In 2013, 1.1 percent of middle school students and 4.5 percent of high school students in the U.S. were current e-cigarette users, compared with 5.5 percent of middle school students and 10 percent of high school students in Hawaii. Lifetime e-cigarette use among U.S. middle school students was 3 percent and 11 percent for U.S. high school students, compared to 7.9 percent of middle school students and 17.6 percent of high school students in Hawaii.
Results also indicate that middle and high school students are seeing and hearing fewer messages about the dangers of cigarettes on TV, the Internet and radio, and are seeing fewer people smoking on TV and in movies. However, data also show that a significant proportion of students are receiving ads and coupons directly from tobacco companies, with 12.7 percent of middle school students and 8.8 percent of high school students reporting that they received ads directly from a tobacco company in the past 30 days through the mail, email, the Internet, social media or a text message.
In addition, 7.9 percent of middle school students and 6.6 percent of high school students reported receiving coupons from a tobacco company through one of these vehicles in the past 30 days.
The Hawaii departments of Health and Education jointly administer the survey, in collaboration with the U.S. Centers for Disease Control and Prevention. They survey is a module of the Hawaii School Health Survey which is conducted biennially among Hawaii public middle school and high school students.
Participation in the survey is voluntary. In 2013 a representative sample of 1,980 middle school students and 1,455 high school students participated in the survey. The overall participation rate among selected schools and students was 67.2 percent for middle schools and 60.4 percent for high schools.