Use of Tobacco by Youth in Philadelphia

Smoking is estimated to cause nearly one of every five deaths in the United States and more than one of every four deaths in Philadelphia. While cigarette use among youth has been decreasing nationally, use of other forms of tobacco is rising. Addiction to nicotine begins in adolescence, so rising use of tobacco in any form is worrisome. This CHART focuses on recent data on tobacco use among youth in Philadelphia.


More than 1 in 4 Philadelphia Youth Reported Using Tobacco in 2015

Source: Youth Risk Behavior Survey, Centers for Disease Control and Prevention
  • Over the past 10 years there was no significant change in total tobacco use that included cigarettes, cigars, and smokeless tobacco.
  • Total tobacco use was 27.6% among youth in Philadelphia when electronic vapor product use was taken into account.

Young Philadelphians are Most Likely to use Cigars and E-cigarettes

Source: Youth Risk Behavior Survey, Centers for Disease Control and Prevention
  • Cigarette use has fallen consistently, mirroring national trends during the same period (from 34.8% to 10.8%).
  • Cigar use has increased more than 75% between 2011 and 2015.
  • 17.4% of youth reported using e-cigarettes, compared to 16.5% who reported using cigarettes, cigars, or smokeless tobacco.
  • Experimentation with electronic e-cigarettes (39.3%) has surpassed experimentation with conventional cigarettes (33.1%).

African-American Youth Most Likely to Smoke Cigars

Sources: Youth Risk Behavior Survey, Centers for Disease Control and Prevention
  • Cigar use more than doubled among black youth from 2011 to 2013. From 2013 to 2015, the increase was statistically significant.

Tobacco Use by All Racial Groups is High

Sources: Youth Risk Behavior Survey, Centers for Disease Control and Prevention
  • Black, white, and Hispanic youth report total tobacco use at significantly higher rates than Asian youth. This pattern was generally consistent across all types of tobacco.
  • Significantly more white (26.1%) and Hispanic (21.7%) youth reported current use of e-cigarettes than black (12.9%) youth.
  • Significantly more white (14.4%) youth reported current use of cigarettes compared to black (3.6%) youth.
  • Significantly more black (6.1%) youth than white (2.7%) youth reported current use of smokeless tobacco.
  • With the exception of higher use of smokeless tobacco in males compared to females, there were no significant differences in tobacco use by gender.
  • Youth who identified as lesbian, gay, or bisexual (LGB) reported higher experimentation with cigarettes (51% vs 29.5%) and e-cigarettes (53.7% vs 36.6%) and higher use of all tobacco types than youth who identified as heterosexual.

Philadelphia Youth Illegally Purchase Cigarettes More than the Rest of the State

Source: Pennsylvania Department of Health, 2015 Annual Synar Report
  • Nearly 1 out of 4 attempts by minors in Philadelphia to purchase tobacco was successful in 2015.

Conclusions

Use of tobacco among youth in Philadelphia remains dangerously high. The shift in use from cigarettes to other tobacco products among youth points out a need for greater efforts to protect children and teenagers from the marketing of other forms of tobacco.

What Can Be Done

The Health Department:

  • Will use the recent increase in the tobacco permit fee to fund increased checks for compliance with the youth sales law at retail establishments that sell tobacco.
  • Passed regulations to create tobacco free school zones, enforce a penalty for retailers who repeatedly sell to youth, and limit the per-capita number of tobacco retailers in Philadelphia.
  • Will continue to use evidence-based practices including mass media campaigns, cessation counseling, and tobacco-free spaces to combat industry marketing of tobacco products.

Health care providers can:

  • Talk with children and teens about tobacco use, remembering that many children start smoking as early as 11 or 12 years old.
  • Counsel parents about quitting to reduce their children’s risk of smoking.
  • Use reminder systems to help make sure you ask every family about tobacco use and counsel all those who screen positive.

People can:

  • Report stores selling tobacco products to minors by calling 1–888–99-SMOKE or visiting http://bit.ly/IllegalSales.
  • Talk to your children about the harms of all forms of tobacco.

Methods

Data on youth behaviors related to tobacco products are from the Youth Risk Behavior Survey (YRBS). YRBS is a bi-annual self-report survey, conducted by school districts across the US, including in the School District of Philadelphia. Survey respondents are high school students in grades 9–12. “Current use”
 is determined by respondents indicating that they have used a tobacco product on at least 1 day during the past 30 days. The YRBS questionnaire defines electronic vapor products as e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs, and hookah pens.

Data from the annual Pennsylvania Department of Health Synar Survey was used to assess adherence to the law that prohibits tobacco sales to minors. Synar is conducted with youth participants, aged 15–17 years, who attempt to purchase cigarettes from randomly selected retailers.

Suggested citation: Philadelphia Department of Public Health. Use of Tobacco by Youth in Philadelphia. CHART 2017;2(4):1–4.

CHART is a publication of the Philadelphia Department of Public Health, and is intended to highlight under-reported or under-appreciated public health issues in an effort to kick-start a conversation. Readers can subscribe to CHART on Medium, or on our website.