Monday, May 4, 2009

HIgh School Smoking

Has the vigilance in fighting cigarette use waned in the media for the past decade or is it just me? Perhaps other things to be vigilant about have been crowding the public health spotlight or perhaps the evidence behind the effects of tobacco has been too overwhelmingly clear that controversy and conversations around the addictiveness, poison of tobacco have dissipated. Regardless, a recent study by the National Center for Chronic Disease Prevention and Health Promotion reported in the Morbidity and Mortality Weekly Report on “High School Students Who Tried to Quit Smoking Cigarettes (United States, 2007).”

My first qualm with this report is the lack of denominator data. The authors reported that of students who have smoked cigarettes daily, 60.9% of them have tried to quit. They also reported the percentage of these students who were successful in quitting (12.2%). Now, I am sure the data can probably be found somewhere else, but my question is how many students smoke daily?! You don’t need to tell me the breakdown of who the people are that smoke but at least give the reader something to work with.

Anybody reading these reports wants to know… is whatever I am about to read important? And one of the ways the reader figures this out is by asking how many people this issue effects. If it affects .01% of the population then OK, the issue might be interesting but I really don’t need to think about it outside of this context. However, if the percentage is 5% with an issue such as daily smoking in high school students, that would be quite alarming.

I just don’t understand why the only two behaviors that were examined were:
1) Ever smoked cigarettes daily and tried to quit smoking, and
2) Ever smoked cigarettes daily, tried to quit smoking cigarettes, and were successful

Doesn’t it just seem logical to have a preceding question:

0) Ever smoked cigarettes daily

The Youth Risk Behavior Survey (YRBS) probably does ask this question in the survey, but why is it not reported as background to this study?

This report leaves the reader asking more questions like what about socioeconomic status? What about private school students versus public school students? Are there other differences that might explain why some students are more successful at stopping than others? The survey must have more to offer than just grade level, sex, and race/ethnicity…

The title looked fascinating to me but that was about it.


  1. Nice analysis, Ed! Very interesting.

  2. As someone who is trying to have an MMWR article published, they definitely asked for all of my denominators so I find it interesting that this information is lacking. I agree with your analysis Ed and I think that those two items may have been reported on due to their statistical significance.

  3. This has got to be a joke:,27574,25426774-13762,00.html

  4. Good analysis.

    Also, I read this last week detailing some of the issues that Philip Morris is going through with its international expansion due to US public relations people educating activists in emerging markets.