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US teen behavior update: pluses and minuses

According to a new report released on June 12 by the Centers for Disease Control and Prevention (CDC), US teens are smoking cigarettes less, drinking less, fighting less, and engaging in risky sex less but other problematic behaviors are on the increase
According to a new report released on June 12 by the Centers for Disease Control and Prevention (CDC), US teens are smoking cigarettes less, drinking less, fighting less, and engaging in risky sex less but other problematic behaviors are on the increase
Robin Wulffson, MD

According to a new report released on June 12 by the Centers for Disease Control and Prevention (CDC), US teens are smoking cigarettes less, drinking less, fighting less, and engaging in risky sex less but other problematic behaviors are on the increase. The results were obtained from a study of 13,000 US high school students last spring. Participation was voluntary and required parental permission; however, responses were anonymous.

The survey found that cigarette smoking among was at the lowest level since the National Youth Risk Behavior Survey (YRBS) began in 1991. With the attainment of a teen smoking rate of 15.7%, the US has met its national Healthy People 2020 of reducing adolescent cigarette use to 16% or less. The report cautions, however, that despite this progress, reducing overall tobacco use remains a significant challenge. For example, other surveys show report increases in hookah and e-cigarette use. N change in smokeless tobacco use was observed among adolescents since 1999, and the decline in cigar use has decreased in recent years, with cigar use now at 23% among male high school seniors.

“It’s encouraging that high school students are making better health choices such as not fighting, not smoking, and not having sex,” noted CDC Director Tom Frieden, MD, MPH. He added, “Way too many young people still smoke and other areas such as texting while driving remain a challenge. Our youth are our future. We need to invest in programs that help them make healthy choices so they live long, healthy lives.”

The report provides data regarding behaviors that contribute to unintentional injuries and violence. It found encouraging reductions in physical fighting among teens. The percentage of high school students nationwide who had been involved in a physical fight at least once during the past 12 months decreased from 42% in 1991 to 25% in 2013. Fights on school property have decreased by 50% during the past 20 years; 16% of high school students were in at least one physical fight on school property during the 12 months before the 1993 survey, compared to 8 percent in 2013.

For the first time, the survey obtained data on texting and e-mailing by teens driving. It found that the use of technology while driving continues to put teens at risk. Among high school students who had driven a car or other vehicle during the past 30 days, the percentage who texted or e-mailed while driving ranged from 32-61% across 37 states and from 19-43% across 15 large urban school districts. Nationwide, 41% of teens who had driven a car or other vehicle during the past 30 days reported texting or emailing while driving.

The report shows found mixed results regarding teen sexual risk behaviors. The percentage of high school students who are currently sexually active (engaged in sexual intercourse during the past three months) has declined from 38% in 1991 to 34% in 2013. However, among the high school students who are currently sexually active, condom use has declined from 63% in 2003 to 59% in 2013. This decline follows a period of increased condom use throughout the 1990s and early 2000s.

The report also indicates varied trends in obesity-related behaviors in recent years, such as TV viewing, nonproductive computer use, and drinking sugary beverages. From 2003 through 2013, the percentage of high school students using a computer three or more hours per day (for non-school related work) nearly doubled from 22% to 41%. The percentage of high school students who watch three or more hours of TV on an average school day decreased since 1999 (from 43% to 32%). A significant decrease was found in drinking sugary beverages one or more times per day from 34% in 2007 to 27% in 2013.

“The Youth Risk Behavior Survey is an important tool for understanding how health risk behaviors among youth vary across the nation and over time,” noted Laura Kann, Ph.D., chief of CDC’s School-Based Surveillance Branch. “We can use these data to help schools, communities, families, and students reduce youth risk behaviors that are still prevalent and to monitor those that are newly emerging.”