594961 disparity of grade-cohort trends for adolescent current smoking rates: From 1991 to 2009

Background/Purpose/Significance: CDC has established Youth Risk Behavior Surveys (YRBS) to monitor tobacco use trends among adolescents. However, current longitudinal analyses are based on the same grade across the years without considering the graders as a cohort. This study attempted to bridge this gap. Methods: The YRBS data from 1991 to 2009 were analyzed. Due to the national representativeness of the data, 9th grader's current smoking prevalence can be ecologically comparable to 11th grader's in 2 subsequent years. 10th grade cohorts are defined respectively. The gender- and race/ethnicity-specific grade cohort trends and cross-sectional trends were depicted along the years. Results: The grade-cohort analysis displays a more accurate portrayal of students as they progress in school as opposed to looking at one same grade level across the years. Upon analysis of adolescent current smoking prevalence, the vast majority of grade-cohort trends are ascending, without distinction to gender. The pattern of grade-cohort trends among Caucasian and Hispanic males increases exponentially. Caucasian male's grade cohort trends are similar to Caucasian female's. However, African American female grade-cohorts had sharp declines in current smoking prevalence while African American males fluctuated. Hispanic male grade-cohorts ascended in current smoking prevalence while Hispanic females fluctuated. Of females, Caucasians, African Americans and Hispanics showed patterns of ascending, descending, and fluctuating current smoking prevalence respectively. Of males, Caucasians and Hispanics exhibited ascending trends while African Americans fluctuated. Conclusions: Cultural sensitive tobacco prevention programs for adolescents are suggested based on the identified high risk groups with respect to their demographics.