Results of a National Survey

TOBACCO USE IS INCREASING among young Americans. Cigarette smoking rates among adolescents increased by 32% between 1991 and 1997. Cigarette smoking by young adults (18-24 years) increased by 16% between 1995 and 1997, presumably reflecting the aging of the adolescent cohort. Young adults, who represent the youngest legal targets of tobacco industry marketing, may also be initiating tobacco use in larger numbers. If this trend continues, it threatens to reverse the decline in smoking prevalence among US adults that has occurred during the past half century. The smoking behavior of college students is a useful index of tobacco use among young adults. More than one third of adults aged 18 to 24 years attend college, and one quarter attend a 4-year college. US colleges and universities enroll more than 12 million students and are a potential site for interventions to discourage tobacco use. Between 1993 and 1997, cigarette smoking prevalence increased 28% among US college students. Whether this trend is continuing needs to be determined. There is also reason to suspect that college students use a broader range of tobacco products than cigarettes, although this has not been assessed. Cigar smoking is a particular concern. Following a sharp increase in promotional activities by manufacturers, cigar consumption in the United States increased by 50% between 1993 and 1998, reversing a 30-year decline. The rise Author Affiliations and Financial Disclosure are listed at the end of this article. Corresponding Author and Reprints: Nancy A. Rigotti, MD, Division of General Medicine, Massachusetts General Hospital, 50 Staniford St, 9th Floor, Boston, MA 02114 (e-mail: [email protected]). Context Adults aged 18 to 24 years, many of whom are in college, represent the youngest legal targets for tobacco industry marketing. Cigarette smoking has been described among college students, but little is known about noncigarette tobacco use by college students or cigar use by adults of any age.