2011 SURVEY RESULTS REPORT TOBACCO USE AND RELATED BEHAVIORS 50 40 30 20 Any tobacco use 10 0 2003 2005 2007 2009 2011 34.0 30.7 30.2 30.8 25.0 Cigarette smoking Cigar smoking Spit tobacco use 30.2 25.7 24.2 24.0 19.9 19.4 21.3 18.9 18.1 15.1 8.8 8.5 11.8 11.8 9.5 Figure 1 n Trends in current tobacco use, Grades 9 12, New Mexico, 2003 2011
2011 HIGHLIGHTS Tobacco Use and Related Behaviors Most rates for tobacco use decreased among high school students from 2003 to 2011. Current cigarette smoking decreased from 30.2% to 19.9%. Current cigar smoking decreased from 19.4% to 15.1%. Current use of any form of tobacco* decreased from 34.0% to 25.0%. Cigarette smoking on school property decreased from 13.6% to 6.5%. * Cigarettes, cigars, or spit tobacco Ever smoked cigarettes decreased from 64.8% to 53.5%. First cigarette before age 13 decreased from 24.7% to 14.9%. Current spit tobacco use showed no statistically significant trend. In 2011, among NM high school students (grades 9 12): 53.5% ever smoked cigarettes (16 students in a class 19.9% were current cigarette smokers (6 students in a class 14.9% smoked cigarettes before age 13 (4 students in a class 5.8% were frequent cigarette smokers (2 students in a class 15.1% were current cigar smokers (5 students in a class 9.5% were current spit tobacco users (3 students in a class 20.0% were current hookah users (6 students in a class 30.1% were current users of any form of tobacco** (9 students in a class 74.3% of attempts to quit cigarette smoking were unsuccessful (22 of every 30 students who tried to quit smoking cigarettes). While American Indian students were more likely to be current cigarette smokers than other racial/ethnic groups, they were less likely to be frequent smokers or heavy smokers. ** Cigarettes, cigars, spit tobacco, or hookah In 2011, among NM middle school students (grades 6 8): 23.1% ever smoked cigarettes (7 students in a class 6.8% were current cigarette smokers (2 students in a class 5.3% smoked cigarettes before age 11 (2 students in a class Less than 1% (0.8%) were frequent cigarette smokers (less than 1 student in a class 5.8% were current cigar smokers (2 students in a class 3.7% were current spit tobacco users (1 student in a class 8.7% were current users of tobacco in any form, excluding hookah (3 students in a class 53.0% of attempts to quit smoking were unsuccessful (16 of every 30 students who tried to quit smoking cigarettes). 2 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors DEMOGRAPHICS OF TOBACCO USE 2011 Figure 2 n Tobacco use by gender, Grades 6 8 and 9 12, 2011 Any tobacco* Cigarettes 8.1 9.3 7.0 6.7 Girls Middle School (Grades 6 8) Boys Cigars 5.6 6.1 Spit tobacco 2.7 4.6 Any tobacco ** Cigarettes 16.5 24.9 23.2 35.2 Girls High School (Grades 9 12) Boys Hookah Cigars 10.7 18.6 19.3 21.3 Spit tobacco 3.9 14.8 0 20 40 60 80 100 * Middle school: cigarettes, cigars, and/or spit tobacco (excludes hookah) ** High school: cigarettes, cigars, spit tobacco, and/or hookah Among high school students, boys had a higher prevalence than girls for every form of current tobacco use except for hookah use (no statistically significant difference). The disparity between boys and girls was most extreme for spit tobacco use, where boys had a rate more than three times that of girls. Among middle school students, there was no statistically significant difference between boys and girls for any form of tobacco use. NM YOUTH RISK & RESILIENCY SURVEY 3 14
2011 DEMOGRAPHICS OF TOBACCO USE (cont.) Tobacco Use and Related Behaviors Figure 3 n Current cigarette smoking by grade level, Grades 6 8 and 9 12, 2011 50 40 Middle School (Grades 6 8) High School (Grades 9 12) 30 17.9 18.3 19.6 24.7 20 10 0 11.0 6.3 3.4 6th 7th 8th 9th 10th 11th 12th Among middle school students, the rate of current cigarette smoking increased by grade level. In high school the increase in prevalence by grade level was not statistically significant. Current cigar smoking increased by grade level from 2.9% in 6th grade to 9.6% in 8th grade, and from 11.7% in 9th grade to 19.1% in 12th grade. Current hookah use to smoke tobacco increased by grade level from 16.2% in 9th grade to 23.1% in 12th grade. The hookah use question was not asked of middle school students. The increase in the rate of current spit tobacco use was not statistically significant (2.8% in 6th grade to 4.4% in 8th grade, and from 7.3% in 9th grade to 12.6% in 12th grade). 4 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors DEMOGRAPHICS OF TOBACCO USE (cont.) 2011 Figure 4 n Current, frequent, and heavy cigarette smoking by race/ethnicity, Grades 9 12, 2011 Current smoking 28.4 21.4 18.6 20.5 16.0 American Indian Asian or Pacific Islander Black or African American Frequent smoking Among current cigarette smokers... 9.1 31.5 35.5 32.0 Hispanic White 42.6 Heavy smoking 1.7 5.6 7.9 18.7 12.3 0 20 40 60 80 100 The current cigarette smoking rate was higher among American Indian high school students than among other racial/ethnic groups. American Indians had a higher rate than Hispanic or White students, but there were no statistically significant differences between them and Asian or Pacific Islanders or African American students. Among the 19.9% of all high school students who were current cigarette smokers, American Indian students were less likely to be frequent smokers or heavy smokers than other racial/ethnic groups. For frequent smoking, this relationship was not statistically significant for Asians or Pacific Islanders. For heavy smoking, this relationship was not statistically significant for African American or Hispanic students. Current cigar smoking was more common among Hispanic (16.6%) than White high school students (11.7%). American Indian (9.1%) and Hispanic (7.6%) middle school students were more likely than White students (4.0%) to be current cigarette smokers. Asian or Pacific Islander (14.9%), American Indian (8.4%) and Hispanic (6.8%) middle school students were more likely than White students (2.1%) to be current cigar smokers. There were no statistically significant differences by race/ ethnicity for current spit tobacco use. NM YOUTH RISK & RESILIENCY SURVEY 5 14
2011 HOOKAH USE Tobacco Use and Related Behaviors Figure 5 n Any form of tobacco use, including hookah only use, Grades 9 12, 2011 30.1% used any form of tobacco, including hookah 25.0% used cigarettes, 5.1% cigars,spit tobacco used a hookah and no other form of tobacco 0 10 20 30 40 50 A hookah is a large waterpipe used for smoking tobacco. Hookahs are commonly found in commercial establishments known as hookah lounges. In 2011, the first year a question about hookah use was included in the YRRS, the prevalence of current hookah use among high school students (20.0%) was roughly equivalent to that of cigarette smoking (19.9%). The inclusion of hookah use increased the rate for any form of tobacco use from 25.0% (excluding hookah) to 30.1% (including hookah). This increase is accounted for by the 5.1% of students who used a hookah, but no other form of tobacco. Figure 6 n Current substance use by hookah only vs. cigarette only tobacco users, Grades 9 12, 2011 High risk drug use* 11.6 22.8 Cigarettes only Hookah only Marijuana use 47.2 53.4 Binge drinking 40.8 39.9 0 20 40 60 80 100 * Cocaine, heroin, methamphetamine, painkillers HOW TO READ THIS CHART Among cigarette only users, 22.8% used high risk drugs. Among hookah only users, 11.6% used high risk drugs. The 5.1% of students who who were current hookah users but used no other form of tobacco had a lower rate of high risk drug use (cocaine, heroin, methamphetamine, or painkillers) than those who used tobacco by only smoking cigarettes (11.6% vs. 22.8%). They did not have statistically different rates of marijuana use or binge drinking. 6 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors FREQUENCY AND DOSE OF CIGARETTE SMOKING 2011 Figure 7 n Heavy and frequent cigarette smoking among current smokers, Grades 6 8 and 9 12, 2011 Frequent smoking 11.4% Middle School (Grades 6 8) High School (Grades 9 12) Heavy smoking (includes those who were both frequent and heavy smokers) 5.9% Frequent smoking (not including those who were also heavy smokers) 24.3% 88.6% Current smoking (not frequent or heavy smoking) 69.8% Current smoking (not frequent or heavy smoking) Among the 6.8% of middle school students who were current cigarette smokers, 11.4% were frequent smokers. Data on heavy smoking are not available for middle school students. Among the 19.9% of high schoolers who were current cigarette smokers, almost one quarter (24.3%) were frequent smokers, and 5.9% were heavy smokers. NM YOUTH RISK & RESILIENCY SURVEY 7 14
2011 FREQUENCY AND DOSE OF CIGARETTE SMOKING (cont.) Tobacco Use and Related Behaviors Figure 8 n Prevalance of substance use by dose and frequency of cigarette smoking, Grades 9 12, 2011 72.9 Multiple forms of tobacco use 93.8 83.1 53.5 Binge drinking 61.7 86.0 Current smoking (not frequent or heavy smoking) Frequent smoking (not including heavy smoking) Heavy smoking (includes smokers who were both frequent and heavy smokers) High risk drug user 31.9 53.5 68.6 Current marijuana user 63.5 73.4 82.9 0 20 40 60 80 100 who engaged in multiple forms of * Cocaine, heroin, methamphetamine, painkillers tobacco use, binge drinking, or drug use HOW TO READ THIS CHART Among current smokers, 72.9% used multiple forms of tobacco. Among frequent smokers, 83.1% used multiple forms of tobacco. Among heavy smokers, 93.8% used multiple forms of tobacco. Cigarette smokers were more likely to engage in other substance use as the frequency (frequent cigarette smoking) and dose (heavy cigarette smoking) of cigarette smoking increased. Heavy cigarette smokers were more likely than current smokers or frequent smokers to be binge drinkers. They were more likely than current smokers to engage in multiple types of tobacco use and high risk drug use. Frequent smokers were more likely than current smokers to engage in multiple types of tobacco use and high risk drug use. The relationship between current marijuana use and frequency and dose of smoking was not statistically significant. 8 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors FREQUENCY AND DOSE OF CIGARETTE SMOKING (cont.) 2011 Figure 9 n Prevalence of selected risk behaviors by dose and frequency of cigarette smoking, Grades 9 12, 2011 23.9 Drinking and driving 34.5 61.3 54.4 Was in a fight 63.5 83.4 Current smoking (not frequent or heavy smoking) Frequent smoking (not including heavy smoking) Heavy smoking (includes smokers who were both frequent and heavy smokers) 32.8 Suicidal ideations 37.5 56.5 17.2 Attempted suicide 21.8 42.1 0 20 40 60 80 100 who engaged in risk behaviors HOW TO READ THIS CHART Among current smokers, 23.9% drove when they had been drinking. Among frequent smokers, 34.5% drove when they had been drinking. Among heavy smokers, 61.3% drove when they had been drinking. Other risk behaviors were also associated with dose and frequency of cigarette smoking. Heavy cigarette smokers were more likely than current smokers or frequent smokers to drink and drive or to be in a physical fight. They were more likely than current smokers to have suicidal ideations and to attempt suicide. Frequent smokers were more likely than current smokers to drink and drive. NM YOUTH RISK & RESILIENCY SURVEY 9 14
2011 ANY TOBACCO USE Tobacco Use and Related Behaviors Figure 10 n Any tobacco use and type of tobacco use, Grades 9 12, 2011 High School (Grades 9 12) Any tobacco use 30.1% Among those who used tobacco in any form, rates for various types of tobacco use were Cigarettes only 15.5% 7.5% Spit only 2.1% Cigar only 16.8% Hookah only 69.9% No tobacco use 58.1% Multiple forms of tobacco use Figure 11 n Any tobacco use and type of tobacco use, Grades 6 8, 2011 Middle School (Grades 6 8) Any tobacco use 8.7% Cigarettes only 25.2% Among those who used tobacco in any form, rates for various types of tobacco use were (Hookah use) not available) 6.1% Spit only 12.6% Cigar only 91.3% No tobacco use 56.1% Multiple forms of tobacco use Among middle school students, 8.7% were current users of at least one form of tobacco, while 30.1% of high school students were current tobacco users. Among both MS and HS students, those who were current users of tobacco in any form were likely to use multiple forms of tobacco (MS=56.1%; HS=58.1%). Among tobacco users, the most common single forms of use for HS students were hookah (16.8%) and cigarettes (15.5%), followed by spit tobacco (7.5%) and cigars (2.1%); and for MS students were cigarettes (25.2%), cigars (12.6%), and spit tobacco (6.1%). Hookah use was not assessed among middle school students. 10 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors MULTIPLE FORMS OF TOBACCO USE 2011 Figure 12 n Multiple forms of tobacco use by type of current tobacco use, Grades 9 12, 2011 100 80 71.8 76.6 95.4 72.6 60 40 20 0 Hookah Cigarettes Cigars Spit tobacco Current cigar smokers were more likely than other current tobacco users to use multiple forms of tobacco. Most cigar smokers (82.4%) also currently smoked cigarettes, while 67.6% smoked tobacco with a hookah, and 35.0% used spit tobacco. NM YOUTH RISK & RESILIENCY SURVEY 11 14
2011 MULTIPLE FORMS OF TOBACCO USE (cont.) Tobacco Use and Related Behaviors Figure 13 n Selected risk behaviors by number of types of current tobacco use, Grades 9 12, 2011 In a physical fight 20.7 38.9 60.9 Suicidal ideation 14.9 22.7 34.3 Attempted suicide 4.8 10.5 18.3 No tobacco use One type of tobacco use Drinking and driving 2.5 12.6 30.0 Multiple forms of tobacco use Binge drinking 8.9 36.6 60.4 Current marijuana use 12.2 44.3 69.4 High risk drug use* 4.2 15.7 41.4 Gets mostly D's or F's in school 4.9 10.4 17.6 0 20 40 60 80 100 who used high risk drugs, marijuana, or who were binge drinkers HOW TO READ THIS CHART * Cocaine, heroin, methamphetamine, painkillers Among those who did not use tobacco, 20.7% were in a physical fight. Among those who used only one form of tobacco, 38.9% were in a physical fight. Among those who used more than one form of tobacco, 60.9% were in a physical fight. Those who used more than one form of tobacco in the past 30 days (i.e., cigarettes, cigars, hookah, and/or spit tobacco) had a higher prevalence for many risk behaviors than those who used only one form of tobacco in the past 30 days. Those who used only one form of tobacco had a higher prevalence for the same risk behaviors than students who used no tobacco at all. Behaviors associated with violence, suicide attempts and ideation, substance use, and poor grades all increased in prevalence with the number of tobacco types used. 12 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors ATTEMPTS TO QUIT SMOKING CIGARETTES 2011 Figure 14 n Attempts to quit smoking cigarettes, Grades 9 12, 2011 High School (Grades 9 12) Successful quit attempt 25.7% Among high school students, half (49.6%) of all current cigarette smokers tried to quit smoking in the past 12 months. Of these, 74.3% were unsuccessful in quitting (i.e., they were still current smokers). 74.3% Unsuccessful quit attempt Figure 15 n Unsuccessful quit attempts among cigarette smokers who tried to quit smoking by current binge drinking and painkiller use, Grades 9 12, 2011 100 80 87.0 90.3 60 40 62.7 68.7 20 0 No Yes No Yes Binge drinking Painkillers to get high HOW TO READ THIS CHART Among binge drinkers, 87.0% of those who attempted to quit smoking cigarettes were unsuccessful. Among those who were not binge drinkers, 62.7% of those who attempted to quit smoking cigarettes were unsuccessful. Unsuccessful quit attempts were more likely among binge drinkers (87.0%) than those who didn t binge drink (62.7%), and among those who used painkillers to get high (90.3%) than among those who did not (68.7%). Unsuccessful quit attempts were also associated with other drug use, suicide attempts, and behaviors associated with violence. NM YOUTH RISK & RESILIENCY SURVEY 13 14
2011 ACCESS TO CIGARETTES Tobacco Use and Related Behaviors Figure 16 n Source of cigarettes among cigarette smokers under 18 years of age, Grades 9 12, 2011 50 40 Student s own social contacts = 59.3% 30 28.8 20 21.2 21.4 10 0 Borrowed or bummed them 9.3 Gave someone Someone over 18 money to buy them gave them to me 12.0 Bought in a store 2.1 Vending machine 5.3 Took them from store or family member Other While students under 18 are prohibited by law from buying cigarettes, 12.0% of current smokers under the age of 18 usually bought their cigarettes in a store. Boys under 18 were more than two times as likely as girls to buy cigarettes in a store (15.7% vs. 6.9%). Most current cigarette smokers under 18 (59.3%) obtained their cigarettes from their own social contacts ( Borrowed or bummed them, 28.8%; Gave someone else money to buy them, 21.2%; Someone over 18 gave them to me, 9.3%). 14 NM YOUTH RISK & RESILIENCY SURVEY
Tobacco Use and Related Behaviors RESILIENCY FACTORS AND TOBACCO USE 2011 Figure 17 n Current use of any form of tobacco by resiliency factors, Grades 9 12, 2011 In my home, a parent or other adult is interested in my school work. 25.1 34.6 40.8 Very much true Little bit or pretty much true In my school, there are clear rules about what students can and cannot do. 27.1 32.1 44.8 Not at all true At school I am involved in sports, clubs, or other extra-curricular activities. 23.3 33.1 39.0 Outside my home and school, there is an adult I trust. 26.9 33.2 35.5 I plan to go to college or some other school after high school. 24.6 41.9 51.6 I have a friend about my own age who really cares about me. 28.4 31.9 37.2 0 20 40 60 80 100 who used any form of tobacco HOW TO READ THIS CHART Among those who said it was Very much true that In my home, a parent or other adult is interested in my school work, 25.1% used tobacco. Among those who said A little bit true or Pretty much true, 34.6% used tobacco. Among those who said Not at all true, 40.8% used tobacco. Students were less likely to use any form of tobacco if they had higher levels of resiliency or protective factors. For instance, among those who said it was Not at all true that their parents were interested in their homework, 40.8% used at least one form of tobacco in the past 30 days, while among those who responded A little bit true or Pretty much true, 34.6% used tobacco, and among those who said Very true, only 25.1% used tobacco. There was a similar relationship for each of the resiliency factors in the chart. NM YOUTH RISK & RESILIENCY SURVEY 15 14
2011 Tobacco Use and Related Behaviors Definitions Any tobacco use for middle school students refers to cigarette, cigar, and/or spit tobacco. For high school students any tobacco use includes hookah use in 2011 only, unless otherwise noted. Attempted suicide: answered 1 time or more to the question During the past 12 months, how many times did you actually attempt suicide? Binge drinking: 5 or more drinks on a single occasion at least once in the past 30 days. Cigar: cigars, cigarillos, or little cigars. Current use of tobacco, alcohol, or other substances refers to use on at least one occasion in the past 30 days. Drinking and driving: answered 1 time or more to the question During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol? Frequent cigarette smoking: smoking on at least 20 of the past 30 days. Heavy cigarette smoking: smoking at least 11 cigarettes per day on days the respondent smoked cigarettes. High risk drug use: use of any form of cocaine, heroin, methamphetamines, or painkillers to get high on at least one time in the past 30 days. Hookah: a large waterpipe. Hookahs are widely available for use in hookah bars or lounges. A questionnaire item about use of a hookah to smoke tobacco was added to the 2011 high school YRRS. Earlier data are unavailable. The hookah question was not used on the middle school survey. In a physical fight: answered 1 time or more to the question During the past 12 months, how many times were you in a physical fight? Multiple forms of tobacco use: use of two or more types of tobacco within the past 30 days. Spit tobacco: chewing tobacco, snuff, or dip. Suicidal ideations: either seriously considered attempting suicide, or made a plan to attempt suicide, or both, in the past 12 months. Unsuccessful attempt to quit smoking: within 12 months of an attempt to quit smoking, was still a current smoker. TOPICS Highlights... 2 Demographics of Tobacco Use... 3 Hookah Use... 6 Frequency and Dose of Cigarette Smoking... 7 Any Tobacco Use... 10 Multiple Forms of Tobacco Use... 11 Attempts to Quit Smoking Cigarettes... 13 Access to Cigarettes... 14 Resiliency Factors and Tobacco Use... 15 Suggested citation: Green D and Peñaloza L. 2014. Tobacco Use and Related Behaviors, New Mexico Youth Risk & Resiliency Survey, 2011 Survey Results Report. Epidemiology and Response Division, New Mexico Department of Health, School and Family Support Bureau, New Mexico Public Education Department, and University of New Mexico Prevention Research Center. This report produced by the New Mexico Department of Health and the Public Education Department, with the generous support of the Office of Substance Abuse Prevention, Human Services Department, and technical assistance of the University of New Mexico Prevention Research Center. NM YRRS receives support from the HHS Centers for Disease Control and Prevention in cooperation with NM PED through Grant number1u87ps004195-01. For more information about the YRRS, including methodology, comprehensive state level reports, or county level reports, and more, see www.youthrisk.org. 16 NM YOUTH RISK & RESILIENCY SURVEY