Many states are developing tobacco use prevention and reduction programs,
and current data on tobacco use behaviors and how these change over time in
response to program activities are needed for program design, implementation,
To assess changes in youth cigarette use and intentions following implementation
of the Florida Pilot Program on Tobacco Control.
Design, Setting, and Participants
Self-administered survey conducted prior to program implementation (1998),
and 1 and 2 years (1999, 2000) later among a sample of Florida public middle
school and high school students who were classified as never users, experimenters,
current users, and former users of cigarettes based on survey responses.
Main Outcome Measures
Changes in cigarette use status, intentions, and behaviors among students
over a 2-year period.
Surveys were completed by 22,540, 20,978, and 23,745 students attending
255, 242, and 243 Florida public middle and high schools in 1998, 1999 and
2000, respectively. Response rates for the 3 survey years ranged from 80%
to 82% and 72% to 82% for the middle school and high school surveys, respectively.
After 2 years, current cigarette use dropped from 18.5% to 11.1% (P<.001) among middle school students and from 27.4% to 22.6% (P = .01) among high school students. Prevalence of never
use increased from 56.4% to 69.3% (P<.001) and
from 31.9% to 43.1% (P = .001) among middle school
and high school students, respectively. Prevalence of experimenting decreased
among middle school and high school students from 21.4% to 16.2% (P<.001) and from 32.8% to 28.2% (P<.001),
respectively. Among never users, the percentage of committed nonsmokers increased
from 67.4% to 76.9% (P<.001) and from 73.7% to
79.3% (P<.001) among middle school and high school
students, respectively. Among experimenters, the percentage of students who
said they will not smoke again increased from 30.4% to 42.0% (P<.001) in middle school and from 44.4% to 51.0% (P<.001) in high school.
Progress toward reduction of youth tobacco use was observed in each
of the 2 years of Florida's Pilot Program on Tobacco Control. Our results
suggest that a comprehensive statewide program can be effective in preventing
and reducing youth tobacco use.