title: Long-term trends in adolescent and young adult smoking in the United States: metapatterns and implications.
abstract: OBJECTIVE
  We sought to describe long-term adolescent and young adult smoking trends and patterns.
  
  
  METHODS
  We analyzed adolescent data from Monitoring the Future, 1976 to 2005, and young adult (aged 18-24 years) data from the National Health Interview Survey, 1974 to 2005, overall and in subpopulations to identify trends in current cigarette smoking prevalence.
  
  
  RESULTS
  Five metapatterns emerged: we found (1) a large increase and subsequent decrease in overall smoking over the past 15 years, (2) a steep decline in smoking among Blacks through the early 1990s, (3) a gender gap reversal among older adolescents and young adults who smoked over the past 15 years, (4) similar trends in smoking for most subgroups since the early 1990s, and (5) a large decline in smoking among young adults with less than a high school education.
  
  
  CONCLUSIONS
  Long-term patterns for adolescent and young adult cigarette smoking were decidedly nonlinear, and we found evidence of a cohort effect among young adults. Continued strong efforts and a long-term societal commitment to tobacco use prevention are needed, given the unprecedented declines in smoking among most subpopulations since the mid- to late 1990s.
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Emerging Investigation and Analytic Methods Branch, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-67, Atlanta, GA 30341-3717, USA. den2@cdc.gov
authors.forename: David E
authors.initials: DE
authors.lastname: Nelson
authors.forename: Paul
authors.initials: P
authors.lastname: Mowery
authors.forename: Kat
authors.initials: K
authors.lastname: Asman
authors.forename: Linda L
authors.initials: LL
authors.lastname: Pederson
authors.forename: Patrick M
authors.initials: PM
authors.lastname: O'Malley
authors.forename: Ann
authors.initials: A
authors.lastname: Malarcher
authors.forename: Edward W
authors.initials: EW
authors.lastname: Maibach
authors.forename: Terry F
authors.initials: TF
authors.lastname: Pechacek
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D017711:Nonlinear Dynamics; D015995:Prevalence; D017678:Sex Distribution; D012907:Smoking / Q000639:trends*; D014481:United States / Q000453:epidemiology