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In the United States, cigarette use is the leading cause of preventable death, and most adult smokers started before the age of 18 years. Nicotine dependence maintains tobacco use and makes quitting difficult. Despite their relatively short smoking histories, many adolescents who smoke are nicotine dependent, and such dependence can lead to daily smoking. To examine the extent to which high school students had tried to quit smoking cigarettes, CDC analyzed data from the 2007 Youth Risk Behavior Survey (YRBS), a nationally representative survey of students in grades 9-12 in the United States. This report describes the results of that analysis, which found that 60.9 percent of students who ever smoked cigarettes daily tried to quit smoking cigarettes, and 12.2 percent were successful. These findings indicate that comprehensive tobacco control programs need to continue to implement community-based interventions that prevent initiation and increase cessation and increase the use of evidence-based cessation strategies for youths. YRBS measures the prevalence of health risk behaviors among high school students through biennial national, state, and local surveys. The national YRBS uses a three-stage cluster sample design to obtain cross-sectional data representative of public- and private-school students in grades 9-12 in the 50 states and the District of Columbia. Students complete school-based, anonymous, self-administered questionnaires that examine the prevalence of health risk behaviors, including tobacco use. In 2007, the school response rate was 81 percent, the student response rate was 84 percent, the overall response rate was 68 percent, and 14,041 students completed a usable questionnaire. The following two behaviors were examined: (1) ever smoked cigarettes daily and tried to quit smoking cigarettes; and (2) ever smoked cigarettes daily, tried to quit smoking cigarettes, and were successful. Race/ethnicity data are presented for non-Hispanic black, non-Hispanic white, and Hispanic students; the numbers of students from other racial/ethnic groups were too small for meaningful analysis. Data were weighted to provide national estimates. Statistical software that takes into account the complex sampling design was used to calculate prevalence estimates and 95 percent confidence intervals and to conduct t-tests for subgroup comparisons (p less than 0.05). (Contains 1 table.)

The article reports on the availability of less nutritious snack food and beverages in secondary schools in selected U.S. from 2002-2008 according to survey data from School Health Profiles for secondary schools of the U.S. Centers for Disease Control and Prevention (CDC). During such period, the percentage of schools in which students could not purchase candy or salty snacks not low in fat rose in 37 of 40 states. The percentage of secondary schools in which students could not purchase soda pop was higher from 2006 to 2008 in all 34 states.

Background: The School Health Policies and Programs Study (SHPPS) 2006 examined 8 components of school health programs: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. All 8 components were assessed at the state, district, and school levels. Two components, health education and physical education and activity, also were assessed at the classroom level. Methods: Computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 538). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1103), with a nationally representative sample of teachers of required health education classes or courses (n = 912), and with a nationally representative sample of teachers of required physical education classes or courses (n = 1194). Results: This article provides a detailed description of the development of the questionnaires; sampling; data collection; and data cleaning, weighting, and analysis. Conclusions: SHPPS 2006 is the largest and most comprehensive study of school health programs ever conducted. Fielding a study of this magnitude provides many challenges, and several recommendations for future studies emerged from the experience. [ABSTRACT FROM AUTHOR]

Problem: Unhealthy dietary behaviors, physical inactivity, and tobacco use contribute to chronic disease and other health conditions, including obesity, diabetes, and asthma. These behaviors often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable.Reporting Period Covered: January--May 2005.Description of System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors, general health status, and the prevalence of overweight and asthma among youth and young adults. YRBSS includes a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education and health agencies.As a component of YRBSS, in 2005, communities participating in the Steps to a HealthierUS Cooperative Agreement Program (Steps Program) also conducted school-based surveys of students in grades 9--12 in their program intervention areas. These communities used a modified core questionnaire that asks about dietary behaviors, physical activity, and tobacco use and monitors the prevalence of overweight, diabetes, and asthma. This report summarizes results from surveys of students in 15 Steps communities that conducted surveys in 2005.Results: Results from the 15 Steps communities indicated that a substantial proportion of adolescents engaged in health risk behaviors associated with obesity, diabetes, and asthma. During 2005, across surveys, the percentage of high school students who had not eaten fruits and vegetables >5 times/day during the 7 days preceding the survey ranged from 80.1% to 85.2% (median: 83.1%), the percentage who were overweight ranged from 6.6% to 19.6% (median: 11.5%), the percentage who did not attend physical education classes daily ranged from 53.7% to 95.1% (median: 74.2%), and the percentage who had smoked cigarettes during the 30 days preceding the survey ranged from 9.2% to 26.5% (median: 17.1%).Interpretation: Although the prevalence of many health-risk behaviors and health conditions varies across Steps communities, a substantial proportion of high school students engage in behaviors that place them at risk for chronic disease.Public Health Action: Steps Program staff at the national, tribal, state, and local levels will use YRBSS data for decision making, program planning, and enhancing technical assistance. These data will be used to focus existing programs on activities with the greatest promise of results, identify opportunities for strategic collaboration, and identify and disseminate lessons learned. [ABSTRACT FROM AUTHOR]

This paper examined changes in human immunodeficiency virus (HIV)-related risk behaviors among high school students in the United States during 1991-2005. Data from 8 national Youth Risk Behavior Surveys conducted during that period were analyzed. During 1991-2005, the percentage of US high school students engaging in HIV-related sexual risk behaviors significantly decreased. (J Sch Health. 2006;76(10):521-524) [ABSTRACT FROM AUTHOR]

In the United States, 71% of all deaths among persons aged 10-24 years result from 4 causes: motorvehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2005 national Youth Risk Behavior Survey (YRBS) indicated that during the 30 days preceding the survey, many high school students engaged in behaviors that increased their likelihood of death from these 4 causes: 9.9% had driven a car or other vehicle when they had been drinking alcohol, 18.5% had carried a weapon, 43.3% had drunk alcohol, and 20.2% had used marijuana. In addition, during the 12 months preceding the survey, 35.9% of high school students had been in a physical fight and 8.4% had attempted suicide. Substantial morbidity and social problems among youth also result from unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus infection. During 2005, a total of 46.8% of high school students had ever had sexual intercourse, 37.2% of sexually active high school students had not used a condom at last sexual intercourse, and 2.1% had ever injected an illegal drug. Among adults aged >=25 years, 61% of all deaths result from 2 causes: cardiovascular disease and cancer. Results from the 2005 national YRBS indicated that risk behaviors associated with these 2 causes of death were initiated during adolescence. During 2005, a total of 23.0% of high school students had smoked cigarettes during the 30 days preceding the survey, 79.9% had not eaten >=5 times/day of fruits and vegetables during the 7 days preceding the survey, 67.0% did not attend physical education classes daily, and 13.1% were overweight. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to examine trends in weight management goals and the use of exercise for weight control among U.S. high school students. METHODS: As part of the Youth Risk Behavior Surveillance System, 6 national school-based surveys were conducted between 1991 and 2001. Each survey used a three-stage cross-sectional sample of students in grades 9-12. African-American and Hispanic students were oversampled. Logistic regression models were used to test for trends among gender and race/ethnic subgroups, controlling demographic changes over time. RESULTS: From 1991 to 2001, the percentage of female students trying to lose weight (61.7%-62.3%) or stay the same weight (15.4%-16.0%) did not change significantly. Among male students, trying to lose weight (22.7%-28.8%) and trying to stay the same weight (17.8%-21.5%) both increased significantly, while trying to gain weight decreased significantly (32.7%-26.3%). Among female and male students who were trying to lose weight or stay the same weight, the use of exercise for weight control increased significantly. Among students who reported using exercise for weight control, participation in vigorous physical activity > or = 3 days per week increased among African-American female students, and participation in strengthening exercises > or = 3 days per week increased among male students. CONCLUSIONS: These findings suggest increased interest in weight control among male adolescents, and increased use of exercise for weight control among female and male adolescents. [ABSTRACT FROM AUTHOR]

CDC developed the Youth Risk Behavior Surveillance System (YRBSS) to monitor six categories of priority health-risk behaviors among youth -- behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity -- plus overweight. These risk behaviors contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. In these surveys, conducted biennially since 1991, representative samples of students in grades 9--12 are drawn. In 2003, a total of 15,214 students completed the national survey, and 32 states and 20 school districts also obtained data representative of their jurisdiction. Although multiple publications have described certain methodologic features of YRBSS, no report has included a comprehensive description of the system and its methodology. This report describes the background and rationale for YRBSS and includes a detailed description of the methodologic features of the system, including its questionnaire; operational procedures; sampling, weighting, and response rates; data-collection protocols; data-processing procedures; reports and publications; and data quality. YRBSS is evolving to meet the needs of CDC and other users of the data. [ABSTRACT FROM AUTHOR]

Problem/Condition: Priority health-risk behaviors, which contribute to the leading causes of morbidity and mortality among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are prevent-able. Reporting Period: This report covers data collected during February-December 2003. Description of System: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults - behaviors that contribute to unintentional injuries and vio-lence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity - plus overweight. YRBSS includes a national school-based survey conducted by CDC as well as state and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 32 state surveys, and 18 local surveys conducted among students in grades 9-12 during February-December 2003. Results and Interpretation: In the United States, 70.8% of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2003 national Youth Risk Behavior Survey demonstrated that, during the 30 days preceding the survey, numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 30.2% had ridden with a driver who had been drinking alcohol; 17.1% had carried a weapon; 44.9% had drunk alcohol; and 22.4% had used marijuana. In addition, during the 12 months preceding the survey, 33.0% of high school students had been in a physical fight, and 8.5% had attempted suicide. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2003, 46.7% of high school students had ever had sexual intercourse; 37% of sexually active students had not used a condom at last sexual intercourse; and 3.2% had ever injected an illegal drug. Among adults aged >25 years, 62.9% of all deaths results from two causes: cardiovas-cular diseases and cancer. Results from the 2003 national Youth Risk Behavior Survey demonstrate that the majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2003, a total of 21.9% of high school students had smoked cigarettes during the 30 days preceding the survey; 78% had not eaten >5 servings/ day of fruits and vegetables during the 7 days preceding the survey; 33.4% had participated in an insufficient amount of physical activity; and 13.5% were overweight. Actions Taken: YRBSS data are being used to measure progress toward achieving 15 national health objectives for 2010 and three of the 10 leading health indicators. In addition, education and health officials at national, state, and local levels are using these YRBSS data to improve policies and programs to reduce priority health-risk behaviors among youth. [ABSTRACT FROM AUTHOR]

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. This report covers data during February-December 2001. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults; these behaviors contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 34 state surveys, and 18 local surveys conducted among students in grades 9-12 during February-December 2001. In the United States, approximately three-fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2001 national Youth Risk Behavior Survey demonstrated that numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 14.1% had rarely or never worn a seat belt during the 30 days preceding the survey; 30.7% had ridden with a driver who had been drinking alcohol; 17.4% had carried a weapon during the 30 days preceding the survey; 47.1% had drunk alcohol during the 30 days preceding the survey; 23.9% had used marijuana during the 30 days preceding the survey; and 8.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2001, 45.6% of high school students had ever had sexual intercourse; 42.1% of sexually active students had not used a condom at last sexual intercourse; and 2.3% had ever injected an illegal drug. Two-thirds of all deaths among persons aged > or = 25 years result from only two causes: cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2001, 28.5% of high school students had smoked cigarettes during the 30 days preceding the survey; 78.6% had not eaten > or = 5 servings per day of fruits and vegetables during the 7 days preceding the survey; 10.5% were overweight; and 67.8% did not attend physical education class daily. Health and education officials at national, state, and local levels are using these YRBSS data to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators. [ABSTRACT FROM AUTHOR]

Problem/Condition: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable.Reporting Period Covered: This report covers data during February--December 2001.Description of System: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults; these behaviors contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 34 state surveys, and 18 local surveys conducted among students in grades 9--12 during February--December 2001.Results: In the United States, approximately three fourths of all deaths among persons aged 10--24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2001 national Youth Risk Behavior Survey demonstrated that numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 14.1% had rarely or never worn a seat belt during the 30 days preceding the survey; 30.7% had ridden with a driver who had been drinking alcohol; 17.4% had carried a weapon during the 30 days preceding the survey; 47.1% had drunk alcohol during the 30 days preceding the survey; 23.9% had used marijuana during the 30 days preceding the survey; and 8.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2001, 45.6% of high school students had ever had sexual intercourse; 42.1% of sexually active students had not used a condom at last sexual intercourse; and 2.3% had ever injected an illegal drug. Two thirds of all deaths among persons aged >/=25 years result from only two causes: cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2001, 28.5% of high school students had smoked cigarettes during the 30 days preceding the survey; 78.6% had not eaten >/=5 servings per day of fruits and vegetables during the 7 days preceding the survey; 10.5% were overweight; and 67.8% did not attend physical education class daily.Public Health Actions: Health and education officials at national, state, and local levels are using these YRBSS data to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators. [ABSTRACT FROM AUTHOR]

Describes the methodological challenges and processes involved in designing and conducting School Health Policies and Programs Study 2000 in the United States. Questionnaire development and testing; Sampling and weighting; Data analysis; Conclusion.

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults--behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, and 16 local surveys conducted among high school students during February through May 1999. In the United States, approximately three fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes--16.4% had rarely or never worn a seat belt; during the 30 days preceding the survey, 33.1% had ridden with a driver who had been drinking alcohol; 17.3% had carried a weapon during the 30 days preceding the survey; 50.0% had drunk alcohol during the 30 days preceding the survey; 26.7% had used marijuana during the 30 days preceding the survey; and 7.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 1999, nationwide, 49.9% of high school students had ever had sexual intercourse; 42.0% of sexually active students had not used a condom at last sexual intercourse; and 1.8% had ever injected an illegal drug. Two thirds of all deaths among persons aged > or = 25 years result from only two causes--cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 1999, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey; 76.1% had not eaten > or = 5 servings/day of fruits and vegetables during the 7 days preceding the survey; 16.0% were at risk for becoming overweight; and 70.9% did not attend physical education class daily. These YRBSS data are already being used by health and education officials at national, state, and local levels to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators. [ABSTRACT FROM AUTHOR]

Problem/Condition: School health education (e.g., classroom instruction) is an essential component of school health programs; such education promotes the health of youth and improves overall public health. Reporting Period: February-May 1998. Description of System: The School Health Education Profiles monitor characteristics of health education in middle orjunior high schools and senior high schools in the United States. The Profiles are school-based surveys conducted by state and local education agencies. This report summarizes results from 36 state surveys and 10 local surveys conducted among representative samples of school principals and lead health education teachers. The lead health education teacher coordinates health education policies and programs within a middle/junior high school or senior high school. Results: During the study period, most schools in states and cities that conducted Profiles required health education in grades 6-12. Of these, a median of 91.0% of schools in states and 86.2% of schools in cities taught a separate health education course. The median percentage of schools in each state and city that tried to increase student knowledge in selected topics (i.e., prevention of tobacco use, alcohol and other drug use, pregnancy, human immunodeficiency virus [HIV] infection, other sexually transmitted diseases, violence, or suicide; dietary behaviors and nutrition; and physical activity and fitness) was >73% for each of these topics. The median percentage of schools with a health education teacher who coordinated health education was 38.7% across states and 37.6% across cities. A median of 41.8% of schools across states and a median of 31.0% of schools across cities had a lead health education teacher with professional preparation in health and physical education, whereas a median of 6.0% of schools across states and a median of 5.5% of schools across cities had a lead health education teacher with professional preparation in health education only. A median of 19.3% of schools across states and 21.2% of schools across cities had a school health advisory council. The median percentage of schools with a written school or school district policy on HIV-infected students or school staff members was 69.7% across states and 84.4% across cities. Interpretation: Many middle/junior high schools and senior high schools require health education to help provide students with knowledge and skills needed for adoption of a healthy lifestyle. However, these schools might not be covering all important topic areas or skills sufficiently. The number of lead health education teachers who are academically prepared in health education and the number of schools with school health advisory councils needs to increase. Public Health Action: The Profiles data are used by state and local education officials to improve school health education. [ABSTRACT FROM AUTHOR]