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NEWS REPORT -- Excerpts from: New study highlights teen cigarette brands

By Sue Pleming, Reuters [08/31/00]

WASHINGTON, Aug 31 (Reuters) - Black teens overwhelmingly choose Newport
cigarettes while white and Hispanic teens prefer Marlboro, according to a study on Thursday
that anti-smoking groups said proved the power of brand advertising.

Tobacco companies have consistently denied targeting youths in their campaigns to win new
smokers. Under an agreement reached in 1998, tobacco firms are forbidden from targeting youths.

But research director for the Campaign for Tobacco-Free Kids, Danny McGoldrick said the survey showed that children who
smoke continued to be influenced by advertising and were more likely than adults to pick the most heavily advertised brands --
Marlboro, Newport and Camel.

The Department of Health and Human Services' annual survey on drug abuse, smoking and alcohol said among 12 to 17 year
olds, nearly 75 percent of African-Americans chose Newport while more than half of young white and Hispanic smokers
named Marlboro as their usual brand.

``These are clearly targeted marketing campaigns on behalf of these tobacco companies. Menthol cigarettes such as Newport
are targeted to African-Americans, for example.... This is consistent with other data we have seen,'' said McGoldrick.

He said advertising billboards had come down since tobacco firms agreed not to use this method of promoting their product but
that his group had noticed a rise in cigarette ads in magazines with high youth readership.

Point-of-sale advertising had also increased since billboards came down, he said.

``We know that 90 percent of people smoke before they are 19 years old. That's where new smokers are. It's hard to imagine
the tobacco companies will have abandoned this market and the evidence is that they have not,'' he said.

Smoking overall was down in recent years, the report found, with teen cigarette use dropping to 15.7 percent in 1999
compared with 19.9 percent two years earlier.

``Despite the declining numbers, all of us -- parents, teachers and the government, media -- still need to do more to help our
young people see through the tobacco companies' smokescreen of deceit,'' Health and Human Services Secretary Donna
Shalala told a news conference, referring to research on preferred brands among children.

I’m pleased to join General McCaffrey this morning to announce the results of the 1999 National Household Survey. Last year,
I optimistically told you that in the fight against illicit drug use we may have finally turned the corner. Well this year’s survey
definitely shows that we’ve not only turned the corner—we’re heading for home plate.

According to national trend data, the decline in illicit drug use among young people ages 12 to 17 that began in 1997 has
continued through 1999—while illicit drug use among the overall population remained flat. Among teens, there has been a
consistent, downward trend from 11.4 percent in 1997 to 9.9 percent in 1998 to 9.0 in 1999—a statistically significant decline.
More of our young people are obviously getting the message that drugs are not the stuff of dreams, but the stuff of nightmares.
Marijuana use among youths ages 12 to 17—still the drug of choice for this age group—also decreased from 9.4 percent in
1997 to 7.0 percent in 1999.

The pattern was the same for cigarette use. Among teens, cigarette use decreased from 19.9 percent in 1997 to 15.9 percent in
1999. For the very first time, the survey also captured which cigarette brands were most popular among adolescents. More
than half of white and Hispanic youth smokers reported Marlboro as their usual brand—while nearly three-quarters of
African-American teen smokers reported that Newport is their first choice. Despite the declining numbers, all of us—parents,
teachers, the government, media—still need to do more to help our young people see through the tobacco companies’
smokescreen of deceit.

We also need to intensify our efforts to protect our children from the threat of alcohol. Current alcohol use among 12 to 17
year olds was 19.0 percent in 1999. And binge drinking—or drinking five or more drinks on the same occasion—was 7.8
percent.

The survey also found that the current use of cocaine, inhalants, hallucinogens and heroin for the 12 and older population
remained stable—while the rates of smokeless tobacco use significantly decreased from 3.1 percent in 1998 to 2.2 percent in
1999.

These national trends from the Household Survey are generally consistent with the results from other recent CDC and NIH
surveys. Both Monitoring the Future and the Youth Risk Behavior Survey have shown a leveling or declining trend in illicit drug,
marijuana and cigarette use among adolescents since 1996 or 1997—after a period of increases since the beginning of the
decade. In a separate study being released today, the annual Drug Abuse Warning Network report found that the number of
emergency room visits for drug-related causes decreased 11 percent for youth age 12 to 17 from 1998 to 1999.

All of this is very good news. But let me be clear: We have a long way to go. To paraphrase the poet, we have miles to go in
our journey to a drug free America. We have miles to go when 14.8 million Americans were current users of illicit drugs in
1999. And we have miles to go if even a single young person is letting his or her dreams—and life—go up in a cloud of
marijuana or cigarette smoke.

That’s why, in 1996, I challenged my department to develop a whole new approach to fighting substance abuse. I wanted our
efforts to be based on science, with measurable outcomes, and designed to help community and state leaders formulate
targeted programs. As a result, we have greatly expanded the 1999 National Household Survey. The previous surveys were
generated by interviewers and self-administered paper questionnaires. They used a sample size of 18,000. And they were only
able to generate national estimates.

The newly designed survey is fundamentally different. It is an interactive, bilingual, computer-based questionnaire. It expands
the sample size almost four-fold to nearly 70,000 persons. And—perhaps most important—it can provide national, state and
sub-population substance use estimates. Of course, because of the changes in methodology, national estimates from the
expanded survey cannot be compared to data from prior surveys. That’s why we kept both surveys in place this year to give us
reliable trend data.

But this new survey will provide parents, governors—and future administrations— with a better, more powerful tool. It will
draw a more accurate picture of substance abuse in America than ever before available. It will establish a new baseline for
better year-to-year calculations and comparisons of future trends—trends that will take a few years to develop. It will help
states and communities to better target their substance abuse strategies. It will allow for better analysis of our progress in
reducing substance use among specific age groups, racial and ethnic minorities, and those in rural areas. And it will help us to
further improve our partnerships with states and communities by better targeting several of our key programs.

Our "State Incentive Grant for Community-Based Action" will now require applicants to select one or two key state estimates
from the Household Survey as a baseline of substance use—and to identify a goal to be achieved within three years. This will
allow states to better manage and direct their resources. Additionally, in Fiscal Year 2001, the Targeted Capacity Expansion
Grant program will give preference to those tribal and local government applicants who propose to address problem areas
identified by the National Household Survey. This will help communities cultivate a substance abuse treatment system that is
responsive to current and emerging needs.

The snapshot of substance use that was developed from the new survey has already provided us with considerable information
that invites further investigation. For example, of the ten states with the highest rates of illicit drug use in the population 12 and
older, six were in the western region—while eight of the ten states with the lowest rates were within the southern region. Eight
of the ten states with the highest rates of binge drinking for those 12 and older were in the northern or midwestern
region—while seven of the nine states with the lowest rates were again in the southern region. Additionally, four of the ten states
with the highest rates of cigarette use among those 12 and older were in the southern region—and six were in the midwestern
region. I must caution, however, that within regions there was considerable variation. Also—because of the margin of
error—simply ranking the states would not provide the most accurate picture.

I am sending letters—today—to all 50 governors and DC Mayor Williams to apprise them of the substance use estimates for
their respective jurisdictions—and to ensure that they understand that states have complete access to our information. Later this
year, HHS will also be issuing a series of four reports—including ones on alcohol dependency and youth tobacco use—based
on the information gleaned from the new survey. We know that the newly designed National Household Survey will help us to
continue to move in the right direction…to remove any roadblocks along the way…and to provide the best mileposts of our
progress in the fight against illicit drugs.

Of course, as we use this powerful new tool, at HHS we’re expanding our efforts to reduce tobacco, alcohol and illicit drug use
among young people. These include developing a program for female Hispanic adolescents based on our highly successful Girl
Power! campaign—and generating new materials to help Spanish-speaking parents talk with their children about drugs. We’re
also working to specifically reduce marijuana use among America’s youth through our comprehensive Marijuana Initiative,
which was started in 1995. And today, I’m pleased to announce that we’re issuing an updated version of our free publication,
"Keeping Youth Drug Free," which is targeted to parents of young teens.

For all we’ve done, we’re still not satisfied with where we are in this fight. We’re going to keep pushing ahead until we’re all
the way home. But protecting our children from drugs isn’t a job for government alone. We need a bipartisan commitment to
target our resources. We need parents—the single most important factor in protecting children from trying drugs—to sit down
with their children, early and often, and tell them that drugs are a one-way ticket to no where. And we need coaches, clergy,
media and everyone involved in our children’s lives to keep up a steady drumbeat of anti-drug messages echoing from every
corner of society. The task may seem daunting—but it’s not impossible. It just takes all of us—all of us helping our young
people move in the right direction. 

     This report is the first release of information from the 1999 National Household Survey on Drug Abuse (NHSDA), a
     project of the Substance Abuse and Mental Health Services Administration (SAMHSA). Since 1971, the NHSDA has
     been the primary source of information on the prevalence and incidence of illicit drug, alcohol, and tobacco use in the
     civilian population age 12 years and older.

     Over the years improvements were made to the Household Survey to provide better and more complete information
     from the public. In 1999 another major improvement was made to the survey. The sample size was expanded almost
     fourfold from previous years and data are now based on information obtained from nearly 70,000 persons. The sample
     design was also changed. Previous samples were designed to produce only national estimates. The new sample design
     supports the development of both national and state estimates of substance use. A new, interactive, bilingual,
     computer-based questionnaire was introduced. Earlier surveys relied on paper and pencil questionnaires for the
     respondent to complete. All these changes were designed to improve the accuracy of the survey. At the same time the
     changes limit the comparisons that can be made with information obtained from surveys prior to 1999.

     To provide a basis for analyzing trends in substance use prevalence given the major changes in the 1999 survey and the
     importance of documenting trends, a supplemental sample of 13,000 individuals was interviewed using the paper and
     pencil technique employed in previous years of the Household Survey. The supplemental survey design produced, for a
     limited set of measures, estimates that are comparable to previous surveys but are slightly different from those generated
     from the 1999 expanded computer-based survey. While each estimate is a valid scientific measure of prevalence based
     on the survey method used, the supplemental survey findings are most useful for making appropriate comparisons with
     earlier data and to identify trends in prevalence. The computer-based expanded sample estimates are used for the
     analysis of national patterns of substance use and demographic differences in 1999, trends in new users, and the State
     estimates.

     This report provides national estimates of rates of use, number of users, and other measures related to use of illicit drugs,
     alcohol, cigarettes, and other forms of tobacco by the population, ages 12 years and older. It includes national estimates
     of trends in the initiation of substance use, as well as the extent of both drug dependence and drug treatment in the
     country. Perhaps the most important new data produced by the expanded Household Survey are the State-by-State
     estimates of substance use prevalence. For the first time ever, the report provides estimates of illicit drug, alcohol, and
     cigarette use by age group that can be compared across States and the District of Columbia. These new data can help
     inform policymakers at the Federal, State and local levels about the unique prevention and treatment needs of States.
     The information on the problems of substance abuse in the States will be greatly expanded in other reports that will be
     published in Fall, 2000.

National Estimates

     Illicit Drug Use

          An estimated 14.8 million Americans were current users of illicit drugs in 1999, meaning they used an illicit drug at
          least once during the 30 days prior to the interview. By comparison, the number of current illicit drug users was at
          its highest level in 1979 when the estimate was 25 million.

          10.9 percent of youths age 12-17 reported current use of illicit drugs in 1999. Marijuana is the major illicit drug
          used by this group; 7.7 percent of youths were current users of marijuana in 1999.

          Among youths age 12-17, the percent using illicit drugs in the 30 days prior to interview was slightly higher for
          boys (11.3 percent) than for girls (10.5 percent). Although in the age group 12-17 years boys had a slightly higher
          rate of marijuana use than girls (8.4 percent vs. 7.1 percent), girls were somewhat more likely to use
          psychotherapeutics nonmedically than boys (3.2 percent vs. 2.6 percent).

          The rates of current illicit drug use for major racial/ethnic groups were 6.6 percent for whites, 6.8 percent for
          Hispanics, and 7.7 percent for blacks. The rate was highest among the American Indian/Alaska Native population
          (10.6 percent) and among persons reporting multiple race (11.2 percent). Asians had the lowest rate (3.2
          percent).

          The rate of illicit drug use in metropolitan areas was higher than the rate in non-metropolitan areas. Rates were 7.1
          percent in large metropolitan areas, 7.0 percent in small metropolitan areas, and 5.2 percent in nonmetropolitan
          areas. Rural non- metropolitan counties had a lower rate of illicit drug use (4.2 percent) than other counties.

     Tobacco Use

          An estimated 66.8 million Americans reported current use of a tobacco product in 1999, a prevalence rate of
          30.2 percent for the population 12 and older. Of this total, 57.0 million (25.8 percent) smoked cigarettes, 12.1
          million (5.5 percent) smoked cigars, 7.6 million (3.4 percent) used smokeless tobacco, and 2.4 million (1.1
          percent) smoked tobacco in pipes.

          Current cigarette smoking rates increase steadily by year of age, from 2.2 percent at age 12 to 43.5 percent at
          age 20. Overall, 14.9 percent of youths age 12 to 17 years in 1999 smoked cigarettes currently. Among young
          adults age 18 to 25 years, the rate was 39.7 percent, and among adults age 26 and older the rate was 24.9
          percent.

          Three brands account for most of adolescent cigarette smoking. 54.5 percent of current smokers 12 to 17 years
          of age report Marlboro as their usual brand. Newport was reported by 21.6 percent of youth smokers, and
          Camel was reported by 9.8 percent. No other cigarettebrand was reported by even 2 percent of youths.

          Race/ethnicity differences in usual cigarette brand used were evident among both adult and youth (age 12-17
          years) smokers. More than half of white (58.4 percent) and Hispanic (59.7 percent) youth smokers reported
          Marlboro as their usual brand. About three quarters (73.9 percent) of black adolescent smokers reported
          Newport as their usual brand.

          Youths age 12-17 who currently smoked cigarettes were seven times more likely to use illicit drugs than youths
          who didn't smoke. Young adults age 18 to 25 who smoked were four times more likely to use illicit drugs than
          their nonsmoking peers.

     Alcohol Use

          In 1999, 105 million Americans age 12 and older reported current use of alcohol, meaning they used alcohol at
          least once during the 30 days prior to the interview. About 45 million of this group engaged in binge drinking,
          meaning they drank 5 or more drinks on one occasion during that 30 day period. 12.4 million were heavy
          drinkers, meaning they had 5 or more drinks on one occasion 5 or more days during the past 30 days.

          Although consumption of alcoholic beverages is illegal for those under 21 years of age, 10.4 million current
          drinkers were age 12-20 in 1999. Of this group, 6.8 million engaged in binge drinking, including 2.1 million who
          would also be classified as heavy drinkers.

          For current alcohol use, binge drinking, and heavy alcohol use, 21 is the age of peak prevalence

     Trends in Substance Use Prevalence

     Because of the differences in methodology and impact of the new survey design on data collection, only limited
     comparisons can be made between data from the 1999 survey and data from surveys prior to 1999. These comparisons
     are made based on data from a separate supplemental sample of 13,000 respondents in 1999 that responded using the
     paper questionnaire used in prior surveys. Thus, 1999 estimates discussed below are different from 1999 estimates
     discussed elsewhere. Trend data from the Household Survey are presented in a way to recognize important shifts in
     attitudes and behavior that are statistically significant.

          There were no significant changes in the rate of past month illicit drug use in any of the age groups 12-17 years,
          18-25 years, 26-34 years, or 35 years and older between 1998 and 1999. However, the rate of use was lower in
          1999 than in 1997 for the age group 12-17 years, and there appears to be a consistent downward trend (11.4
          percent in 1997, 9.9 percent in 1998, 9.0 percent in 1999). Among young adults age 18 to 25 years, the rate
          increased between 1997 and 1999 (14.7 percent in 1997, 16.1 percent in 1998, and 18.8 percent in 1999). The
          rates for the age group 26-34 years old and 35 years and older in 1999 have not changed significantly since
          1994.

          Trends for marijuana use were similar to the trends for any illicit use. There were no significant changes between
          1998 and 1999 for any of the four age groups, but an increasing trend since 1997 among young adults age 18-25
          years (12.8 percent in 1997, 13.8 percent in 1998, and 16.4 percent in 1999) and a decreasing trend since 1997
          for youths age 12-17 years (9.4 percent in 1997, 8.3 percent in 1998, and 7.0 percent in 1999).

          The rate of current cigarette use in the population age 12 and older was similar in 1999 (29.7 percent) to the rates
          estimated from 1994 through 1998. Among youths age 12-17, the rate was 15.9 percent in 1999, not statistically
          different than in 1998 (18.2 percent) but significantly lower than the rate in 1997 (19.9 percent).

          Rates of current alcohol, binge alcohol, and heavy alcohol use remained unchanged from 1998 to 1999, for all
          ages 12 and older; and the same was true for each age group, continuing a level trend seen throughout the 1990s.

          The percentage of youths age 12-17 years reporting great risk of harm in using cocaine once a month decreased
          between 1998 and 1999, from 54.3 percent to 49.8 percent. This is down from the estimate of 63.3 percent in
          1994.

          Although there were no significant changes among youth age 12 to 17 years in perceived risk of marijuana use
          between 1998 and 1999, the percentages were down somewhat. More important, the perceptions of risk were
          significantly lower than in 1996. The percent of youths who reported great risk in smoking marijuana once a
          month was 32.6 percent in 1996, 30.9 percent in 1997, 30.8 percent in 1998, and 29.0 percent in 1999. For
          smoking marijuana once or twice a week, percentages for those years were 57.1, 54.0, 54.4, and 52.6 percent,
          respectively.

     Trends in New Use of Substances (Incidence)

     Trends in new use of substances are estimated using the data reported on age at first use from the
     computer-administered 1999 NHSDA. Because information on when people first used a substance is collected on a
     retrospective basis, information on first time use or incidence is always one year behind information on current use. Trend
     data from the Household Survey are presented in a way to recognize important shifts in attitudes and behavior that are
     statistically significant.

          An estimated 2.3 million persons first used marijuana in 1998. This translates to about 6,400 new marijuana users
          per day. More than two-thirds of these new users were under age 18. The rates of marijuana initiation for youth
          during 1995 through 1998 are at their highest levels since the peak levels in the late 1970s. The rate had increased
          between 1991 and 1995 from 46 per thousand potential new users in 1991 to 80 per thousand potential new
          users in 1995; that is, use of marijuana by youths who had never previously used the substance doubled during
          that time period. However, the 1998 rate for youth (81.0) was significantly lower than the 1997rate (90.8).

          There were an estimated 149,000 new heroin users in 1998, not statistically different than the 189,000 new users
          in 1997 or the 132,000 new users in 1996. Estimates of heroin incidence are subject to wide variability and
          usually do not show any clear trend.

          A large proportion of the recent heroin initiates are young and are smoking, sniffing, or snorting heroin. Among the
          estimated 471,000 persons who used heroin for the first time during 1996 through 1998, a quarter (125,000)
          were under age 18 and another 47 percent (222,000) were age 18 to 25 at the time of first use. Only 37 percent
          reported having ever injected heroin by 1999. Most (89 percent) were living in metropolitan areas.

          An estimated 1.6 million Americans used prescription-type pain relievers nonmedically for the first time in 1998.
          This represents a significant increase since the 1980s, when there were generally fewer than 500,000 initiates per
          year. Among youths age 12-17, the incidence rate increased from 6.3 per 1,000 potential new users in 1990 to
          32.4 per 1,000 potential new users in 1998. For young adults age 18-25, there was also an increase in the rate of
          first use between 1990 and 1998 (from 7.7 to 20.3 per 1,000 potential new users).

          An estimated 1.6 million people began smoking cigarettes daily in 1998. About half of these new smokers were
          younger than age 18. This translates to more than 4,000 new regular smokers per day, of which more than 2,000
          are youths.

          An estimated 4.9 million people tried cigars for the first time in 1998, about 13,000 per day. This represents a
          threefold increase in cigar initiation since 1991, when there were only 1.5 million new cigar smokers. The average
          age of cigar initiates has changed little since the 1980s, and incidence rates have increased among both youths
          (from 21.4 in 1991 to 97.6 in 1998) and young adults (from 27.1 in 1991 to 89.0 in 1998).

     Prevention-Related Data

          In 1999, 37.2 percent of youth believed that there was a great risk of harm if they smoked marijuana once a
          month. Those reporting a moderate or great risk had a past month prevalence rate of marijuana use of only 3.1
          percent, while those reporting they believed there was no risk or only a slight risk had a rate of 18.5 percent.

          56.5 percent of youths age 12-17 reported marijuana was easy to obtain in 1999. 15.6 percent of youths
          reported being approached by someone selling drugs during the 30 days prior to the interview.

          6.5 percent of youth said that their parents would neither approve or disapprove if they smoked one or more
          packs of cigarettes a day, while 87.4 percent thought their parents would strongly disapprove. Those youth who
          thought their parents would neither approve nor disapprove weremore likely to have used marijuana in the past
          month (19.6 percent) compared to those whose parents would strongly disapprove (about 5.7 percent).

     Substance Dependence and Treatment

          In 1999 an estimated 3.6 million Americans (1.6 percent of the total population age 12 and older) were
          dependent on illicit drugs. An estimated 8.2 million Americans were dependent on alcohol (3.7 percent). Of these,
          1.5 million people were dependent on both. Overall, an estimated 10.3 million people were dependent on either
          alcohol or illicit drugs (4.7 percent).

          Adults who had first used drugs at a young age were more likely to be dependent on drugs than adults who
          initiated use at a later age. Among adults who had first tried marijuana at age 14 or younger, 8.9 percent were
          dependent on an illicit drug in the past year, compared with only 1.7 percent of adults who had first tried
          marijuana at age 18 or older.

          Males were more likely to be dependent on illicit drugs than females. In 1999, 2.0 percent of males (ages 12 and
          older) were dependent on illicit drugs compared to 1.3 percent of females. Males were also more likely to be
          dependent on alcohol (4.9 percent compared to 2.6 percent). However, for the youngest age group, 12-17, the
          percent dependent on illicit drugs was the same for males and females (3.3 percent for both). The rate for
          adolescent males and females was also essentially the same for alcohol (3.3 percent for males and 3.9 percent for
          females).

State Estimates

     Estimates of substance use for all 50 states and the District of Columbia were developed using a small area estimation
     model that combines sample data from each state with a national regression model that includes local indicators related
     to substance use.

          Of the ten states with the highest rates of current illicit drug use in the population age 12 and older, six were in the
          West region. Eight of the ten states with the lowest rates were in the South region. However, within the regions,
          there was considerable variation. For example, Utah, a Western state, had a relatively low past month prevalence
          rate of 6.2 percent. Delaware, a Southern state, had one of the higher rates in the country (8.5 percent).
          Prevalence estimates ranged from a low of 4.7 percent (Virginia) to a high of 10.7 percent (Alaska).

          Six of the 10 states that were in the highest ranking category for past month use of any illicit drug for persons age
          12 and older were also in the highest group for youth ages 12 to 17. The rate for youth was lowest for the state of
          Utah (8.0 percent). The highest estimate for youth was in Delaware (18.3 percent).

          The state with the highest rate of binge drinking for persons age 12 and older was North Dakota(28.7 percent).
          Most of the states with high rates were northern states. Seven out of the top 10 states were in the Midwest region.
          The state with the lowest rate was Maryland at 15.3 percent. Most of the states with the lowest rates of binge
          drinking were Southern states.

          A number of the states which rank in the top ten for past month cigarette use were not in the top 10 for illicit drug
          use or binge alcohol use. Those states include Kentucky, West Virginia, Ohio, Oklahoma, North Carolina, and
          Indiana.

          For cigarette use, five states ranked in the top ten for both youth age 12-17 and for all ages 12 and older. These
          states were Kentucky, West Virginia, Minnesota, Delaware, and North Carolina.

          The state with the highest rates of past year dependence on illicit drugs and on illicit drugs or alcohol was Alaska
          with 2.8 percent of its 12 and older population dependent on illicit drugs and 7.3 percent dependent on illicit drugs
          or alcohol. Six of the ten states with the highest rates of dependence on any illicit drug or alcohol were Western
          states and three were Midwestern states.