Youth Smoking in the 1990's: Why Did It Rise and What Are the Long-Run Implications?

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One of the most striking trends in the behavior of youth in the United States during the 1990's has been the increased incidence of smoking. After steadily declining over the previous 15 years, youth smoking began to rise precipitously in 1992. By 1997, smoking by teenagers in the United States had risen by one-third from its 1991 trough, before declining again somewhat in 1998 and 1999. This trend is particularly striking in light of the continuing steady decline in adult smoking in the United States. This striking time trend has motivated substantial public-policy interest in youth smoking, highlighted by the recent unsuccessful attempt of the Clinton Administration to pass a comprehensive tobacco-regulation bill that had the ostensible main pulpose of reducing youth smoking. This public-policy interest arises out of concern that youth are not appropriately recognizing the long-run implications of their smoking decisions. Indeed, young smokers clearly underestimate the likelihood that they will still be smoking in their early twenties and beyond. For example, among high-school seniors who smoke, 56 percent say that they will not be smoking five years later, but only 31 percent of them have in fact quit five years hence. Moreover, among those who smoke more than one pack per day, the smoking rate five years later among those who stated that they would not be smoking (74 percent) is actually higher than the smoking rate among those who stated that they would be smoking (72 percent) (Department of Health and Human Services, 1994). If youth smoking leads to adult smoking, particularly in a manner that is underappreciated by the youth smokers themselves, it can have drastic implications for the health of the U.S. population. Smoking-related illness is the leading preventable cause of death in the United States, and smokers on average live from 6.5 (males) to 5.7 (females) fewer years, relative to those who have never smoked (David Cutler et al., 1999). The notion that this increase in youth smoking will lead to a rise in adult smoking is supported by the fact that 75 percent of smokers begin before their 19th birthday (Gruber and Jonathan Zinman, 2001). But this fact does not prove that the curTent upswing in youth smoking will lead to higher long-run adult smoking rates, as it is difficult to distinguish causality from these intertemporal colTelations; smoking later in life may not be a consequence of youth smoking for adults in the past, but rather smoking at both points in life may simply arise from intertemporal correlation in tastes for this activity. In this paper, I first discuss the causes of the rise in youth smoking in the 1990's, then provide some evidence to help causally assess its long-run implications for smoking in the United States and the health of the U.S. population.