Patterns of tobacco smoking in Australia.

A large representative sample of Australians aged 14 years or more was interviewed about smoking. Forty-one per cent of the males and 29% of the females aged 16 years and over currently smoked cigarettes. Smoking rates for both sexes were highest in the 20 to 24 years age group. People in metropolitan areas smoked more than those in rural areas. There was a clear excess of smoking among British immigrants. Higher socioeconomic level was associated with lower smoking rates, with higher ex-smoking rates and with more frequent choice of low-tar brands. Low-tar cigarrettes were used more where health education had emphasized the importance of tar content. Choice of brands among young smokers appeared related to the advertising strategies employed by cigarette companies. The majority of ex-smokers over 60 years of age had given up more than five years previously. Although comparison with earlier surveys of smoking habits is difficult, the results suggested a decrease in cigarette smoking among males and a slight increase among females.     

上海市虹口区15～69岁人群吸烟行为、态度及影响因素

目的 了解上海市虹口区居民的吸烟行为、态度和可能的影响因素,为开展控烟工作提供依据.方法 采用多阶段分层随机抽样方法,共抽取上海市虹口区15～69岁对象960人,其中958人完成了吸烟情况的调查.结果 该区15～69岁人群吸烟率和标化吸烟率分别为20.04%和18.73%,男性吸烟率和标化吸烟率分别为41.05%和30.07%,女性吸烟率和标化吸烟率分别为0.80%和1.70%,男性吸烟率高于女性(RR＝0.02,95%CI:0.01～0.03);25岁以上各年龄组吸烟率高于15～24岁组;大专及以上文化程度人群吸烟率低于初中及以下文化程度人群(RR＝0.45,95%CI:0.25～0.79);饮酒人群吸烟率高于不饮酒人群(RR＝2.68,95%CI:1.76～4.09).家庭人均年收入越低、烟草危害知识得分越高的人群越反对吸烟,赞同禁烟.结论 上海市虹口区15～69岁人群吸烟率较低,性别、年龄、文化程度和饮酒情况是影响吸烟情况的因素.应加强对35岁以上人群的控烟教育;对文化程度较低的人群应加强吸烟有害知识的宣传,纠正其对吸烟和禁烟的态度;在控烟教育的同时应强调控制饮酒.     

上海市虹口区15～69岁人群吸烟行为、态度及影响因素

目的 了解上海市虹口区居民的吸烟行为、态度和可能的影响因素,为开展控烟工作提供依据。方法 采用多阶段分层随机抽样方法,共抽取上海市虹口区15～69岁对象960人,其中958人完成了吸烟情况的调查。结果 该区15～69岁人群吸烟率和标化吸烟率分别为20.04%和18.73%,男性吸烟率和标化吸烟率分别为41.05%和30.07%,女性吸烟率和标化吸烟率分别为0.80%和1.70%,男性吸烟率高于女性（RR＝0.02,95%CI：0.01～0.03）;25岁以上各年龄组吸烟率高于15～24岁组;大专及以上文化程度人群吸烟率低于初中及以下文化程度人群（RR＝0.45,95%CI：0.25～0.79）;饮酒人群吸烟率高于不饮酒人群（RR＝2.68,95%CI：1.76～4.09）。家庭人均年收入越低、烟草危害知识得分越高的人群越反对吸烟,赞同禁烟。结论 上海市虹口区15～69岁人群吸烟率较低,性别、年龄、文化程度和饮酒情况是影响吸烟情况的因素。应加强对35岁以上人群的控烟教育;对文化程度较低的人群应加强吸烟有害知识的宣传,纠正其对吸烟和禁烟的态度;在控烟教育的同时应强调控制饮酒。     

Hearing loss and contributing factors among airport workers in Malaysia

Sensorineural hearing loss is a common and important source of disability among the workers and often caused by occupational noise exposure. Aims of the study were to determine the prevalence and contributing factors of hearing loss among airport workers. A cross-sectional study was carried out at an airport in Malaysia. This study used stratified sampling method that involved 358 workers who were working in 3 different units between November 2008 and March 2009. Data for this study were collected by using questionnaires eliciting sociodemographic, occupational exposure history (previous and present), life-style including smoking habits and health-related data. Otoscopic and pure-tone audiometric tests were conducted for hearing assessment. Noise exposure status was categorize by using a noise logging dosimeter to obtain 8-hour Time-Weighted Average (TWA). Data was analyzed by using SPSS version 12.0.1 and EpiInfo 6.04. The prevalence of hearing loss was 33.5%. Age >40 years old (aOR 4.3, 95%CI 2.2-8.3) is the main risk factors for hearing loss followed by duration of noise exposure >5 years (aOR 2.5, 95%CI 1.4-4.7), smoking (aOR 2.1, 95%CI 1.2-3.4), duration of service >5 years (aOR 2.1, 95%CI 1.1-3.9), exposure to explosion (aOR 6.1, 95%CI 1.3-29.8), exposure to vibration (aOR 2.2, 95%CI 1.1-4.3) and working in engineering unit (aOR 5.9, 95%CI 1.1-30.9). The prevalence rate ratio of hearing loss for nonsmokers aged 40 years old and younger, smokers aged 40 years old and younger, non-smokers older than 40 years old and smokers older than 40 years old was 1.0, 1.7, 2.8 and 4.6 respectively. This result contributes towards better understanding of risk factors for hearing loss, which is relatively common among Malaysian workers.     

Association between household and workplace smoking restrictions and adolescent smoking

CONTEXT: Recent marked increases in adolescent smoking indicate a need for new prevention approaches. Whether workplace and home smoking restrictions play a role in such prevention is unknown. OBJECTIVE: To assess the association between workplace and home smoking restrictions and adolescent smoking. DESIGN, SETTING, AND SUBJECTS: Data were analyzed from 2 large national population-based surveys, the Current Population Surveys of 1992-1993 and 1995-1996, which included 17,185 adolescents aged 15 to 17 years. MAIN OUTCOME MEASURES: Smoking status of the adolescents surveyed, compared by presence of home and workplace smoking restrictions. RESULTS: After adjusting for demographics and other smokers in the household, adolescents who lived in smoke-free households were 74% (95% confidence interval [CI], 62%-88%) as likely to be smokers as adolescents who lived in households with no smoking restrictions. Similarly, adolescents who worked in smoke-free workplaces were 68% (95% CI, 51%-90%) as likely to be smokers as adolescents who worked in a workplace with no smoking restrictions. Adolescent smokers were 1.80 (95% CI, 1.23-2.65) times more likely to be former smokers if they lived in smoke-free homes. The most marked relationship of home smoking restrictions to current adolescent smoking occurred in households where all other members were never-smokers. Current smoking prevalence among adolescents in homes without smoking restrictions approached that among adolescents in homes with a current smoker but with smoking restrictions. CONCLUSIONS: Parents with minor children should be encouraged to adopt smoke-free homes. Smoke-free workplaces can also augment smoking prevention. These findings emphasize the importance of tobacco control strategies aimed at the entire population rather than at youth alone. JAMA. 2000;284:717-722     

2000-2014年中国40岁以上成人慢性阻塞性肺疾病患病率的Meta分析

目的:探讨2000-2014年我国40岁以上成人慢性阻塞性肺疾病(COPD)的患病状况和分布特征,阐明COPD患病的高危人群。方法:计算机检索PubMed、EMbase、维普(VIP)数据库、中国学术文献总库(CNKI)和万方数据库等中、英文数据库公开发表的有关我国40岁以上人群COPD患病率的文献,根据文献纳入和排除标准提取资料,并进行质量评价,采用Stata12.0软件对纳入的文献进行粗患病率和不同亚组患病率的Meta分析。结果:最终纳入文献49篇,共调查118 233人,患病10 819例。40岁以上成人COPD患病率为9.3%(95%CI:8.4%~10.1%);男性COPD患病率为(12.5%,95%CI:11.2%~13.8%),高于女性(6.1%,95%CI:5.3~6.8);年龄越大,COPD患病率越高;学历越高,COPD患病率越低;近几年COPD患病率有所下降;农村人群COPD患病率为(10.2%,95%CI:9.3~11.2),高于城市人群(7.9%,95%CI:6.8~9.0);吸烟人群COPD患病率为(15.7%,95%CI:13.4~18.1),高于非吸烟人群(5.4%,95%CI:4.5~6.3);男性人群COPD患病率以华北地区(15.8%,95%CI:10.9~20.7)最高,女性则以东北地区(6.9%,95%CI:5.0~8.9)最高。结论:我国COPD患病率较高,不同特征群体患病率不同,男性、高年龄者、低学历者、吸烟人群和农村人群是COPD的高危人群。     

Comparison of daily life habits and health examination data between smokers and ex-smokers suggests that ex-smokers acquire several healthy-lifestyle practices

BACKGROUND: The association between smoking and health status including healthful life habits was evaluated in subjects living in a rural Japanese area. METHODS: A cross-sectional survey was conducted with subjects who were smokers and ex-smokers ranging in age from 40 to 59 years who participated in health examinations in 1993 in 17 towns of Gunma Prefecture, Japan. A total of 4,629 of 6,076 subjects (76.2%) agreed to an interview by our public health nurses. Numbers of smokers and ex-smokers among subjects were 2,681 and 245, respectively. RESULTS: Percentages of subjects in their 40s (p <0.01) who ate breakfast daily and those of subjects in their 50s (p <0.05) who exercised more than once a week were significantly higher among ex-smokers than among smokers. Mean body mass index (BMI) was higher in ex-smokers than in current smokers in their 40s (p <0.05) and 50s (p <0.01), and mean high-density lipoprotein cholesterol level (HDLC) was also significantly higher in ex-smokers than in current smokers in their 40s (p <0.05). Furthermore, two-way analysis of variance on BMI and HDLC was conducted considering smoking and drinking habits. BMI was related only with smoking both in subjects in their 40s (p <0.05) and those in their 50s (p <0.001). HDLC was related with both smoking and drinking in subjects in their 40s and to only drinking in subjects in their 50s (p <0.001). CONCLUSIONS: Ex-smokers performed regular exercise more often and showed improvement of lipid metabolism. To clarify cause-effect relationship between smoking and health status or habits, a follow-up study including factors such as smoking status, pulmonary function, exercise habits, and obesity should be conducted.     

Risk of death due to hepatocellular carcinoma among smokers and ex-smokers. Univariate analysis of JACC study data

Hazard ratios (HR) of death due to hepatocellular carcinoma (HCC) were analyzed by gender and age strata (40-59 and 60-79) among smokers and ex-smokers in 65,528 eligible subjects from a large cohort of males and females aged 40-79 years, based on information about several smoking-related characteristics. Both current smokers and ex-smokers among total older males had hazard ratios (HR) for dying from HCC that were 2 to 4 times higher than those who had never smoked at the baseline survey. When subjects were restricted to those without history of liver disease (LD), older male (60-79) ex-smokers presented a statistically significant HR of 5.0. Earlier age at start of smoking (15 to 19) showed a significantly increased HR of 4 to 8 for both current and ex-smokers. Moderate number of cigarettes smoked per day showed an increased HR, and later age at cessation of smoking had a higher HR compared to earlier cessation. Larger cumulative amount of smoking resulted in an elevated HR of 11 times than in those who had never smoked. Cigarette smoking was suggested to be an important risk factor for death from HCC regardless of whether the smoking habit was in the past or was continuing at present. To eliminate confounding effects and interaction with other risk factors of HCC and to clarify the net association between smoking habits and HCC, farther careful analysis using multivariate models is needed.     

Trends in pregnancy-related smoking rates in the United States, 1987-1996

CONTEXT: Rates of smoking are increasing among adolescents and young adults, but trends in smoking among pregnant women have not been studied. OBJECTIVE: To assess pregnancy-related variations in smoking behaviors and their determinants among women of childbearing age in the United States. DESIGN: Analysis of data collected between 1987-1996 from the Behavioral Risk Factor Surveillance System survey. SETTING AND SUBJECTS: A total of 187302 (178499 nonpregnant and 8803 pregnant) noninstitutionalized women aged 18 to 44 years from 33 states. MAIN OUTCOME MEASURES: Prevalence rates of smoking initiation and current smoking, median number of cigarettes smoked, and adjusted odds ratios for smoking stratified by pregnancy status; prevalence rate ratio for current smoking comparing pregnant with nonpregnant women. RESULTS: The overall percentage of women who had ever initiated smoking decreased significantly from 44.1% in 1987 to 38.2% in 1996. During that 10-year period, the prevalence of current smoking also decreased significantly among both pregnant women (16.3% to 11.8%) and nonpregnant women (26.7% to 23.6%). Overall, pregnant women were about half (54%) as likely as nonpregnant women to be current smokers during 1987-1996. Over time, the median number of cigarettes smoked per day by pregnant smokers remained at 10, whereas among nonpregnant smokers it decreased from 19 to 15 (P<.05 for trend). In the same period, among young women (aged 18-20 years), prevalence rates of smoking initiation and current smoking increased slightly. Sociodemographic subgroups of women at increased risk for current smoking were the same for pregnant and nonpregnant women (ie, those with a completed high school education or less, whites, and those who were unmarried). CONCLUSIONS: In this analysis, the decline in smoking over time among pregnant women was primarily due to the overall decline in smoking initiation rates among women of childbearing age, not to an increased rate of smoking cessation related to pregnancy. To foster effective perinatal tobacco control, efforts are needed to further reduce the number of young women who begin smoking. Clinicians should query all pregnant women and women of childbearing age about smoking and provide cessation and relapse interventions to each smoker.     

上海市闵行区6~11岁在校学生血红蛋白连续监测结果分析

 目的  了解上海市闵行区6～11岁在校学生贫血流行特征,为制定新形势下中小学生贫血预防措施和策略提供依据。方法   2012—2015学年连续4年对本区所有6～11岁在校学生42 872名进行血红蛋白测定。应用SPSS 18.0统计软件完成所有资料分析。结果   6～11岁在校学生贫血患病率为5.05% (95 % CI:4.84～5.26),女生贫血患病率为5.28%,显著高于男生4.84% (χ2=4.24,P=0.037)。男、女生贫血易患年龄为6岁。持续就读于希望学校学生较公办学校学生更易患贫( 男生:OR=2.37,95%CI:2.03～2.76;女生:OR=2.08,95%CI:1.74～2.49)。持续超重或肥胖的学生贫血患病风险较营养正常学生低(男生:OR=0.65,95%CI:0.55～0.76;女生:OR=0.75,95%CI:0.61～0.92)。贫血3年累积发病率为12.80% (95%CI:12.49～13.12%),其中女生为14.52%,显著高于男生的11.28% (χ2=100.26,P<0.001)。6岁组男生3年累积发病风险最高,10~11岁组女生贫血3年累积发病率最高。持续就读于希望学校的学生贫血发病风险最高(男生:RR=1.93,95%CI:1.72～2.16;女生:RR=1.20,95%CI:1.04～1.39),持续超重或肥胖是贫血发病的保护因素(男生:RR=0.75,95%CI:0.67～0.84;女生:RR=0.77,95%CI:0.68～0.88)。贫血单次检出率为14.58%,复发性贫血检出率为2.54%。不同年龄、不同性质学校、不同营养状况的男、女生贫血检出次数均以1次为主(P<0.05)。结论   上海市闵行区6～11岁在校学生贫血处于轻度流行状态。有必要继续开展全年龄段学龄儿童贫血的普查普治工作,并根据监测结果辅以个性化干预措施,加强学龄儿童家长和青春期女生健康宣教,重点关注希望学校和复发性或持续性贫血的学生。     

Effect of cigarette smoking on clinical outcomes of hospitalized Chinese male smokers with acute myocardial infarction

Background Smoking is known to be a strong risk factor for premature atherosclerosis, acute myocardial infarction （AMI） and sudden cardiac death. According to a cross-sectional survey conducted in 2000-2001 in China, the prevalence of smoking among the Chinese men was 60.2%, the highest prevalence in the world. Up to date, the relationship between smoking and AMI in Chinese male smokers is still unclear. This study analyzed the baseline characteristics for male smokers hospitalized with AMI and investigated the effect of cigarette smoking on their clinical outcomes.Methods A total of 890 men aged 18 years or over with AMI were prospectively recruited from 1 January 2007 to 31 December 2009 from Shanxi Provincial People＇s Hospital. Patients were grouped into smokers and nonsmokers. The relationships between baseline characteristics and clinical outcomes were tested using either the chi-square test for trend for discrete variables or analysis of variance for continuous variables.Results Smokers accounted for 66.7% （594）, more than twice of nonsmokers （296 （33.3%））, and were averaged 7 years younger （（56.61±11.44） vs. （63.61±11.62） years, P 〈0.001）. Smokers had the higher rate of TIMI flow grade 2 or 3 after thrombolytic therapy （42.4 % vs. 24.5%, P=0.002）, 1 vessel disease （25.5% vs. 14.5%, P=0.003） than nonsmokers.Smokers had better in-hospital outcome with lower in-hospital mortality rate than nonsmokers （6.2% vs. 10.8%,P=0.023）.Conclusions Male smokers suffered from AMI in this study presented an average of 7 years earlier than nonsmokers and were more than twice as likely to have AMI as nonsmokers in China. Smoking appeared to result in earlier infarction,especially ST elevated myocardial infarction in otherwise healthier patients who are likely to survive.     

社区35岁以上人群慢性阻塞性肺疾病流行病学患病率及危险因素研究

目的了解沈阳部分社区35岁以上人群慢性阻塞性肺疾病(COPD)的患病率及危险因素,为COPD社区防治提供基础数据。方法采用统一的流行病学调查表,以整群随机抽样的方法,对沈阳市中山社区和桂林社区35～80岁居民进行问卷调查,并进行体格检查和肺功能检测,取资料完整的2 194份问卷进行分析。结果调查资料完整且肺功能检查合格的2 194例人群中,男903例,女1 291例,平均年龄为55.8岁。COPD患病率为5.1%,其中男性患病率为6.5%,女性患病率为4.1%,男性患病率高于女性,差异有统计学意义(P<0.05)。被调查人群的吸烟率为37.1%,男性吸烟率明显高于女性,差异有统计学意义(P<0.05)。吸烟者中COPD的患病率为10.33%,显著高于非吸烟人群,差异有统计学意义(P<0.05),而COPD人群中吸烟率为75.0%。单因素分析结果显示:吸烟、年龄、低体质指数、6个月以上的燃煤应用史是COPD的可能危险因素,而良好的家庭收入和文化水平是COPD的保护因素。多元回归分析显示,吸烟和年龄是COPD的危险因素。结论沈阳市部分社区35岁以上人群COPD患病率为5.1%,吸烟和年龄是COPD患病的主要危险因素。除了吸烟和年龄以外,低体质指数、6个月以上的燃煤应用史、经济状况和受教育程度也是COPD的可能危险因素。控烟、改善经济状况和提高文化素质将有利于COPD的社区防治。     

中国城乡成年人群哮喘患病状况及其影响因素

目的：分析中国成年人群的哮喘患病状况及其影响因素。方法：以中国12个地区的常住居民为研究 对象,评估不同特征人群哮喘的患病状况;采用logistic回归对2009年和2011年中国健康营养调查(China Health and Nutrition Survey,CHNS)的数据进行影响因素分析。结果：中国成人哮喘患病率为1.25%(95% CI：1.06%~1.43%)。年 龄、性别、地区、城乡、吸烟、体重指数(body mass index,BMI)、受教育程度、婚姻、幸福感等在哮喘患者与非哮 喘患者间的差异均有统计学意义(均P<0.05)。与正常人群比较,哮喘患者合并高血压、糖尿病、心肌梗死、脑卒中的 风险较大(均P<0.01)。多元logistic回归分析显示：成人哮喘的影响因素包括年龄(OR=1.042,95% CI：1.032~1.053)、 性别(男性OR=1.533,95% CI：1.080~2.167)、地区(北京OR=2.470,95% CI：1.155~5.308)、城市(OR=1.355,95% CI： 1.026~1.786)、BMI(OR=1.021,95% CI：1.000~1.037)、吸烟(OR=1.428,95% CI：1.028~1.989)、饮酒(OR=0.711, 95% CI：0.515~0.976)、受教育年限(OR=0.964,95% CI：0.930~0.999)、短期健康状况欠佳(OR=5.295,95% CI： 4.055~6.934)、主观幸福感(低OR=2.219,95% CI：1.272~3.887)、打游戏机(OR=2.732,95% CI：1.023~6.088)、看电视 (OR=1.695,95% CI：1.036~2.941)。结论：中国成年人哮喘患病受年龄、性别、生活方式、社会环境等多方面因素的 共同影响。     

同心县农村居民两周患病及住院影响因素分析

目的了解同心县农村居民两周患病及住院卫生服务利用情况,为相关决策部门制定相应的政策提出意见和建议。方法采用多阶段分层随机抽样方法入户调查宁夏同心县10个乡镇共52个村庄1040户共5001人,分析农村居民两周患病及住院卫生服务利用情况。结果宁夏同心县农村居民两周患病率为13.3%,慢性病患病率为13.5%,两周患病率女性(15.2%)高于男性(11.6%);回族为14.4%,高于其他民族;60岁以上年龄组两周患病率最高(21.4%);在婚、离婚和丧偶人群两周患病率均高于未婚人群的两周患病率(9.8%)。文化程度以文盲人群两周患病率最高,为18.9%,高中及以上人群的两周患病率最低(5.0%);家庭年均收入小于8000元的人群两周患病率最高16.7%。不同性别、年龄、婚姻状况、文化程度,家庭年均收入居民两周患病率差异均有统计学意义(P<0.05)。同心县居民住院率为7.5%,年龄、婚姻状况、文化程度、家庭年均收入水平均影响农村居民住院卫生服务利用率。结论同心县农村居民健康状况好于全国平均水平,住院卫生服务利用率处于较低水平,经济困难是制约住院卫生服务利用的主要因素。女性、老年人、经济困难人群是住院卫生服务利用重点提高人群。     

Cancer patterns in Canada.

Cancer is diagnosed in about 70 000 Canadians each year and is the leading cause of the loss of potential years of life before age 75 among women. Life-threatening forms of cancer will develop in at least one of every three Canadian newborns during their lifetimes if current cancer risks are not reduced. Lung and breast cancers are, respectively, the leading causes of premature death due to cancer among men and women. Compared with other countries Canada has low death rates for stomach cancer but high rates for certain smoking-related cancers (those of the lung and of the mouth and throat), leukemia and cancers of the colon, breast and lymphatic tissues. Newfoundland has the highest rates of death from stomach cancer and the lowest rates of death from prostatic cancer, whereas the western provinces have the opposite pattern. The rates of death from lung cancer among men are highest in Quebec, the province with the highest prevalence of smoking. In Canada the overall rates of death from cancer increased by 32% among men from 1951 to 1983. However, among women they declined by 12% from 1951 to 1976 and increased from 1976 to 1983, particularly among those aged 55 to 74. The rising rates of death due to lung cancer were primarily responsible for these increases. Lung cancer will likely displace breast cancer as the leading cancer killer of Canadian women by 1990. Given the relatively low survival rates for cancers caused by smoking and the lack of substantial improvement in rates for the most frequent types of cancer, preventive strategies that include effective measures to reduce tobacco consumption are urgently required.     

Difference of body mass index stratified by the period of smoking cessation from a cross-sectional study

BACKGROUND: Smoking cessation is associated with subsequent obesity. This study was designed to clarify the duration of weight gain lasted after cessation of smoking. METHODS: A total of 2,511 male subjects aged 25-62 years participated in an annual health examination at their workplace. The relationship between body mass index (BMI) and the period since cessation of smoking was evaluated by multiple logistic regression analysis using age, drinking status, and physical activity as covariates. RESULTS: Percentages of current and nonsmokers with BMI not <25 kg/m(2) were 23.3 and 27.5%, respectively. Percentage of ex-smokers with BMI not <25 and with periods of 0-1 year, 2-4 years, 5-7 years, 8-10 years, and >10 years since giving up smoking were 37.5, 27.9, 43.2, 29.4, and 29.8%, respectively. Among ex-smokers with the previously mentioned periods after giving up smoking, odds ratios (ORs) and 95% confidence intervals (95% CIs) of BMI not <25 kg/m(2) were 1.58 (0.90-2.76), 1.01 (0.57-1.81), 2.01 (1.08-3.71), 1.10 (0.59-2.05), and 1.11 (0.75-1.65), respectively. ORs and 95% CIs of BMI with not <25 kg/m(2) on current smokers were 0.80 (0.66-0.97). CONCLUSIONS: Obesity due to smoking cessation was observed in subjects within the period from 5 to 7 years after stopping smoking; obesity due to smoking cessation is not a permanent phenomenon.     

Tobacco and alcohol use among Australian secondary schoolchildren in 1987

A survey of 19 166 secondary schoolchildren aged 12-17 years in five Australian states, the Australian Capital Territory and the Northern Territory was undertaken in 1987 to determine the prevalence of tobacco and alcohol use. Current smoking (that is, smoking at least one cigarette in the last week) rose with age to 27% in boys who were aged 16 years and to 30% in girls who were aged 16 years. The prevalence of current drinking (that is, consuming one alcoholic drink in the last week) rose with age to 55% in boys who were aged 16 years and to 50% in girls who were aged 17 years. Compared with an identical survey in 1984, the prevalence of smoking among 12- to 17-year-old schoolchildren had fallen significantly. The prevalence of drinking alcohol among 12- to 15-year-old schoolchildren also had fallen significantly, but not to the same extent as that of smoking; no significant reduction was found in the drinking of alcohol among 16- to 17-year-old schoolchildren. These trends are encouraging, but a need remains for all states to enact tobacco-control legislation, including the prohibition of tobacco advertising.