Method Comparison for Assessing Trends Over Time of Age of First Cigarette Use Among High-School Students in the U.S.--Youth Risk Behavior Survey, 1991-2009

• Activity Number: 362
• Type: Contributed
• Date/Time: Tuesday, August 2, 2011 : 10:30 AM to 12:20 PM
• Sponsor: Section on Government Statistics
• Author(s): Emily O'Malley Olsen*+ and Sherry Everett Jones
• Companies: Centers for Disease Control and Prevention/NCCDPHP/DASH and Centers for Disease Control and Prevention/NCCDPHP/DASH
• Keywords: trend analysis ; surveillance ; Youth Risk Behavior Survey ; adolescent health ; smoking

Abstract

Secular trend analysis of Youth Risk Behavior Survey (YRBS) data identifies changes in prevalence of youth cigarette use over time. A single YRBS question assessing age of first whole cigarette use captures both the prevalence of smoking and the age of first cigarette use, both of which have important public health implications. To best understand trends in cigarette smoking among high school students nationwide, this question was analyzed using multiple modeling approaches: time-until-event outcome "years from birth until first cigarette" modeled with Cox PH regression, a linear outcome "age of first cigarette" modeled with linear regression, and dichotomous outcomes "smoked before age 13" and "ever smoked" modeled with logistic, Poisson, and negative binomial regressions. Different modeling approaches might result in different conclusions. Conversely, they might result in similar conclusions but might be more computationally intensive and difficult to interpret. Comparisons between each of the different modeling approaches and their resulting public health implications will be presented.