While 11-year-olds in the US began smoking at rates comparable to 11-year-olds in other nations, only 12% of American 15-year-olds smoke daily, compared with more than 25% of 15-year-olds in Austria, Germany, Hungary, and Greenland. ``At the early ages, (smoking) is mostly experimentation,'' said Dr. Mary Overpeck, an epidemiologist with the National Institute of Child Health and Human Development, in an interview with Reuters Health. ``At the older ages, it's more of a cultural pattern,'' Overpeck added. ``The rate of smoking in adults in the United States has decreased... and if adults have reduced their smoking then teenagers are less likely to continue smoking.'' The report, Health Behaviors in School-Aged Children (HBSC), includes data from a survey of the attitudes and behaviors of over 120,000 children, aged 11, 13 and 15, in 26 European countries and regions, as well as in the US and Canada, between 1997 and 1998. The HBSC was coordinated in the US by the National Institute of Child Health and Human Development (NICHD). Television watching among US adolescents decreased with age, according to the HBSC. While 27% of 15-year-old males and 18% of 15-year-old females in the US watched 4 or more hours of television a day, 11-year-olds reported much higher rates, ranking 6th among the surveyed nations with 36% for males and 34% for females. Overall, US adolescents consider themselves healthy, although US and Israeli respondents reported the highest levels of health-related problems, including headache, stomachache, backache, nervousness and fatigue. US and Israeli adolescents were also most likely to take medication to treat these conditions. ``The fact that (US adolescents) are... more likely to take medications for (health-related conditions) indicates that we may be more likely to say 'I hurt, I should take a pill to stop this hurt', rather than taking some other form a relief that might be available,'' Overpeck said. Additionally, in all countries surveyed, females were more likely to report a higher frequency of health problems, recurrent pain symptoms and negative feelings than were males. According to Overpeck, the high incidence of health problems among females may be attributed to the pubertal changes experienced by girls between the ages of 11 and 15, rather than any specific behavior. US adolescents also ranked low when surveyed regarding physical activity. Seventy-four percent of 15-year-old males in the US reported exercising twice a week or more, compared with 90% in Northern Ireland, 87% in Austria, and 83% in Germany. In all cases, females reported exercising less than males. ``The study's findings are of crucial importance for the development of timely and relevant health promotion and health education initiatives at local, national and international levels,'' said Dr. Duane Alexander, director of the NICHD. ``The information will be helpful to US policy makers in designing a variety of... programs.'' Additional findings of HBSC indicate that alcohol consumption among US adolescents ranked in the middle, with 23% of 15-year-old males in the US drinking on a weekly basis, compared with 53% in Wales, 47% in England, and 52% in Greece. The survey also indicates that in almost all cases, males were more likely to consume alcohol than females.

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