Nearly 40 percent of Minnesotans 18 to 24 smoke at least once in a while, and a third of them smoke every day -- nearly twice the rate of older adults, according to new study.
The study, the first in-depth survey of the smoking habits of that age group, also found that 32,000, or 7 percent, of young adults fall into the category of occasional smoker. The so-called "unrecognized smokers" don't fit most of the other adult smoking patterns identified by tobacco researchers, the survey found. They smoke infrequently -- only a few days per month -- and then only one or two cigarettes a day.
The study, released Wednesday, was conducted by the Minnesota Health Department, the Minnesota Partnership for Action Against Tobacco, Blue Cross and Blue Shield of Minnesota and the University of Minnesota. The findings were based on interviews with nearly 9,000 Minnesota adults between November 2002 and June 2003, including 1,205 young adults.
Some of the young smokers will quit, but others will smoke for years, adding millions in health care costs to the state, officials said. One in three who become habitual smokers will die from a tobacco-related illness, they said.
The survey also found some good news. Adults of all ages are trying to quit more often than they used to, and they are increasingly using nicotine patches and other medications to improve their chances.
The Minnesota survey found that 28 percent started smoking after age 18, the legal age to smoke in the state, defying the well-documented pattern that smokers almost always start before that.
Researchers said that more young adults may be smoking because as teenagers they were exposed to cigarette advertisements, including the cartoon character Joe Camel, which was widely criticized for its appeal to children. Tobacco industry officials have denied targeting teenagers, and Joe Camel no longer is used. In legal settlements in the late 1990s manufacturers agreed not to advertise in ways that would attract teenagers.
Dr. Edward Ehlinger, a professor of epidemiology at the University of Minnesota, said cigarette companies have focused their marketing on young adults since 1999. The efforts have included advertising in alternative weekly magazines and promotions featuring popular bands at bars, he said.
Researchers said 18 to 24 are critical years when smoking -- or not smoking -- becomes ingrained.
"Maybe this path to addiction is not as inevitable or as quick as we may have assumed," said Pamela Ling, an assistant professor and tobacco researcher at the University of California, San Francisco. "Young adults may not think of themselves as smokers. They may stop, and restart, and that pattern reinforces that they are not really a smoker."
The Minnesota Health Department still spends much of its $3 million in anti-smoking money on teenagers under 18. The Minnesota Legislature last year eliminated a $446 million endowment that funded the larger Target Market program, an anti-smoking campaign that was aimed at teenagers.
The groups who collaborated on the Minnesota study said they don't know how it will influence future anti-smoking efforts, though it clearly put young adults in the spotlight.
"The fate of the state's efforts rests on changing smoking behavior in young adults," said Pete Rode, a research scientist with the Health Department.