Monthly Archives: November 2011

Children and the Great American Smokeout Day

Thirty-four years ago, I came home from first grade and asked my father, who had been a smoker since his teenage years, to quit smoking. At school, we’d learned about a new campaign, the Great American Smokeout Day, which was coming up, and about the harmful effects from smoking.  I remember feeling terrified about what his daily smoking meant for his health.  My father quit smoking the next day, on the third Thursday in November 1977.

Back then, more than one third of Americans were smokers and about 29 percent of high school seniors reported smoking daily.  Today, the latest data tell us that significant progress has been made.  Just one in five adults report being current smokers, and the percentage of high school seniors who smoke daily has dropped to 10.7 percent in 2010. (See Child Trends’ recent Indicator Brief on Adolescent Daily Cigarette Use by my colleague, David Murphey, for more information.)

Despite these declines, more than 8.2 million young people between the ages of 12 and 20 currently use some form of tobacco.[1] According to a newsletter from the U.S. HHS Office of Adolescent Health, more than six million of today’s adolescents and young adults will eventually die a preventable death from tobacco.[2]

For many social problems, those of us involved with policy and research often turn to data to better monitor and describe troubling trends or to identify promising solutions.  In this case, the data are clear: overwhelming scientific evidence confirms that tobacco use is harmful to health. Tobacco use is the leading cause of preventable death and disease in the United States.[3] The tobacco industry has been required to invest substantial resources in educating the public about these ills, cigarette advertising to youth has been restricted, and prices for cigarettes have gone up (Child Trends’ Adolescent Daily Cigarette Use). In many states, smoking has been banned from public buildings, spaces and private businesses.

The Great American Smokeout Day movement combined with efforts to increase public awareness, and smart public policies have all contributed to the overall decline in smoking in the United States.

And yet, each day, 3,800 adolescents will try a cigarette for the first time. Research shows that the earlier adolescents begin smoking cigarettes, the more likely they are to become addicted to nicotine.[4] According to results from a nationally representative health survey, nearly 90 percent of adults who smoke started smoking during adolescence, or earlier.[5]

So what can we do, those of us who monitor children’s health outcomes to inform policy and practice, when the data are clear and the policies align with the intended outcomes, and yet the problem persists?

We keep on.  The Office of Adolescent Health newsletter reports that for every one percentage-point reduction in the youth smoking rate, it is estimated that 172,000 of today’s high school students will not start smoking and 56,000 will not die a tobacco-related death.[6]

Today, on the Annual Great American Smokeout Day, I’m hoping that we not only can encourage our young people who are smoking to quit, but that we can do more to prevent our children from ever starting.

Marci McCoy-Roth
Senior Policy and Communications Director

This blog was written using data prepared by my colleagues here at Child Trends for a variety of briefs and reports (cited where possible though some are pending). Special thanks to David Murphey, Lina Guzman, Jennifer Manlove, Megan Barry and Brigitte Gavin for their outstanding and ongoing research.

[1] Substance Abuse & Mental Health Services Administration Office of Applied Studies. (2010). Results from the 2009 National Survey on Drug Use and Health: Detailed tables. Tables 2.2A-2.5A. Washington, DC: U.S. Department of Health and Human Service,. Retrieved March 14, 2011, from

[2] Hahn, E. J., Rayens, M. K., Chaloupka, F. J., Okoli, C. T. C., & Yang, J. (2002). Projected smoking-related deaths among U.S. youth: A 2000 update. ImpacTeen Research Paper Series, No. 22.

[4] Centers for Disease Control and Prevention, & National Center for Chronic Disease Prevention and Health Promotion. (2010). Health topics: Tobacco use and the health of young people. Retrieved February 16, 2011, from

[5] National Survey on Drug Use and Health cited by Campaign for Tobacco-Free Kids. (2010). Tobacco use among youth. Retrieved February 16, 2011, from

[6] Campaign from Tobacco-Free Drugs. (2010). Benefits and savings from each one percentage point decline in the USA smoking rates. Washington, DC. Available at

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Cost of Living Relates to Child Development

As everyone knows, it costs a lot more to live in some places in the United States than others. New findings indicate that these cost of living differences have implications for the well-being of young children in families with lower incomes.

A new analysis using data from the Early Childhood Longitudinal Studies-Kindergarten Cohort (ECLS-K), a nationally-representative sample of children entering kindergarten in 1998, found that the local cost of living is correlated with child development outcomes.[i]  Higher cost of living was related to lower academic achievement in first grade, even after controlling for family income and a comprehensive set of social and demographic variables.  This effect was found only for families with incomes below 300% of the federal poverty threshold (i.e., below $66,339 for a family of four). It may be that families with higher incomes are not as sensitive to geographic variations in cost of living.

Basic expenses for necessities such as housing and child care vary dramatically across locales. For example, rent for a typical two-bedroom apartment in the Washington, DC, area is $1,324 a month, compared with $555 for a similar apartment in Casper, Wyoming (2007 Basic Family Budgets, Economic Policy Institute). Likewise, costs for child care for a two-parent, two-child household typically run $1,512 a month in DC, and $683 in Casper. Family income also varies across regions, but not as much as costs vary: the median income in Washington, DC, is $40,342, compared with $29,506 in Wyoming (Mapping the Measure of America). The minimum wage in Washington DC is $8.25, compared with $7.25 in Wyoming (U.S. Department of Labor).  Thus, while in this example wages/incomes are about 15-30 percent higher in DC than in Wyoming, major cost-of-living drivers are more than double.

Why might living in a higher-cost area have negative consequences for child development? Because parents living in such areas have to spend more on basic needs, such as housing and child care, they may have less financial resources left over to make other “investments” in their children’s development (e.g., to buy books, enroll children in extracurricular activities, buy a home computer). Indeed, we found that, for families living below the poverty threshold, a higher cost of living (independent of family income) was related to lower levels of parental “investments” in these types of activities. In spite of big differences by geographic location in a family’s expenses on basic needs like housing and child care, the official federal poverty threshold is applied uniformly across the nation. The federal poverty guidelines (somewhat different from, but based on, the threshold methodology) are used by 85 government programs serving over 22 million people yearly to determine eligibility for receiving assistance.

A new measure  of poverty  released by the Census Bureau on Monday, the Supplemental Poverty Measure (SPM), takes strides towards improvement by making geographic adjustments to the poverty threshold. However, because the old measure will still be used in determining eligibility for government programs, some families and children who have exceptional cost burdens because of their living in higher-cost areas will continue to be ineligible for assistance, because their incomes are marginally too high. Although eligibility for some government assistance programs, such as child care subsidies and Temporary Assistance for Needy Families (TANF), does vary by state, many families living in high-cost areas are struggling to make ends meet, yet have incomes too high to qualify for assistance. This is all the more troublesome in light of these study findings showing that children in these families may suffer negative consequences.

– Nina Chien, Research Scientist
– David Murphey, Senior Research Scientist

[i] Chien, N., & Mistry, R. (in press). Geographic Variations in Cost of Living: Associations with Family and Child Well-Being. Child Development.

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