Is smoking making a comeback?

I stroll by one of the smoking areas on my campus* fairly frequently and I recently noticed three apparently undergraduate aged women smoking. This is unusual first, because if anyone is there it is typically only 1-2 people and second, they are mostly older than the undergraduate age range. This is the second or third tiny tingle of a suggestion to me that perhaps smoking is becoming slightly more popular again. It is reminiscent of an experience from back in the early to mid 1990s when those of us above the undergraduate age on college and university campuses noticed “the kids are smoking again“. And there was indeed a….bump. The Monitoring the Future trends tell the tale, I pulled this one from the 2023 report on 1975-2022 data. This is the “have you smoked in the past 30 days?” question but the trends look the same from lifetime incidence to near-daily use. In the late 70s, upwards of 35% of 12th graders had smoked a cigarette in the past month. There was then a long downward trend to 2022 when only 4% of 12th graders had smoked a cigarette in the past month; the most recent report** shows this fell to 2.5% in 2024.

There is a significant disruption in the trends for 12th graders, and you can see that smoking rates increased from 1993 onward to a 1997 peak. It took until about 2002 for 30 day cigarette prevalence to drop below the 1992 low of 27.8%. A full decade’s worth of the late teen cohort with elevated smoking rates. Patterns post 1990 for lower grades suggest a similar, parallel increase in the mid-1990s, even though they don’t report the trends prior to 1990. The increases (and decreases) are well-aligned by year, so this is not a cohorting effect whereby increases in 8th grade are inflating 10th grade rates two years later. Whatever caused this affected 8th-12th graders at the same time.

I still don’t know what caused this pattern***. Drug use epidemiology is not my field, I am merely a consumer of the data they report. But these data ultimately validated a real world impression of increased smoking rates in undergraduates back in the mid-1990s. If you were a high school teacher across that key interval, I’m sure you had the same feeling. I wonder if we are about to see a return of this phenomenon.

I am probably over-interpreting the tiny clues I have been exposed to. I sure hope I am.

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*Yes, we are a “smoke free campus”. The smokers around my building have an out of the way place they go to smoke.

**The latest MtF has a novel dataset which I’ve never seen in their usual reports. They numbers date back to the 80s so clearly it has always been part of the survey. These data asked the kids in a given grade who were smokers (I think?) to recall if they were already smoking by prior grades. For the purposes of the day, you can see that the early 90s bump in this subset (not sure why it is not the full sample but the footnote warns about this).

***The cohort**** trend isn’t limited to cigarettes. Similar increases in the mid-1990s were reported for cocaine, hallucinogens, heroin, amphetamines, sedatives, tranquilizers and for marijuana, which remained elevated after a late-90s peak unlike the others. Alcohol prevalence didn’t increase during this key decade, although perhaps the declines in the late 80s were flattened out.

****The kids driving the early part of this wave were born approximately 1977-1984, if we consider the 8th-12th grade range. Late Gen-X and early Millennials. This is perhaps another way to define the social boundaries of the generations. My side is the abstainer side. Their side has a greater affection for using drugs. My side was raised by pre-WWII and early Boomer parents, who share many traits. Their side was raised by the fully flowered mid-to-late Boomers.