Young adults ate and smoked more in the 1990s

Young adults, apparently believing they are immune from risk, had large increases in smoking and obesity and had continued poor eating habits during the 1990s, according to surveys of more than 120,000 people.

The result may be higher future rates of heart disease, cancer, diabetes and lung disease as their generation ages, say Marilyn A. Winkleby, Ph.D., M.P.H., and Catherine Cubbin, Ph.D., of Stanford University, writing in the September/October issue of the American Journal of Health Promotion.

Older Hispanics and older black men showed decreases in these behaviors, the survey found.

The information was gathered from black, Hispanic and white women and men in 1990 and 2000 as part of the Behavioral Risk Factor Surveillance System, a telephone survey conducted by state health departments and the Centers for Disease Control and Prevention.

More than one-third of white men and women ages 18 to 24 smoked, the highest rate among all the groups covered in the survey in 2000. Those young people and Hispanic women the same age produced the largest increases in smoking rates from 1990 to 2000.

“Not only is smoking increasing among selected young people, failure to quit smoking is also increasing in selected ethnic and racial groups,” the authors say. More than half of women and men ages 18 to 24 from all ethnic groups failed to quit smoking in 2000.

Smoking is especially worrisome, because it is the leading cause of preventable death and disability in the United States.

Obesity increased among every ethnic group, Winkleby and Cubbin say, and was especially a problem for black women.

“Almost 20 percent of black women were obese by ages 18 to 24, and this increased to over 35 percent by ages 25 to 44,” they say.

Contributing to obesity in all groups, between one-third and one-half of those surveyed ate fewer than three servings of fruit and vegetables a day, although older black men and older Hispanic men and women improved dramatically in that regard between 1990 and 2000.

Older black men and older Hispanic women (65 to 74) improved their overall risk factors and had the largest increases in physical activity. Older people fared better in other ways, as well. Smoking rates for men and women ages 65 to 74 from all three ethnic groups decreased during the 10 years of the study. Older Hispanic women had the largest decreases in smoking and older Hispanic women and men and black men had the largest increases in vegetable and/or fruit intake.

The authors conclude that young women and men ages 18-24 showed some of the most adverse changes in their health behaviors from 1990 to 2000.

“These poor health behaviors are not just because of young people’s choices — they are greatly influenced by the media and by what is available in their communities,” Winkleby says.

Younger white men and women (18 to 44) had higher overall risk levels, probably due to increased smoking and obesity.

“Effective smoking prevention and cessation programs need to be developed for youth who are at particular risk,” Winkleby and Cubbin say, but they add that policies should not write off older smokers.

“Programs that encourage quit attempts and smoking cessation must also be available later in life, with a special focus on persons with few financial resources,” they add.

Efforts to reduce all these risk factors and ward off future chronic illness should be aimed not only at educating individuals, but at making helpful social and environment changes, like reducing the fat content in school lunches, changing policies about fast food sales and portion sizes, upping activity in physical education classes and opening gyms for young people, the authors conclude.