NEW YORK, Jan 28 (Reuters Health) -- More young Americans are smoking alternative tobacco products such as bidis and kretek cigarettes, leading federal researchers to call use of these products ``an emerging public health problem among US youth.''

While cigarettes remain the most commonly used tobacco product among young people, the upswing in use of bidis, and kretek or clove cigarettes ``underscore the importance of monitoring the rates at which youth adopt other tobacco products,'' according to a report released by the Centers for Disease Control and Prevention (CDC). The report is based on the results of a survey of middle and high school students conducted last fall. The researchers found that 5.0% of high school students smoke bidis and 5.8% smoke kreteks, figures that nearly equal the 6.6% rate of use of smokeless tobacco products in this age group. The survey also shows that 9.2% of middle school students and 28.4% of high school students are current cigarette smokers. In addition, about one in eight (12.8%) of middle school students reported using some form of tobacco in the past month. This number is even higher -- more than one in three (34.8%) -- among high school students. Of particular concern, the CDC team adds, is the comparatively rapid increase in smoking among African-American youth, who have generally had lower smoking rates than other racial groups. In this survey, smoking prevalence rates among middle school students were approximately the same among African Americans, Hispanics and Caucasians -- ranging from 8.8% to 11%. ``Additional research is needed to help understand why African-American youth are again finding smoking more appealing and socially acceptable,'' write CDC officials. Cigar smoking is also gaining popularity among youth, with 6.1% of middle school students reporting smoking cigars in the past month. African-American middle school students are more likely to report cigar smoking than their white counterparts, the report shows, at 8.8% and 4.9%, respectively. Among high school students, 15.3% report cigar smoking in the past month, with 20.3% of boys and 10.2% of girls reporting cigar use. ``If current patterns of smoking behavior persist, an estimated 5 million US persons who were aged 18 years or younger in 1995 could die prematurely from smoking-related illnesses,'' CDC officials note. They suggest that nationwide prevention efforts aimed at stopping teens from smoking, making smoking cessation programs more available, and increasing the excise tax on tobacco products ``could dramatically reduce these projected deaths.'' SOURCE: Morbidity and Mortality Weekly Report 2000;49:49-53

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