THURSDAY, July 8 (HealthDay News) -- The decline in the number of U.S. high school students who smoke has slowed significantly, following dramatic drops starting in the late 1990s, according to a new federal report.

Twenty percent of high school students still smoke, making it impossible to reach the 2010 national goal of reducing cigarette use among teens to 16 percent or less, the U.S. Centers for Disease Control and Prevention reported.

"The rate of change started slowing in 2003, and in some groups of students has totally stopped and is almost not declining at all," noted lead study author Terry F. Pechacek, associate director for science at the CDC's Office on Smoking and Health.

"The only group in which we are seeing a decline is in African-American females," he added.

Part of the problem, Pechacek said, is that "we have taken our eye off the issue. Sometimes, we get complacent with our success and move on to other things."

Also, states have significantly cut their budgets for tobacco education and cessation programs, Pechacek said. And the tobacco industry continues to aggressively target teenagers, he said, adding, "The industry has been left with the only voice out there with their $12 billion campaign."

Pechacek said there needs to be renewed emphasis on getting teens not to smoke. "We've got a new opportunity with the FDA legislation [which gives the agency oversight over the tobacco industry] and the ability it gives the community to do more about restricting advertising, promotion and availability of tobacco products," he said.

That effort needs to be combined with stronger anti-smoking programs, including smoke-free laws and increases in cigarette taxes, Pechacek said. "The ability to shut off the inflow of new smokers is critical," he said. "The fact that we have had a stall has dramatic implications for the future. Millions of more youth are going to become addicted and one in three of them are going to die prematurely."

According to the CDC report, in 1991 nearly 28 percent of high school students said they "currently smoked," meaning they had smoked on at least one of the preceding 30 days. By 1997, that percentage had increased to 36.4 percent.

However, by 2003, the percentage of teens who smoked had fallen to 21.9 percent. Since then the rate of decline has slowed, so that by 2009 the percentage of teens who smoked had dropped only a little, to 19.5 percent.

The rate of teens who labeled themselves as "frequent" smokers (at least 20 of the last 30 days) rose from about 12 percent in 1991 to close to 17 percent in 199, but then dipped to 9.7 percent in 2003, falling to 7.3 percent in 2009.

The percentage of teens who reported ever smoking (even a puff or two) stayed stable at about 70 percent through the 1990s, but dropped to 58.4 percent in 2003. By 2009, that number stood at 46.3 percent.

The findings were published in the July 9 issue of the CDC's Morbidity and Mortality Weekly Report.

Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in a news release that "the good news in the CDC's 2009 Youth Risk Behavior Survey is that the high school smoking rate (the percentage who smoked in the past month) declined to 19.5 percent in 2009. This is the first time it has fallen below 20 percent and the lowest rate since this survey was started in 1991.

"The bad news," he added, "is that high school smoking declined by just 11 percent between 2003 and 2009, compared to a 40 percent decline between 1997 and 2003."

The challenge for elected officials is to fight tobacco use with the political will and resources that match the scope of the problem, Myers said.

"Tobacco use kills more than 400,000 Americans and costs $96 billion in health-care bills each year," he said. "We know how to win the fight against this killer. What's needed is the political will to do so."

Dr. Norman H. Edelman, chief medical officer at the American Lung Association, added that "the rise in smoking by this group in the mid to late '90s is disturbing. The subsequent decline is encouraging, but the most recent slowing of the rate of decline reminds us that we must be ever alert to the many modalities which can and must be used in smoking prevention efforts.

"Reduction in smoking by school-age children should yield large payoffs in control of future smoking-related diseases," he said.

More information

For more on teens and smoking, visit the U.S. National Library of Medicine.