Between 1997 and 1998, the percentage of smoking-attributable deaths compared with all deaths by all causes in Florida remained steady. During 1997 an estimated 18.90% of all deaths in Florida were attributable to cigarette smoking, and 18.74% were smoking-attributable in 1998. Using the Smoking-Attributable Mortality, Morbidity and Economic Costs (SAMMEC 3.0) software program, developed by the Centers for Disease Control and Prevention, as a model, Florida’s smoking-attributable deaths were determined by analyzing the available smoking and mortality data by county. This county by county analysis required data from several different sources: the 1997 and 1998 Florida population estimates provided by the Executive Office of the Governor, Office of Policy and Budgeting; mortality data from the Office of Vital Statistics; and smoking prevalence calculated from data obtained from the Behavioral Risk Factor Surveillance System.

In 1997, there were 153,830 deaths from all causes. Smoking-attributable mortality accounted for 29,073 (18.90%) of those deaths. Males accounted for 18,228 (62.7%) of smoking attributable deaths while females accounted for 10,845 (37.3%).

In 1998, there were 157,160 deaths from all causes. Smoking-attributable mortality accounted for 29,450 (18.74%) of those deaths. Males accounted for 18,372 (62.4%) of smoking-attributable deaths while females accounted for 11,078 (37.6%).

Each year, 1997 and 1998, is analyzed separately in the attached summaries and tables. The tables show a breakdown for each year by county distributed by age, sex and cause of death. The information supplied herein can be used for targeting counties for anti-tobacco programs as well as documenting the burden of cigarette smoking to different populations.

The first section of this report will explain the methodology as well as provide further detail on smoking-attributable mortality. Questions regarding this publication and requests for copies may be addressed to the Florida Department of Health, Bin #A-12, 2020 Capital Circle SE, Tallahassee, Florida 32399-1720. The telephone number is (850)245-4401.

The Florida Department of Health (FDOH) initiated a tobacco prevention program in 1989 when it received federal funding to implement tobacco prevention and control activities. By 1997, the State of Florida successfully settled with the tobacco industry for $11.3 billion to recoup Medicaid costs incurred by smokers. As part of the settlement agreement, the FDOH launched the Tobacco Pilot Program targeting tobacco use among underage youth.

The Florida Youth Tobacco Survey (FYTS), which was originally part of the Tobacco Pilot Program, is a statewide, school-based anonymous survey that has been conducted annually since 1998. The FYTS collects information regarding the prevalence of tobacco use, attitudes, and related behaviors among middle and high school students throughout Florida and tracks those behaviors over time. The FYTS has been administered to a state-level sample annually since 1998, with county-level surveys being conducted in 2000, 2002, 2006, and 2008.

In 2000, the FDOH worked with other state agencies to coordinate school-based surveys to reduce the burden on schools, teachers, and students. The FYTS became part of a multi-agency joint survey effort that also includes the Florida Youth Substance Abuse Survey (FYSAS), the Youth Physical Activity and Nutrition Survey (YPANS), and the Youth Risk Behavior Survey (YRBS).

The 2008 FYTS was based on a two-stage cluster probability sample design. First, a random sample of public middle schools and high schools was selected for participation in the survey. Then, within each selected school, a random sample of classrooms was selected, and all students in that class were invited to participate in the survey. To be able to generalize the data to all of Florida, the survey data were statistically weighted. Weighting is a procedure that adjusts for oversampling and for any discrepancies between the sample and the entire population from which the sample is drawn. The weighted responses of the survey participants that are presented in this report were calculated to reflect the prevalence of tobacco usage and related indicators among all Florida public middle and high school students within each county and for Florida as a whole.

The 2008 county-level FYTS was implemented in the spring of 2008. Sixty-six of the 67 Florida counties participated in this survey. The survey was administered to 38,510 middle school students (grades six to eight) and 40,283 high school students (grades nine to twelve) in 744 public schools throughout the state. The survey response rate for middle school students was 79% and the survey response rate for high school students was 73%. Sarasota County did not participate in the 2008 Florida Youth Survey and, therefore, has been omitted from this report. In addition, no middle school students from Gilchrist County participated in the survey so results for Gilchrist County are presented at the high school level only.

In this report, county values are presented for key indicators with maps for both middle and high school students, followed by detailed tables listing the prevalence by county. On each map, counties have been split into four groups: (1) counties with rates higher than the state rate and statistically significant; (2) counties with rates higher than the state rate, but not statistically significant; (3) counties with rates lower than the state rate, but not statistically significant; and (4) counties with rates lower than the state rate and statistically significant. Confidence intervals (C.I.s) were used to determine significance. A 95% C.I. is a range in which the “true” rate will fall 95% of the time. The tables in this document show the total percentage for the county, as well as the breakdown by gender for each county, including 95% C.I.s. These maps and tables will allow readers to view their county in comparison to other counties, as well as to the State of Florida. Results were omitted if there were less than 30 respondents for a specific indicator.

An Occasional Paper of the Bureau of Epidemiology, Florida Department of Health