The report, published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, also said tobacco use among U.S. middle school and high-school students showed a slow decline from 2000 to 2011.
Dr. Thomas R. Frieden, director of the CDC, said even though tobacco use continued an 11-year downward trend, smoking remained high among high-school students.
For example, among black high-school students, cigar use increased significantly from 7.1 percent in 2009 to 11.7 percent in 2011. In 2011, 15.7 percent of high school boys smoked cigars -- including cigarette-like cigars that can be packaged and smoked like typical cigarettes, but are taxed at a lower rate -- comparable to the 17.7 percent who smoked cigarettes.
"An overall decline in tobacco use is good news, but although 4-out-of-5 teens don't smoke, far too many kids start to smoke every day," Frieden said in a statement. "Most tobacco use begins and becomes established during adolescence."
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