Though the prevalence of cigarette smoking among California high school students has declined over the past decade, smokeless tobacco use has risen among high school students, from 3.1 percent in 2004 to 3.9 percent in 2010, according a report released Thursday.
The report, by Ron Chapman, state health officer and director of the California Department of Public Health, attributed the increase in part to a rise in the promotion and availability of snuff and other smokeless tobacco products.
The study found that the prevalence of smoking was higher at schools in neighborhoods with five or more stores that sell tobacco than at schools in neighborhoods without any stores selling tobacco.
The study also documented a rise in the illegal sale of tobacco to minors. According to the survey, 8.7 percent of retailers sold tobacco to minors this year, up from 5.6 percent in 2011.
"For the first time in the last three years, tobacco retailers are selling tobacco to our youth more often," Chapman said in a conference call with reporters Thursday morning.
Sales of non-cigarette tobacco and nicotine products have risen dramatically over the last decade, from $77.1 million in 2001 to $210.9 million in 2011, according to the report.
"Tobacco use takes a tremendous toll on our state, from both a health and economic perspective," Chapman said in the report. "Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined."
While the adult smoking rate has been cut in half since 1988, from 23 percent to 12 percent of California adults, there remain about 3.6 million smokers in the state, and tobacco use kills more than 34,000 Californians every year, according to the report.
Tobacco-related health care expenses will cost the state $6.5 billion this year, or about $400 per taxpayer, according to the study.
California men continue to smoke at a higher rate, 14.9 percent, than women, 9.3 percent, according to the survey. Black and Latino men smoke at higher rates 18.9 percent and 15.5 percent respectively than white men, but Asian men smoke at slightly lower rates.
The report said the tobacco industry spent about $656 million on marketing in 2010.
The study comes after the Centers for Disease Control and Prevention reported in May that California used relatively little of the billions of dollars in tobacco money it has to prevent kids from smoking or to help smokers quit.
Chapman said the state has been "very successful" using what money it has to reduce smoking rates.