Cigarette smoking rates among high school students have dropped to the lowest levels since 1991, when the (YRBS) began, according to the 2013 results released by the Centers for Disease Control and Prevention (CDC). More than 13,000 U.S. high school students participated in the 2013 National YRBS, which includes data from surveys conducted in 42 states and 21 large urban school districts.

Although there has been progress in kicking butts, decreasing overall tobacco use is still a major challenge. The CDC pointed out that other national surveys show teens engaging more in hookah and e-cigarette use.

Since 1999, there has been no change in smokeless tobacco use among adolescents. The decline in cigar use has slowed in recent years, with cigar use now at 23 percent among male high school seniors.

Dr. Andrew S. Ting, an assistant professor of pediatrics, pulmonary and critical care, at Mount Sinai Hospital in New York, told Healthline, "While it is certainly encouraging that teen smoking rates continue to decrease, we as pediatricians must remain vigilant. The use of e-cigarettes cannot be ignored as a gateway to nicotine addiction. Legalization of marijuana in a number of states may lead to easier access for teenagers with a subsequent impact on road safety."

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Hazardous Driving Is Up, Fighting Down

Among high school students who had driven a car or other vehicle during the past 30 days, the percentage of high school students who texted or emailed while driving ranged from 32 percent to 61 percent across 37 states, and from 19 percent to 43 percent across 15 large urban school districts.

Nationwide, 41 percent of students who had driven a car or other vehicle during the past 30 days reported texting or emailing while driving.

Dr. Tom Frieden, director of the CDC, said in a press statement, “Way too many young people still smoke, and other areas, such as texting while driving, remain a challenge. Our youth are our future. We need to invest in programs that help them make healthy choices so they live long, healthy lives.”

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On the plus side, teens are not fighting with each other as much as they did. The study showed that the percentage of high school students nationwide who had been in a physical fight at least once during the past 12 months decreased from 42 percent in 1991 to 25 percent in 2013.

Fights on school property have been cut in half during the past 20 years. Sixteen percent of high school students were in at least one physical fight on school property during the 12 months before the survey in 1993, compared to eight percent in 2013.

Condom Use Declines, TV Watching Increases

Teens are less sexually active (had sexual intercourse during the past three months), but those who are having sex are less likely to use a condom. The percentage of high school students who are currently sexually active has declined from 38 percent in 1991 to 34 percent in 2013.

Among the high school students who are currently sexually active, condom use also has declined from 63 percent in 2003 to 59 percent in 2013. This decline comes on the heels of increased condom use throughout the 1990s and early 2000s.

Teens are watching TV less, but they are using computers more for non-related school work. From 2003 to 2013, the percentage of high school students using a computer three or more hours per day for non-school related work increased from 22 percent to 41 percent.

The percentage of high school students who watch three or more hours of TV on an average school day decreased since 1999, from 43 percent to 32 percent.

The study also looked at teens’ consumption of sugary drinks, and found a significant decrease in drinking soda (or pop) one or more times per day, from 34 percent in 2007 to 27 percent in 2013.

Alissa Rumsey, R.D., a spokesperson for the Academy of Nutrition and Dietetics in New York, told Healthline, "It is encouraging to see that the amount of sugar-sweetened beverages consumed by teens is decreasing, as this often adds up to excess calories. Television watching decreased, which may mean that kids are spending more time being physically active. However, daily computer time has almost doubled, so it may not make a difference. We need to encourage teens to move more, and that will involve decreasing time spent on computers, smartphones, video games, and television."

Commenting on the study's results, Dr. Angela Diaz, director of the Adolescent Health Center at Mount Sinai, told Healthline, "Many areas of the new CDC teen behavior survey are encouraging. Health outcomes for young people could be favorably impacted by such trends as a decline in cigarette smoking, as well as reduced early sexual activity, interpersonal violence, TV use, and soda consumption. However, improving adolescent health will require the ongoing diligence of health professionals, legislators, and other organizations to monitor and appropriately message around newly emerging, unfavorable trends, for example, texting while driving, not using condoms, other forms of tobacco use, and having a sedentary lifestyle. These public health messages must be articulated and promoted to prompt youth behavioral change."