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The U. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products. Cigarettes are the most commonly used tobacco product among U. The proportion of U. Sociodemographic disparities in cigarette smoking persist. During —, increases occurred in the proportion of adult ever smokers who quit smoking Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, high-impact anti-tobacco media campaigns, and barrier-free access to tobacco cessation counseling and medications, are critical to reducing cigarette smoking and smoking-related disease and death among U.
Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products 1. To assess progress toward the Healthy People target of reducing the proportion of U. In , the prevalence of current cigarette smoking among adults was During —, the percentage of ever smokers who quit smoking increased from Proven population-based interventions are critical to reducing the health and economic burden of smoking-related diseases among U.
NHIS is an annual, nationally representative in-person survey of the noninstitutionalized U. The NHIS core questionnaire is administered to a randomly selected adult in the household the sample adult. The mean number of cigarettes smoked per day was calculated among daily smokers. Quit ratios were defined as the ratio of former smokers to ever smokers i.
Data were weighted to adjust for differences in the probability of selection and nonresponse and to provide nationally representative estimates. Population counts were estimated from extrapolated probability weights, rounded down to the nearest 10, persons. Quit ratios were calculated overall and by age group.
T-tests were performed to examine differences between and In , Overall, smoking prevalence did not change significantly from Current cigarette smoking prevalence was higher among males By age group, prevalence was higher among adults aged 25—44 years Prevalence was higher among persons living below the poverty level By region, prevalence was higher in the Midwest By insurance status, prevalence was higher among Medicaid enrollees Prevalence was higher among LGB adults Among current smokers, the proportion of daily smokers was Whereas mean number of cigarettes smoked per day declined from During —, increases occurred in the proportion of daily smokers who smoked 1—9 cigarettes per day from At the same time, decreases occurred in the proportion of daily smokers who smoked 20—29 from No significant changes in any category of number of cigarettes smoked per day occurred during — The overall quit ratio increased from During —, the largest increase in quit ratios occurred among adults aged 25—44 years from During —, the prevalence of cigarette smoking among U.
However, during —, cigarette smoking prevalence did not change significantly. Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, anti-tobacco mass media campaigns, and barrier-free access to tobacco cessation counseling and medications, are critical to reduce cigarette smoking and smoking-related disease and death among U.
The observed disparities in smoking prevalence are likely attributable to multiple factors 1. Racial or ethnic differences might be partly explained by sociocultural influences and norms related to the acceptability of tobacco use and variations in exposure to tobacco marketing, whereas disparities by education might be partly attributable to variations in understanding of the range of health hazards caused by smoking 3 , 4.
Variations in access to evidence-based tobacco cessation treatments through insurance coverage might partially explain the differences observed across insurance types 5. Smoking prevalence was higher among persons with severe psychological distress 6 , 7 , potentially because of higher levels of addiction and dependence, lack of financial resources, less access to cessation treatments, and stressful living conditions among these persons 6 , 7.
Assessing the smoking status of all patients served in psychiatric inpatient and outpatient settings, integrating evidence-based cessation interventions into mental health treatment plans, and implementing tobacco-free campus policies in mental health care facilities could help reduce smoking in this population 6 , 7.
During —, an increasing proportion of adults who ever smoked cigarettes had quit smoking. However, following consecutive significant annual declines during — and — 8 , no change in smoking prevalence was observed between and These findings could be the result of multiple factors, including slowed progress in the adoption of proven interventions 9 , or increased nicotine dependence from the concurrent use of other tobacco products 1. These findings underscore the importance of enhanced and sustained implementation of proven population-level interventions to continue previously observed annual declines in adult cigarette smoking 2.
The findings in this report are subject to at least five limitations. First, smoking status was self-reported and not validated by biochemical testing; however, self-reported smoking status is correlated with serum cotinine levels Second, because NHIS does not include institutionalized populations and persons in the military, results are not generalizable to these groups. Third, the NHIS response rate of These differences can be partially explained by varying survey methodologies and definitions of current smoking; however, trends in prevalence are comparable across surveys 1.
Sustained implementation of comprehensive state tobacco control programs can accelerate progress toward reducing adult smoking prevalence 2. Targeted interventions are warranted to reach subpopulations with the highest incidence of use, and can result in substantial reductions in tobacco-related disease and death and billions of dollars in savings from averted medical costs 1.
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