CDC Releases Data on Smoking Prevalence, Attitudes

Tobacco use, particularly cigarette smoking, is the leading preventable cause of death in the United States, but the health consequences extend beyond smokers to nonsmokers involuntarily exposed to environmental tobacco smoke or secondhand smoke. Each year, an estimated 3,000 lung cancer deaths and 62,000 deaths from coronary heart disease in adult nonsmokers are attributed to secondhand smoke. Among children, secondhand smoke causes sudden infant death syndrome, low birth weight, chronic middle ear infections, and respiratory illnesses including asthma, bronchitis and pneumonia.

Smoking Prevalence Varies by State from 12.9-30.5%
To characterize state-specific prevalence of cigarette smoking among adults, exposure to secondhand smoke at home, smoke-free workplace policies, and attitudes toward smoke-free policies by state, the Centers for Disease Control and Prevention (CDC) analyzed data from the 2000 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis and indicates that in 2000, state-specific adult smoking prevalence ranged from 12.9-30.5%, and that high levels of public support exist, even among smokers, for smoke-free policies in many settings.

To determine current cigarette smoking, respondents were asked, "Have you smoked at least 100 cigarettes in your entire life?" and "Do you now smoke cigarettes every day, some days, or not at all?" Current smokers were defined as those who reported having smoked >100 cigarettes during their lifetime and who currently smoked every day or some days.

In the BRFSS study, the 12 areas with the highest prevalence of current smoking (Kentucky, Nevada, Missouri, Indiana, Ohio, West Virginia, North Carolina, Tennessee, New Hampshire, Alabama, Arkansas, and Alaska) differed significantly from the 12 areas with lower prevalence (Utah, Puerto Rico, California, Arizona, Montana, Hawaii, Minnesota, Connecticut, Massachusetts, Colorado, Maryland, and Washington). The median smoking prevalence among men was 24.4% and among women was 21.2%. Utah had the lowest prevalence for men (14.5%) and Puerto Rico had the lowest for women (9.9%).

In Wisconsin, smoking prevalence registered at 24.4% for men, 23.9% for women, and 24.1% overall. In the Milwaukee-Waukesha metropolitan statistical area, prevalence was 25.3% for men, 19.6% for women, and 22.3% overall; in addition 52% of smokers in this region reported quitting for at least one day.

Where Should Smoking Be Allowed?
Respondents in 20 states were asked questions on smoking in the home, awareness of an official workplace smoke-free policy, and their attitudes about smoking bans in specific areas. To assess home exposure to secondhand smoke, respondents were asked, "In the past 30 days has anyone, including yourself, smoked cigarettes, cigars, or pipes anywhere inside your home?" Those who reported no smoking in the home during the preceding 30 days provided some indication of protection from exposure but not the existence of any rules or policies about smoking in the home.

To assess awareness of workplace smoking policies, respondents who reported working indoors most of the time were asked, "Which of the following best describes your place of work's official smoking policy for indoor public or common areas, such as lobbies, rest rooms, and lunch rooms?" and "Which of the following best describes your place of work's official smoking policy for work areas?" Possible responses for both questions were "not allowed in any public/work areas," "allowed in some public/work areas," "allowed in all public/work areas," or "no official policy."

To assess attitudes about smoke-free policies, respondents were asked, "In the following locations, do you think that smoking should be allowed in all areas, some areas, or not allowed at all?" These locations were restaurants, schools, day care centers, and indoor work areas. The percentage of respondents who reported that no smoking was allowed in the home, that smoking was not allowed in work areas, and that smoking should not be allowed at all in restaurants, schools, day care centers, and indoor work areas was calculated and reported by state.

For the 20 states that collected optional information, the proportion of adults reporting no smoking in their home during the 30 days preceding the survey ranged from 60.8% in West Virginia to 79.0% in Colorado. The proportion of adults who work primarily indoors and reported an official workplace policy that no smoking was allowed in indoor public or common areas and work areas ranged from 61.4% in Mississippi to 83.9% in Montana. The proportion who thought that smoking should not be allowed in restaurants ranged from 44.3% in North Carolina to 63.6% in Montana. The proportion who thought that smoking should not be allowed at all in schools and day care centers was uniformly high. The proportion who thought that smoking should not be allowed at all in indoor work areas ranged from 66.4% in Wisconsin to 83.8% in DC.

Most Agree on Smoke-Free Schools, Day Care
Current smokers and nonsmokers reported similar attitudes about not allowing smoking at all in schools (median: 89.1% for smokers and 95.6% for nonsmokers) and day care centers (median: 94.2% for smokers and 97.6% for nonsmokers); however, the proportion who thought smoking should not be allowed at all differed widely between smokers and nonsmokers for restaurants (median: 25.9% for smokers versus 66.2% for nonsmokers) and indoor work areas (median: 57.6% for smokers versus 82.1% for nonsmokers).

In Wisconsin 72.1% of respondents reported there had been no smoking in their home for the 30 days preceding the survey, and 63.7% reported that no smoking was allowed in the public or private areas of their workplace. As for agreeing in principle to smoking bans in specific areas, Wisconsinites reported the following:

• No smoking in restaurants 53.1%
• No smoking in schools 93.9%
• No smoking in day care centers 96.3%
• No smoking in indoor work areas 66.4%