Cigarette Smoking among Adults in the United States

Tobacco use is the single agent most responsible for avoidable illness and death in America today. One of the national health objectives for 2010 is to reduce the prevalence of cigarette smoking among adults to no more than 12%. To assess progress toward meeting this objective, the Centers for Disease Control analyzed data from the 1998 National Health Interview Survey about cigarette smoking among US adults.

The survey was administered to 32,440 adults aged 18 and older in the US civilian population. The participants 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 persons who reported both having smoked more than 100 cigarettes during their lifetime and having smoked every day or some days at the time of the interview. Attempts to quit were determined by asking current smokers, "During the past 12 months, have you stopped smoking for one day or longer because you were trying to stop smoking."

• An estimated 47.2 million adults (24.1%) were current smokers, including 24.8 million men and 22.4 million women.
• 82.4% of all smokers were everyday smokers.

Age


• The highest rate of smoking was in 18-24 year olds: 27.9% and 25-44 year olds: 27.5%.
• The lowest rate of smoking was in people aged 65 years and older: 10.9%

Ethnicity


• Prevalence of current smoking was highest among American Indians/Alaska Natives: 40%,
• 25% of non-Hispanic whites and 24.7% of non-Hispanic blacks smoke.
• Smoking rates were lowest among Hispanics: 19.1% and Asians/Pacific Islanders:13.7%.

Education and income


• Adults with post-college education had the lowest smoking prevalence: 11.3%.
• Smoking prevalence was highest among persons with 9-11 years of education: 36.8%.
• Smoking prevalence was higher among persons living below the poverty level: 32.3%, than among those living at or above the poverty level 23.5%.

Trying to quit

• If you smoke now but have tried to quit, you're not alone. Based on the 1998 survey, 15.2 million (39.2%) daily smokers had stopped for at least 1 day during the preceding year because they were trying to quit.

Appropriate and effective smoking cessation programs need to be developed for specific communities and age groups. The relation between tobacco use and increased risk for failing or dropping out of high school demonstrates the necessity of reaching these students through school-based programs before they leave school. Although many factors contribute to the high prevalence of smoking among American Indians/Alaska Natives, it is important to develop culturally appropriate prevention and control measures that distinguish between the use of manufactured tobacco products and the ceremonial use of tobacco.

The US Department of Health and Human Services has released guidelines with specific evidence-based recommendations for tobacco-use treatment. The recommended interventions include counseling that offers practical advice about and support for quitting. Smokers trying to quit should be encouraged to use a medication approved by the Food and Drug Administration, either nicotine replacement therapy (gum, inhaler, nasal spray, or patch) or a non-nicotine pharmacologic aid (buproprion). To ensure that smokers interested in quitting receive appropriate treatment, health-care systems should routinely screen patients for tobacco use. Improved access to treatment by reducing cost barriers will also increase the number of quitters.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.