foodconsumer.org: Cigarette Smoking Among Adults and Trends in Smoking Cessation --- United States, 2008

Cigarette Smoking Among Adults and Trends in Smoking Cessation --- United
States, 2008
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admin on 11/13/2009 00:56:00
 
November 13, 2009 / 58(44);1227-1232
CIGARETTE SMOKING AMONG ADULTS AND TRENDS IN SMOKING CESSATION --- UNITED
STATES, 2008
Cigarette smoking continues to be the leading cause of preventable morbidity and
mortality in the United States (1). Full implementation of population-based
strategies (2) and clinical interventions can educate adult smokers about the
dangers of tobacco use and assist them in quitting (3,4). To assess progress
toward the Healthy People 2010 objective of reducing the prevalence of cigarette
smoking among adults to 18 years from among the noninstitutionalized, U.S.
civilian population. Respondents were selected by a random probability sample,
and the survey included questions on cigarette smoking and cessation attempts.
The overall response rate for the 2008 adult core questionnaire was 62.6%. To
determine smoking status, respondents were asked, "Have you smoked at least 100
cigarettes in your entire life?" Those who answered "yes" were asked, "Do you
now smoke cigarettes every day, some days, or not at all?" Ever smokers were
defined as those who reported having smoked at least 100 cigarettes during their
lifetime. Current smokers were those who had smoked at least 100 cigarettes
during their lifetime and, at the time of interview, reported smoking every day
or some days. Former smokers were those who reported smoking at least 100
cigarettes during their lifetime but currently did not smoke. Never smokers were
those who reported never having smoked 100 cigarettes during their lifetime.
Starting in 2007, income-related follow-up questions were added to NHIS to
reduce the number of responses with unknown values.* For this report, poverty
status was defined by using 2006 poverty thresholds published by the U.S. Census
Bureau for the 2007 estimates and 2007 poverty thresholds published by the U.S.
Census Bureau for the 2008 estimates; family income was reported by the family
respondent who might or might not have been the same as the sample adult
respondent from whom smoking information was collected.
To measure trends in cigarette smoking cessation in the population, quit ratios
were calculated as the ratio of former smokers to ever smokers for each survey
year from 1998 to 2008. Quit ratios were analyzed by education level to
determine if differing quit ratios accounted for part of the differing
prevalence among education groups. Data were adjusted for nonresponse and
weighted to provide national estimates of cigarette smoking prevalence; 95%
confidence intervals were calculated using statistical analysis software to
account for the survey's multistage probability sample design. For year-to-year
prevalence comparisons, statistical significance (p65 years (9.3%) (Table,
Figure 1).
During 1998--2008, the proportion of U.S. adults who were current cigarette
smokers declined 3.5% (from 24.1% to 20.6% [p25 years (53.8%) (Figure 2). During
1998--2008, the overall quit ratio was stable (or varied little) and ranged from
48.7% (1998) to 51.1% (2008). Persons with an undergraduate degree and persons
with a graduate degree had quit ratios consistently higher than 60.0%. The only
group with a significant upward linear trend in cessation was persons with a
graduate degree; in 2008, the quit ratio was 80.7%, compared with 76.0% in 1998.
Adults with a GED had the lowest quit ratio; during 1998--2008, their quit
ratios ranged from 31.2% (2001) to 39.9% (2008).
Reported by: SR Dube, PhD, K Asman, MSPH, A Malarcher, PhD, R Carabollo, PhD,
Office on Smoking and Health, National Center for Chronic Disease Prevention and
Health Promotion, CDC.
EDITORIAL NOTE:
The prevalence of current cigarette smoking among adults has declined (from
24.1% in 1998 [6] to 20.6% in 2008) since the 1998 Master Settlement Agreement
(MSA),† which stipulated that seven tobacco companies would change their
marketing of tobacco products and pay an estimated $206 billion to states as
compensation for tobacco-related health-care costs. Significant year-to-year
decreases in smoking prevalence have been observed only sporadically. For
example, a decrease occurred from 2006 to 2007 (3) but not from 2007 to 2008;
during the past 5 years, rates have shown virtually no change. Some population
subgroups (e.g., Hispanic and Asian women, persons with higher levels of
education, and older adults) continue to meet the Healthy People 2010 target of