Heavy smoking dropped drastically over last four decades: Study

By Dr. Ananya Mandal, MDMar 15 2011

A new study has shown that the rate of “pack-a-day” or more smokers in the United States has fallen sharply since 1965, particularly in California. There is evidence from earlier literature that a smaller percentage of Americans smoke now than in previous decades. This new study was published online in the Journal of the American Medical Association. It shows that high-intensity smoking is also less common.

Authors reveal that in the mid-1960s, 56 percent of all smokers in the United States had 20 or more cigarettes a day. It was in 1964 when the Office of the Surgeon General issued the first report linking smoking and cancer. Over the next four decades the rates have fallen steadily say researchers from the University of California, San Diego. By 2007, 23 percent of California smokers and 40 percent of smokers in the rest of the United States smoked a pack-a-day or more.

Lead study author John P. Pierce, of UC San Diego’s Moores Cancer Center added that there hasn’t been a corresponding increase in less-intense smoking since 1965, suggesting that the 40-year decline in heavy smoking wasn’t fueled solely by high-intensity smokers cutting back. He said, “The major decline is in the young people never [becoming smokers] in the first place. It’s much easier to quit when you don’t have to.” He said the changing social norms about smoking have played a role in the trend.

California has been an aggressive anti smoking player with its high cigarette tax to anti-smoking ordinances in the workplace. The state also uses cigarette tax revenue to fund its tobacco control program. This study was based on survey responses from 139,176 Californians and 1,662,353 people from the rest of the country taken between 1965 and 2007. Main outcome measure, and smokers were divided into three groups: high intensity (20 or more Cigarettes per day or CPD), moderate intensity (10 to 19 CPD), and low intensity (zero to nine CPD).

Heartening thought is that with drop of smoking rates, rates of lung cancer smoking deaths have also dropped. This said, it must be noted that lung cancer remains the leading cause of cancer death for both men and women.

Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids, noted that, “California has reduced overall smoking and high-intensity smoking much faster than the rest of the country, and this has led to declines in lung cancer rates that are larger than the rest of the country - saving lives and health-care dollars…Every state should follow California’s example.” However, these gains are in jeopardy, as California has fallen behind its funding of tobacco control programs, McGoldrick said. “To continue its progress, California must raise its tobacco tax, which has fallen well below the national average, and use some of the new revenue to increase funding for its model prevention and cessation program, which has declined significantly in recent years,” McGoldrick said.

Dr. Norman H. Edelman, scientific consultant for the American Lung Association, said that “this is validation of all of our efforts.” These findings show that both prevention programs and programs to help people quit are essential, he said. “The ban on public smoking seems to help people quit…But, the job is not over - 20 percent of Americans still smoke, so there is still a long way to go. But we have begun to turn the tide in lung cancer and it looks like it's happening in chronic obstructive pulmonary disease (COPD),” he concluded.