Smoking rates go down in the US, lowest since 1965

By Dr. Ananya Mandal, MDNov 8 2018

According to the latest report from the Centers for Disease Control and Prevention (CDC) and the National Institute of Health's National Cancer Institute (NCI), released yesterday (8th November 2018), cigarette smoking is at its lowest in the United States since 1965.

Image Credit: OtmarW / Shutterstock

Brian King, senior author of the report and deputy director for research translation at the CDC's Office on Smoking and Health in a statement said, “The good news is that cigarette smoking has reached unprecedented lows, which is a tremendous public health win, down to 14 percent from over 40 percent in the mid-1960s.” The report shows that in 2017, 19.3 percent Americans (47.4 million individuals) used tobacco in some form or the other. King and other experts agree that this dramatic decline in the numbers is due to the government policies about keeping areas smoke-free and also due to the government policies of raising taxes and prices of tobacco products.

The data for this report comes from the National Health Interview Survey that looked at noninstitutionalized U.S. civilian population of 26,742 adults in 2017. Response rates were 53 percent. The team asked the population about use of five types of tobacco products including cigarettes, cigars, e-cigarettes, snuffs and dips and pipes such as hookahs and water pipes.

The report states, “During 2016-2017 declines occurred in current use of any tobacco product; any combustible tobacco product, [two or more] tobacco products; cigarettes; and smokeless tobacco.” King said there are still 47 million Americans are using some form of tobacco products. He said –

• 14 percent are smoking cigarettes
• 3.8 percent are smoking cigars, cigarillos or filtered little cigars
• 2.8 percent are using e-cigarettes
• 1 percent are using pipes and
• 2.1 percent are using smokeless tobacco products.
• Around 4 percent are using two or more tobacco products with the commonest combination being cigarettes and e-cigarettes
• 24.8 percent men are smoking compared to 14.2 percent women.
• Smoking was highest (22.5 percent of the whole smoking populations) among individuals aged between 25 and 44 years
• Smoking rates were least (11 percent) among people aged 65 years and above
• Smoking rates were highest among Southerners and Midwesterners (20.8% and 23.5%, respectively)
• Smoking rates were lowest among those in the Northeast and the West (15.6 percent and 15.9 percent, respectively)
• Use of e-cigarettes has also declined slightly between 2016 and 2017.
• Highest use is seen among non-Hispanic American Indian/Alaska Natives closely followed by multiracial, white, and black adults.
• Tobacco use was higher (2 in 5 individuals) among people with psychological distress compared to those without (1 in 5)

CDC Director Robert Redfield, said in a statement, “This new all-time low in cigarette smoking among U.S. adults is a tremendous public health accomplishment – and it demonstrates the importance of continued proven strategies to reduce smoking. Despite this progress, work remains to reduce the harmful health effects of tobacco use.”

NCI Director Norman E. Sharpless said in a statement, “For more than half a century, cigarette smoking has been the leading cause of cancer mortality in the United States. Eliminating smoking in America would, over time, eliminate about one-third of all cancer deaths. The persistent disparities in adult smoking prevalence described in this report emphasize the need for further research to accelerate reductions in tobacco use among all Americans.”

FDA Commissioner Scott Gottlieb also said that these trends of decline in smoking rates were “encouraging”. He said, “We've taken new steps to ultimately render combustible cigarettes minimally or non-addictive and to advance a framework to encourage innovation of potentially less harmful products such as e-cigarettes for adults who still seek access to nicotine, as well as support the development of novel nicotine replacement drug therapies. At the same time we're also working to protect kids from the dangers of tobacco product use, including e-cigarettes.”

King warned that the declining rates are encouraging but there is also a rise in use of e-cigarettes that needs to be considered. “It's critical that we not only modernize our strategies in terms of population but also modernize our interventions to be sure that we are capturing the full diversity of tobacco products that the American public are using,” he said.