Smoking rates, which declined precipitously in the United States from 1964 to 2004, have remained virtually unchanged since then, according to data from the 2009 National Health Interview Survey. In 2009, 20.6% of adult Americans smoked cigarettes, compared with 20.9% of Americans in 2005, a difference that was not statistically significant.
© PhotoDisc
The rate of cigarette smoking in the United States has leveled off since 2004 after years of decline. However, rates of secondhand smoke exposure in nonsmokers have dropped significantly.
On the other hand, data from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) demonstrated a significant drop in the proportion of nonsmoking Americans aged 3 years and above with detectable levels of serum cotinine, an indication of exposure to secondhand smoke. That rate fell from 52.5% in the 1999-2000 survey to 40.1% in the 2007-2008 survey.
Both studies appeared in the Sept. 7 issue of the Morbidity and Mortality Weekly Report, published by the Centers for Disease Control and Prevention (MMWR 2010;59:1-6 and 7-12).
In announcing the results at a press briefing today, Dr. Thomas R. Frieden, director of the CDC, said that both the tobacco industry and federal, state, and local governments bear the blame for the failure of smoking rates to decline. “The industry has gotten even better at sidestepping laws designed to get people to stop smoking,” he said. “They ensure that every cigarette they sell delivers nicotine quickly and efficiently to keep people addicted.”
In addition, the industry has found ways to sidestep regulations banning the sale of flavored cigarettes, which can encourage children to start smoking, Dr. Frieden said. And while tobacco companies are not permitted to market their products as having lower levels of tar and nicotine, “they continue to deceive smokers with color coding and other subtle and not-so-subtle ways of sending the message that some cigarettes are less deadly than others, when in fact all cigarettes kill equally,” he said.
Furthermore, “government is also not doing what it needs to reduce smoking,” he charged. “Comprehensive, evidence-based programs are not being widely implemented. Last year, states took in about $25 billion from tobacco taxes and the [Tobacco] Master Settlement Agreement but spent only about $700 million – about 3 cents on every dollar [on tobacco control]. By 2015, if all states funded tobacco control at the CDC recommended level – 15 cents on the dollar of tobacco revenue – there would be an estimated 5 million fewer smokers in this country and that would prevent at least 1 million deaths in the future.”
While the NHANES study did find significant overall declines in the proportion of nonsmokers with detectable levels of serum cotinine, that decline did not extend to children who live with a smoker. Virtually all such children – 98.3% – had detectable cotinine levels, compared with 39.9% of children not living with someone who smoked inside the home. For nonsmoking adults, the corresponding figures were 93.4% and 33.4%.
The first study used data collected in 2009 by the National Health Interview Survey, which involved telephone interviews with 27,603 Americans aged 18 years and older. The second study used NHANES data collected from a nationally representative sample of 30,451 nonsmoking Americans aged 3 years and older.
In answer to a reporter’s question, Dr. Frieden said, “There’s a lot that doctors can do. Doctors can ask every patient if they smoke, and they can advise every patient who does to quit and quit today, and, if not today, then to set a date when they can quit. [Physicians] should also know what services are available in their community to help smokers quit and refer people to quit [telephone] lines. With the Affordable Care Act, tobacco cessation medication will be free of charge, so it should be easier for people to quit smoking in the future.”
No disclosures were reported.