Prevention: A Blueprint for Action. Tobacco


Facts and Figures on Tobacco [30]

  • An estimated 71.5 million Americans reported current use (past month use) of a tobacco product in 2002, a prevalence rate of 30.4 percent for the population aged 12 or older.
  • Among that same population, 61.1 million (26.0 percent of the total population aged 12 or older) smoked cigarettes, 12.8 million (5.4 percent) smoked cigars, 7.8 million (3.3 percent) used smokeless tobacco, and 1.8 million (0.8 percent) smoked tobacco in pipes.
  • Young adults aged 18 to 25 continued to report the highest rate (45.3 percent) of use of tobacco products. Past month rates of use for this age group were 40.8 percent for cigarettes, 11.0 percent for cigars, 4.8 percent for smokeless tobacco, and 1.1 percent for pipes.
  • By age group, the prevalence of cigarette use was 13.0 percent among 12 to 17 year olds, 40.8 percent among young adults aged 18 to 25 years, and 25.2 percent among adults aged 26 or older.
  • Higher proportion of males than females aged 12 or older smoked cigarettes in 2002 (28.7 vs. 23.4 percent). However, among youths aged 12 to 17, girls were slightly more likely than boys to smoke (13.6 vs. 12.3 percent)
  • In 2002, 17.3 percent of pregnant women aged 15 to 44 smoked cigarettes in the past month compared with 31.1 percent of nonpregnant women of the same age group.
  • Current cigarette smoking rates among persons aged 12 or older were 37.1 percent among American Indians/Alaska Natives, 35.0 percent among persons reporting two or more races, 26.9 percent among whites, 25.3 percent among blacks, 23.0 percent for Hispanics, and 17.7 percent for Asians.
  • The prevalence of cigarette smoking decreased with increasing levels of education. Among adults aged 18 or older in 2002, college graduates were the least likely to report smoking cigarettes (14.5 percent) compared with 35.2 percent of adults who lacked a high school diploma.
  • The annual toll on the nation’s health and economy is staggering: 440,000 deaths, 8.6 million people suffering from at least one serious illness related to smoking, $75 billion in direct medical costs, $82 billion in lost productivity, and 5.6 million years of potential lives lost [31,32,33].

Perhaps the most impressive recent accomplishment has been the decline in smoking among adolescents after nearly a decade (during the 1990s) of rising smoking rates among youth (Figure 4).  Although more than one in four U.S. high school students currently smokes cigarettes, smoking among this group has been falling since 1997.

Tobacco use remains the leading preventable cause of death and disease in the U.S. and continues to pose a formidable challenge to the public health community.  The downward trend in adult smoking is far too slow, particularly among people with lower education and income levels; declines in smoking among middle-school students appear to have stalled; and the long-term success rate for smokers who try to quit each year is still under 5 percent [34].

Figure 4. Percentage of High School Students Who Reported Current Cigarette Smoking*—United States, 1991–2001

Percentage of High School Students Who Reported Current Cigarette Smoking—United States, 1991–2001

*Smoked cigarettes on 1 or more of the 30 days preceding the survey.
Source: CDC, Youth Risk Behavior Surveillance System (MMWR 2002;51(19):409–12).

Compounding these challenges is the current fiscal condition in several states that threatens successful statewide comprehensive tobacco control programs.  The amount of money states are spending on tobacco prevention dropped by 28 percent over the past two years [35].

Over the past four decades, the scientific knowledge about the health consequences of tobacco use has expanded greatly.  Much of this knowledge is the outgrowth of research that HHS has conducted or sponsored.  It is now well documented that smoking cigarettes causes heart disease, lung cancer and many other cancers, chronic lung disease, and a wide range of other diseases and conditions affecting virtually every organ of the body.  Cigar smoking and smokeless tobacco use have also been found to increase the risk of certain types of cancer and are not safe alternatives to smoking cigarettes.  In addition to these conventional tobacco products, a new generation of nicotine products that purport to be less harmful has emerged, such as cigarettes that promise fewer carcinogens, and tobacco lozenges.  However, establishing any claim of harm reduction requires extensive independent research on the products themselves and their impact on human health.

The health hazards of tobacco use extend beyond the actual users.  Exposure to secondhand smoke increases nonsmokers’ risk for cancer (particularly lung cancer), other respiratory diseases, and heart disease.  Among children, secondhand smoke increases the risk of developing serious respiratory problems, including asthma, pneumonia, and bronchitis.  Additionally, substantial evidence now links secondhand smoke with sudden infant death syndrome and low birth weight.

The burden of tobacco use is not evenly distributed within the U.S. population.  Specific population groups differ in the risk, incidence, morbidity, mortality, exposure, and burden of tobacco–related illness, as well as in their access to resources.  For example, American Indians and Alaska Natives smoke at higher rates than any other ethnic/racial group.

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