State-Specific Prevalence of Cigarette Smoking Among Adults and Quitting Among Persons Aged 18--35 Years --- United States, 2006

Morbidity and Mortality Weekly Report. 2007;56(38):993-996. 

In This Article

Introduction

Each year, cigarette smoking in the United States causes approximately 438,000 deaths and results in an estimated $167 billion in health-care costs plus lost productivity attributed to premature deaths.[1] Although smoking cessation has major and immediate health benefits for persons of all ages,[2] the benefit is greater the earlier in life a person quits. Persons who quit before the age of 35 years have a life expectancy similar to that of those who never smoked.[3] To assess the prevalence of current smoking among all adults and among those aged 18--35 years, and to assess the proportion of smokers aged 18--35 years who have quit or attempted to quit, CDC analyzed state and area data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report summarizes the results of that analysis, which indicated substantial variation in current cigarette smoking prevalence among the 50 states, the District of Columbia (DC), Puerto Rico (PR), and the U.S. Virgin Islands (USVI) (range: 9.1%--28.6%). The majority of current smokers aged 18--35 years reported that they had attempted to quit smoking during the past year (median: 58.6%; range: 48.0% [Nevada] to 69.2% [New Mexico]), and the median proportion of ever smokers aged 18--35 years who had quit smoking was 34.0% (range: 27.0% [Louisiana] to 47.9% [Utah]). Effective, comprehensive tobacco-use prevention and control programs should be continued and expanded to further reduce smoking initiation by young persons and to encourage cessation as early in life as possible.[4,5]

BRFSS is a state-based, random-digit--dialed telephone survey of the noninstitutionalized, U.S. civilian population aged ≥18 years. Estimates were weighted by age and sex distributions of each state or area population. Because BRFSS data are state-specific, national median prevalences are reported instead of national averages. The median response rate for the 50 states and DC was 51.4% (range: 35.1% [New Jersey] to 66.0% [Nebraska]).

Respondents were asked, "Have you smoked at least 100 cigarettes in your entire life?" and "Do you now smoke cigarettes every day, some days, or not at all?" Ever smokers were defined as those who reported having smoked ≥100 cigarettes during their lifetime. Current smokers were defined as those who reported having smoked ≥100 cigarettes during their lifetime and who currently smoked every day or some days. Former smokers were defined as those who reported having smoked ≥100 cigarettes during their lifetime and who currently did not smoke at all. Attempted smoking cessation was assessed by asking those who smoked every day, "During the past 12 months, have you stopped smoking for 1 day or longer because you were trying to quit?" The percentage of ever smokers who had quit smoking was calculated by dividing the number of former smokers by the number of ever smokers.

Current Cigarette Smoking Prevalence

In 2006, the median prevalence of current cigarette smoking among adults in the 50 states and DC was 20.2%, with a nearly threefold difference among states with the lowest and highest prevalences ( Table 1 ). Current smoking prevalence was highest in Kentucky (28.6%), West Virginia (25.7%), Oklahoma (25.1%), and Mississippi (25.1%) and was lowest in Utah (9.8%). Smoking prevalence was 12.5% in PR and 9.1% in USVI. The median smoking prevalence for the 50 states and DC was 22.2% (range: 10.4%--29.1%) for men and 18.5% (range: 9.2%--28.1%) for women. Similar variation among the states also was observed in the prevalence of current smoking among persons aged 18--35 years (median for the 50 states and DC: 25.3% [range: 11.3%--34.1%]) ( Table 2 ). Current smoking prevalence for this age group was 16.8% in PR and 8.1% in USVI.

Quitting and Quit Attempts Among Persons Aged 18--35 Years

In 2006, the median percentage of ever smokers aged 18--35 years who had quit was 34.0% for the 50 states and DC ( Table 2 ). The states with the highest percentages of ever smokers who had quit in this age group were Utah (47.9%) and Minnesota (43.7%). The median prevalence of current daily smokers aged 18--35 years who had quit for at least 1 day during the past year was 58.6% for the 50 states and DC (range: 48.0% [Nevada] to 69.2% [New Mexico]) ( Table 2 ). The proportion of current daily smokers who had quit for at least 1 day during the past year was 71.4% in PR and 53.8% in USVI.

Reported by: J Kahende, PhD, A Teplinskaya, MPH, A Malarcher, PhD, C Husten, MD, E Maurice, MS, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

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