Abstract and Introduction
Smoking cigarettes and other combustible tobacco products causes adverse health outcomes, particularly cancer and cardiovascular and pulmonary diseases. A priority of the U.S. Department of Health and Human Services is to develop innovative, rapid-response surveillance systems for assessing changes in tobacco use and related health outcomes. The two standard approaches for measuring smoking rates and behaviors are 1) surveying a representative sample of the public and asking questions about personal smoking behaviors and 2) estimating consumption based on tobacco excise tax data. Whereas CDC regularly publishes findings on national and state-specific smoking rates from public surveys, CDC has not reported consumption estimates. The U.S. Department of Agriculture (USDA), which previously provided such estimates, stopped reporting on consumption in 2007. To estimate consumption for the period 2000–2011, CDC examined excise tax data from the U.S. Department of Treasury's Alcohol and Tobacco Tax and Trade Bureau (TTB); consumption estimates were calculated for cigarettes, roll-your-own tobacco, pipe tobacco, and small and large cigars. From 2000 to 2011, total consumption of all combustible tobacco decreased from 450.7 billion cigarette equivalents to 326.6, a 27.5% decrease; per capita consumption of all combustible tobacco products declined from 2,148 to 1,374, a 36.0% decrease. However, while consumption of cigarettes decreased 32.8% from 2000 to 2011, consumption of loose tobacco and cigars increased 123.1% over the same period. As a result, the percentage of total combustible tobacco consumption composed of loose tobacco and cigars increased from 3.4% in 2000 to 10.4% in 2011. The data suggest that certain smokers have switched from cigarettes to other combustible tobacco products, most notably since a 2009 increase in the federal tobacco excise tax that created tax disparities between product types.
USDA's previous consumption estimates were based on 1) information from TTB, including data on products that are produced domestically or imported and taxed for legal sale in the United States; 2) tobacco industry reports; and 3) information from industry advisors. CDC developed a method to estimate consumption exclusively by using publicly available federal excise tax data available from TTB on products taxed domestically and imported into the United States. Using monthly tax data, CDC calculated the per unit (e.g., per cigarette or per cigar) consumption for each product. To enable comparisons with pipe tobacco and roll-your-own tobacco, CDC converted the tax data from pounds of tobacco to a per cigarette equivalent, based on the conversion formula contained in the Master Settlement Agreement (0.0325 oz [0.9 g] = one cigarette).* Adult per capita cigarette consumption was estimated by dividing total consumption by the number of persons aged ≥18 years in the United States each year using data from the U.S. Census Bureau. When compared with USDA's previous calculations for adult per capita cigarette consumption during 2000–2006, CDC's estimates differed each year by a median of only 0.15% and a mean of 0.76%.
From 2000 to 2011, total cigarette consumption declined from 435.6 billion to 292.8 billion, a 32.8% decrease (Table 1). Per capita cigarette consumption declined from 2,076 in 2000 to 1,232 in 2011, a 40.7% decrease. Conversely, total consumption of noncigarette combustible products increased from 15.2 billion cigarette equivalents in 2000 to 33.8 billion in 2011, a 123.1% increase, and per capita consumption increased from 72 in 2000 to 142 in 2011, a 96.9% increase. Total consumption of all combustible tobacco decreased from 450.7 billion cigarette equivalents to 326.6, a 27.5% decrease from 2000 to 2011, and per capita consumption of all combustible tobacco products declined from 2,148 to 1,374, a 36.0% decrease.
Consumption of loose tobacco (i.e., roll-your-own cigarette tobacco and pipe tobacco) changed substantially from 2000 to 2011. Roll-your-own cigarette equivalent consumption decreased by 56.3%, whereas pipe tobacco consumption increased by 482.1% (Table 2). The largest changes occurred from 2008 to 2011, when roll-your-own consumption decreased from 10.7 billion to 2.6 billion (a 75.7% decrease), whereas pipe tobacco consumption increased from 2.6 billion to 17.5 billion (a 573.1% increase).
Substantial changes also were observed in consumption of small cigars† and large cigars (Figure 1). From 2000 to 2011, consumption of small cigars decreased 65.0%, whereas large cigar consumption increased 233.1% (Table 2). The largest changes occurred from 2008 to 2011, when small cigar consumption decreased from 5.9 billion to 0.8 billion (an 86.4% decrease), whereas large cigar consumption increased from 5.7 billion to 12.9 billion (a 126.3% increase).
Physical differences between combustible tobacco products — Government Accountability Office, United States
Source: Government Accountability Office. Tobacco taxes: large disparities in rates for smoking products trigger significant market shifts to avoid higher taxes. Available at https://www.gao.gov/products/gao-12-475
Annual cigarette consumption declined each year during 2000–2011, including a 2.6% decrease from 2010 to 2011, but total consumption of combustible tobacco decreased only 0.8% from 2010 to 2011, in part because of the effect of continued increases in the consumption of noncigarette combustible tobacco products (Figure 2). From 2000 to 2011, the percentage of total combustible tobacco consumption composed of loose tobacco and cigars increased from 3.4% (15.2 billion cigarette equivalents out of 450.7 billion) to 10.4% (33.8 billion of 326.6 billion).
Consumption of cigarettes and other combustible tobacco products — United States, 2001–2011
Morbidity and Mortality Weekly Report. 2012;61(30):565-569. © 2012 Centers for Disease Control and Prevention (CDC)