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Tobacco

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Explore the latest data for the LHI topic Tobacco.
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Where We’ve Been and Where We’re Going

Over the past decade, the current cigarette smoking rate decreased by 18.4% among adults aged 18 years and over, from 22.3% (age adjusted) in 2002 to 18.2% in 2012. Moreover, the rate of decline since 2009, more than 4% per year, is greater than even the steep declines seen from 1965 to the early 1990s. Adults with lower education attainment and lower income levels have higher rates of smoking compared to their counterparts. For example, among education groups for adults aged 25 years and older, those with an advanced degree had the lowest rate of current cigarette smoking at 6.0%, while those with less than high school had the highest rate of current cigarette smoking at 26.3%. The rate of cigarette use in the last 30 days among students in grades 9-12 decreased by 36.5% from 28.5% in 2001 to 18.1% in 2011.

Leading Health Indicators

Leading Health Indicators (LHI) are critical health issues that – if tackled appropriately – will dramatically reduce the leading causes of death and preventable illnesses. The LHIs for Tobacco are:

Current Cigarette Smokers — adults (TU-1.1)

  • Healthy People 2020 objective TU-1.1 tracks the proportion of adults who are current cigarette smokers.
    • HP2020 Baseline: In 2008, 20.6% of adults aged 18 years and older were current cigarette smokers (age adjusted).
    • HP2020 Target: 12.0% (retained from HP2010), a 41.7% improvement over the baseline.
    • The percentage of adults aged 18 years and over who were current cigarette smokers decreased 18.4% between 2002 and 2012, from 22.3% to 18.2% (age adjusted). Moreover, the rate of decline since 2009, more than 4% per year, is greater than even the steep declines seen from 1965 to the early 1990s.

In 2012, among adults aged 18 years and older:

  • Asian adults had the lowest rate of current cigarette smoking among racial and ethnic groups at 10.2% of adults aged 18 years and over (age adjusted). Rates for other racial and ethnicity groups were (age adjusted):
    • American Indian or Alaska Native: 18.8%, almost twice the best group rate
    • Two or more races: 24.5%, almost two and a half times the best group rate
    • Black or African American, not Hispanic: 17.8%, almost twice the best group rate
    • White, not Hispanic: 20.6%, about twice the best group rate
    • The rate for the Native Hawaiian or Other Pacific Islander population was statistically unreliable.

    Current Cigarette Smoking among Adults by Race/Ethnicity, 2012

    Note: Data are age adjusted to the 2000 standard population.
    Data Source: National Health Interview Survey (NHIS), CDC/NCHS.

  • Adult males had a higher rate of current smoking than adult females (20.6% vs. 15.9%, age adjusted).
  • Adults living in families with family incomes at 600% of the poverty threshold or higher had the lowest rate of current cigarette smoking at 9.0% (age adjusted). Rates for current smoking for other family income levels were (age adjusted):
    • 400-599% poverty threshold: 13.7%, about one and a half times the best group rate
    • 200-399% poverty threshold: 19.4%, more than twice the best group rate
    • 100-199% poverty threshold: 23.7%, more than two and a half times the best group rate
    • <100% poverty threshold: 27.7%, more than three times the best group rate
  • Adults born outside of the United States had a lower rate of current cigarette smoking than adults born in the United States (10.5% vs. 19.9%, age adjusted).
  • Adults without activity limitations had a lower rate of current cigarette smoking than adults with activity limitations (16.7% vs. 27.2%, age adjusted).
  • Adults who live in metropolitan areas had a lower rate of current cigarette smoking than adults living in non-metropolitan areas (16.9% vs. 25.7%, age adjusted).

Also in 2012:

  • Among broad age groups, adults aged 65 years and older had the lowest rates of current smoking at 8.9%. Rates for age groups 18-44 and 45-64 were more than twice as high at 20.4% and 19.5%, respectively.
  • Among education groups, adults aged 25 years and older with an advanced degree had the lowest rate of current cigarette smoking at 6.0% (age adjusted). Rates for the other levels of educational attainment were (age adjusted):
    • 4-year college degree: 8.9%, about one and a half times the best group rate
    • Associates degree: 17.6%, almost three times the best group rate
    • Some college: 20.8%, about three and a half times the best group rate
    • High school: 26.3%, almost four and a half times the best group rate
    • Less than high school: 26.3%, almost four and a half times the best group rate
  • Adults aged 18-64 with private health insurance had the lowest rate of current cigarette smoking (15.2%, age adjusted) compared to adults with public or no health insurance (29.0% and 29.6%, age adjusted, respectively). The rates of current cigarette smoking for adults with public or no insurance were almost twice as high as those with private health insurance.

Endnotes:

  • All disparities described are statistically significant at the 0.05 level of significance.
  • Data (except those by education, health insurance, and age group) are age adjusted to the 2000 standard population using the age groups 18-24, 25-34, 35-44, 45-64, and 65 years and over. Data by education are adjusted using the age groups 25-34, 35-44, 45-64, 65 years and over. Data by health insurance coverage are adjusted using the age groups 18-24, 25-34, 35-44, 45-54, 55-64. Data by age group are not age adjusted. Age-adjusted rates are weighted sums of age-specific rates.
  • Current cigarette smokers are defined as persons who have smoked at least 100 cigarettes in their lifetime and now report smoking cigarettes every day or some days.
  • Data for this measure are available annually and come from the National Health Interview Survey (NHIS), CDC/NCHS.
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.

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Cigarette use in the past 30 days — students grades 9-12 (TU-2.2)

  • Healthy People 2020 objective TU-2.2 tracks the proportion of students in grades 9-12 who smoked cigarettes in the last 30 days.
    • HP2020 Baseline: In 2009, 19.5% of students in grades 9-12 smoked cigarettes in the last 30 days.
    • HP2020 Target: 16.0% (retained from HP2010), a 17.9% improvement over the baseline.
    • The percentage of students in grades 9-12 who smoked cigarettes in the last 30 days decreased 36.5% between 2001 and 2011, from 28.5% to 18.1%.

In 2012, among students in grades 9-12:

  • Asian students had the lowest rate of cigarette use in the past 30 days among racial and ethnic groups at 9.3%. The rate for the black or African American, non-Hispanic population (10.5%) was not significantly different from the rate for the Asian population. Rates for all other racial and ethnicity groups were approximately two to two and a half times as high:
    • American Indian or Alaska Native: 23.1%
    • Native Hawaiian or Other Pacific Islander: 23.0%
    • Two or more races: 18.3%
    • Hispanic or Latino: 17.5%
    • White, not Hispanic: 20.3%

    Cigarette Use in the Past 30 Days among Students by Race/Ethnicity, 2012

    Data Source: Youth Risk Behavior Surveillance System (YRBSS), CDC/NCCDPHP.

  • Male students had a higher rate of cigarette use in the last 30 days than females (19.9% vs. 16.1%).
  • Students in 9th grade had the lowest rate of cigarette use in the last month (13.0%):
    • The rate for 10th grade students was 15.6%.
    • The rate for 11th grade students was 19.3%, about one and a half times as high as the rate for 9th grade students.
    • The rate for 12th grade students was 25.1%, nearly two times as high as the rate for 9th grade students.

Endnotes:

  • All disparities described are statistically significant at the 0.05 level of significance, unless otherwise stated.
  • Students are classified as using cigarettes in the past 30 days if they report smoking cigarettes on one or more of the 30 days preceding the survey.
  • Data for this measure are available biennially from the Youth Risk Behavior Surveillance System (YRBSS), CDC/NCCDPHP.
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.

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