CDC: 1 in 4 Adults Still Use Tobacco Products

Cigarette use hits new record low, but emerging products a concern


Rates of cigarette smoking have dropped to record lows in the United States, but one in four adults still use tobacco products at least occasionally, the CDC reported.

During 2013 through 2014, a total of 21.3% of U.S. adults age 18 and older used a tobacco product every day or some days and 25.5% used a tobacco product every day, some days, or rarely, according to an analysis published July 14 in the CDC's Morbidity and Mortality Weekly Report.

Young adults between the ages of 18 and 24 had the highest rates of e-cigarette use and use of other emerging tobacco products, but there is emerging evidence that e-cigarette use among adults may be plateauing, said the senior author of the report, Brian A. King, PhD, of the CDC's Office on Smoking and Health.

King and colleagues analyzed data from the 2013-2014 National Adult Tobacco Survey (NATS), which is a recurring telephone survey of adults in all 50 states and the District of Columbia designed to assess the prevalence of tobacco use in the U.S., as well as the demographic factors associated with use.

During 2013-2014, an estimated 49.2 million adults in the U.S. used a tobacco product every day or some days, and 58.8 million adults used tobacco products either frequently or sporadically.

Males were more likely to use tobacco products than females were (26.3% versus 16.7%), and lower socioeconomic status, younger age (< 45), and being lesbian, gay, or bisexual were all associated with higher rates of tobacco use.

Tobacco use prevalence was highest among American Indian, Alaska native, and Pacific Islander (32.6%) individuals, and lowest among Asians (11.2%).

Regionally, people living in the South had the highest rates of tobacco use (24%), while those living in the Pacific states had the lowest (17.6%).

"These findings are consistent with what we have seen in the past, but the tobacco product landscape is changing and this is concerning," King told MedPage Today. "Although cigarettes are still the most commonly used tobacco product, we are seeing the use of other forms of tobacco increasing -- which is why it is important to address all forms of tobacco use among adults, not just cigarettes."

Overall, 17% of 2013-2014 NATS respondents reported smoking cigarettes, which represents close to 40 million people, while 3.3% ( 7.8 million) reported e-cigarette use; 1.8% (4.1 million) reported regular cigar/cigarillo/filtered little cigar use; and less than 1% reported use of other combustible or noncombustible tobacco products.

The CDC researchers noted that the rate of tobacco use among younger adults was particularly high when all frequencies of use were included in the assessment, including rare use. The team cited a focus group study involving cigar smokers where some participants refused to call themselves smokers because their use was infrequent (less than daily or several times a week).

"This finding underscores the importance of further research on the ascertainment of tobacco product use, as well as efforts to educate the public about the potential harms of all tobacco product use, including risks associated with occasional use," they wrote.

The report concluded with a call for greater funding of sustained, comprehensive state tobacco-control programs at levels recommended by CDC.

The researchers noted that during fiscal year 2016, despite combined revenue of $25.8 billion nationally from settlement payments and tobacco taxes, states are on track to spend only 1.8% of this amount ($468 million) on comprehensive tobacco-control programs (which is less than 15% of the CDC-recommended level of funding for all states combined).

"Full implementation of comprehensive tobacco-control programs at CDC-recommended funding levels, in conjunction with FDA regulation of tobacco products, could reduce tobacco use in the United States, thereby reducing morbidity and mortality caused by tobacco use," they wrote.