To return to the Table of Contents (TOC)
To return to the Table of Contents (TOC)
|
 |
|||||||||||
 |
|
|||||||||||
|
Tobacco Use in America: Highlights |
||||||||||||
This report includes detailed information about tobacco use in the United States from the 1999 National Household Survey on Drug Abuse (NHSDA), an annual cross sectional study sponsored by the Office of Applied Studies (OAS) within the Substance Abuse and Mental Health Services Administration (SAMHSA) and conducted by the Research Triangle Institute (RTI). Since 1971, the NHSDA has been a primary source of information on the prevalence and incidence of illicit drug, alcohol, and tobacco use in the civilian population aged 12 years old or older.
Over the years, improvements have been made to the NHSDA to obtain better and more complete substance use information from the public. In 1999, major improvements were made. The sample size was expanded almost fourfold from previous years, so the data contained in this report were based on information obtained from nearly 70,000 persons. The sample design was also changed. Previous samples were designed to produce only national estimates. The new sample design supports the development of both national and State estimates of substance use. Moreover, a new, interactive, bilingual, computer-based questionnaire was introduced. Earlier surveys relied on paper-and-pencil questionnaires for respondents to complete. All of these changes were designed to improve the accuracy of the survey. At the same time, the changes limit the types of trend comparisons that can be made with information obtained from surveys prior to 1999. Included below are highlights from each chapter in this report.
An estimated 66.8 million Americans reported current use (i.e., use in the past month) of a tobacco product in 1999, a prevalence rate of 30.2 percent for the population aged 12 years old or older. Of this total, 57.0 million (25.8 percent) smoked cigarettes, 12.1 million (5.5 percent) smoked cigars, 7.6 million (3.4 percent) used smokeless tobacco, and 2.4 million (1.1 percent) smoked tobacco in pipes.
In 1999, past month cigarette smoking rates increased steadily by age, from 2.2 percent at age 12 to 43.5 percent at age 20. Overall, 14.9 percent of youths aged 12 to 17 years in 1999 were current cigarette smokers. Among young adults aged 18 to 25 years, the rate was 39.7 percent; among adults aged 26 or older, the rate was 24.9 percent.
More than 1 in 10 (11.5 percent) young adults 18 to 25 years of age reported smoking cigars in the month prior to the survey. This rate is more than twice that found for the other age groups. The current rate of cigar use was 5.4 percent among youths aged 12 to 17 years and 4.5 percent among persons 26 years of age or older.
Males were more likely than females aged 12 or older to be current users of cigarettes, smokeless tobacco, cigars, and pipes. Past month cigarette use was 28.3 percent for males and 23.4 percent for females, but gender differences were greater for other tobacco products.
American Indians and Alaska Natives were more likely than any other racial/ethnic group to report the use of cigarettes, smokeless tobacco, and pipes. Among those aged 12 or older, 36.0 percent of American Indians/Alaska Natives reported past month cigarette use. The next highest rates were for non-Hispanic whites and persons of more than one race (27.0 and 29.8 percent, respectively). The lowest current cigarette use rates were observed for Asians (16.6 percent).
Cigarette use rates varied by region of the country. Past month cigarette use ranged from a low of 21.9 percent for persons living in the Pacific portion of the West region of the country to a high of 30.5 percent for persons living in the East South Central part of the country.
Among adolescents, the prevalence of past month cigarette use was highest in completely rural counties compared with small or large metropolitan areas. For youths aged 12 to 17 years, past month cigarette use was reported by 19.2 percent of those living in completely rural counties compared with 13.3 percent of adolescents living in large metropolitan areas.
Among persons aged 18 or older, the prevalence of cigarette smoking decreased with increasing levels of education. College graduates were the least likely to report that they smoked cigarettes (14.4 percent) compared with 28.5 percent of persons with some college, 31.5 percent of those with only a high school diploma, and 32.5 percent of persons who lacked a high school diploma.
Unemployed persons aged 18 or older were significantly more likely to be current cigarette smokers compared with full-time employed persons (43.9 vs. 30.0 percent).
Current cigarette use was almost double among persons in the lowest family income group (< $9,000 per year) compared with people in the highest income category ($75,000+) (33.3 vs. 18.2 percent, respectively).
To return to the Table of Contents (TOC)
State Data (See Chapter 3 for full report)
Estimates of substance use for all 50 States and the District of Columbia were developed using a small area estimation model that combines sample data from each State with a national regression model that includes local indicators related to substance use. States were grouped into quintiles for comparison purposes.
All States currently have laws making it illegal to sell or distribute tobacco to minors, and all States have developed methods for measuring statewide compliance with tobacco access laws.
For past month cigarette use, 5 States ranked in the top 10 for both youths aged 12 to 17 and for all ages 12 or older: Delaware, Kentucky, Minnesota, North Carolina, and West Virginia.
The top 10 States for past month cigarette use among 12 to 17 year olds were Arkansas, Delaware, Kentucky, Minnesota, Montana, North Carolina, North Dakota, South Carolina, South Dakota, and West Virginia. Current cigarette use in these States ranged from 18.8 to 23.9 percent among 12 to 17 year olds.
The lowest 10 States for past month cigarette use among 12 to 17 year olds were California, District of Columbia, Florida, Hawaii, Idaho, Maryland, New Jersey, New York, Texas, and Utah. The prevalence of current cigarette use among youths in these States ranged from 9.0 to 13.8 percent.
To return to the Table of Contents (TOC)
Initiation of Tobacco Products and Patterns of Use (See Chapter 4 for full report)
Trends in the new use of substances were estimated using the data reported on age at first use from the computer-administered 1999 NHSDA. Because information on when people first used a substance is collected on a retrospective basis in the NHSDA, information on first-time use or incidence is always 1 or more years behind information on current use.
An estimated 3.2 million people tried their first cigarette in 1997; most of these new users were aged 12 to 17 (2.3. million).
An estimated 1.7 million people began smoking cigarettes daily in 1998. More than half of these new smokers were younger than age 18. This translates to more than 4,000 new regular smokers per day, including more than 2,000 youths.
After increasing since the early 1990s, the number of 12 to 17 year olds initiating daily smoking dropped significantly between 1997 and 1998. The number of 12 to 17 year olds reporting initiation of daily cigarette use decreased from 1.1 million in 1997 to 864,000 in 1998.
Following a sharp increase in promotional activities by manufacturers, cigar sales in the United States increased by almost 50 percent between 1993 and 1998. An estimated 4.9 million people tried cigars for the first time in 1998, about 13,000 per day. This represents a threefold increase in cigar initiation since 1991, when there were only 1.5 million new cigar smokers. The average age of cigar initiates changed little since the 1980s, and incidence rates increased among both youths (from 21.8 in 1991 to 99.5 in 1998) and young adults (from 30.4 in 1991 to 93.3 in 1998).
The average age of first use of tobacco products in 1999 among all persons who ever used in their lifetime was 15.4 for cigarettes, 20.5 for cigars, and 16.7 for smokeless tobacco across all age groups.
For all current daily cigarette smokers, the majority reported using about a half a pack per day (70.6 percent). For all current cigarette smokers, the majority reported smoking on more than 20 days on the past month (71.3 percent).
In 1999, the majority of cigar smokers started their tobacco use with cigarettes. This ordering of tobacco products was particularly true for females. Almost 90 percent of all persons who had ever smoked cigarettes and cigars initiated cigarettes before cigars.
Blacks were as likely to smoke cigars as whites, and blacks smoked cigars more frequently than their white counterparts, particularly among young adults. For persons aged 18 to 25 years old, 6.3 percent of white current cigar users smoked them on 11 or more days in the past month compared with 33.7 percent of black current cigar smokers.
Youths aged 12 to 17 who currently smoked 6 to 15 cigarettes per day were 10 times more likely to use illicit drugs or to report binge alcohol use than youths who did not smoke.
To return to the Table of Contents (TOC)
Prevention-Related Measures (See Chapter 5 for full report)
The 1999 NHSDA included a youth risk and protective factor module enhanced from the module originally added to the 1997 survey. Risk factors involve individual characteristics or social environments associated with an increased likelihood of substance use, while protective factors are attitudes and behaviors related to a decreased likelihood of substance use. The main domains included in the 1999 youth module were community, family, peer/individual, school, and general. It is well known that perceptions of risk of harmfulness are among the most important predictors of actual substance use. The NHSDA for many years has included questions about attitudes related to cigarette and other substance use.
Despite all the information on the dangers of smoking in the research literature, on television, and in the media, perceptions of physical harm from cigarettes did not change much between 1994 and 1999 for current smokers, former smokers, and those who had never smoked. Only for daily smoking did more male and female daily smokers perceive great risk of harm from smoking one or more packs of cigarettes per day in 1999 as compared with 1994.
Adolescents who felt their parents never say positively reinforcing things to them were more likely to smoke as compared with individuals who always got positive reinforcement from their parents. This was particularly true for 12 and 13 year olds; those who said they never got positive reinforcement from their parents were 6½ times as likely to be past month cigarette smokers when compared with 12 and 13 year olds who said their parents always indicated being proud of them.
In the 1999 survey, 6.5 percent of youths said their parents would neither approve nor disapprove if they smoked one or more packs of cigarettes a day, while 87.4 percent thought their parents would strongly disapprove. Those youths who thought their parents would neither approve nor disapprove were 5 times more likely to have used cigarettes in the past month compared with those who thought their parents would strongly disapprove.
The personality factors of novelty seeking or sensation seeking have been shown in the literature to be related to substance use, including cigarettes. As compared with youths who reported never getting a kick out of doing something a little dangerous, the likelihood of smoking increased fourfold for youths who said they sometimes enjoyed slightly dangerous activities and up to ninefold for those saying they always got a kick out of doing something a little dangerous.
Even having a few friends who smoked cigarettes was a strong risk factor for current smoking. For 12 to 15 year olds with a few friends who smoked, the risk of cigarette use increased 7 to 8 times. Among older youths (i.e., 16 and 17 year olds), those with only a few friends who smoked were 4½ times as likely to be smokers themselves.
Tobacco Use among College Students, School Dropouts, and Pregnant Women (See Chapter 6 for full report)
Tobacco use is common nationwide, and its use is not limited to cigarettes. Three particular subpopulations discussed separately in this report are college students, high school dropouts, and pregnant women. Common reasons that college students have given for smoking are stress, less supervision, having more free time, and the number of their friends who were smoking. Unfortunately, many members of the general population, including college students who may or may not smoke, do not realize how addictive nicotine is.
In general, college students were less likely than peers their age who were not enrolled in school to be current cigarette smokers. Also, 18 to 24 year olds not enrolled in any school were significantly more likely to be daily users of cigarettes as compared with full-time college students. Among females not enrolled in any school, 24.7 percent were daily smokers in 1999 in contrast to 13 percent of their female peers who were full-time college students.
Unlike the relationship seen for college enrollment and cigarette use, 18 to 24 year olds enrolled full-time in college or those not enrolled in any school were equally likely to be current cigar users in 1999. Cigar use is a predominantly male behavior, and current use in 1999 was reported by 17.9 percent of males enrolled full-time in college, 19.2 percent of males enrolled part-time in college, and 17.8 percent of males not enrolled in any school.
Current cigarette use was significantly higher among those who had dropped out of school compared with those who had not. Among 16 and 17 year olds, 56.4 percent of dropouts compared with 24.7 percent of nondropouts had smoked cigarettes in the past month; among those aged 18 to 25, comparable percentages were 50.8 percent and 38.4 percent.
Pregnant women generally were less likely to use tobacco products compared with nonpregnant women. About 17 percent of pregnant women aged 15 to 44 were current cigarette users compared with 30.5 percent of women who were not pregnant.
To return to the Table of Contents (TOC)
Tobacco Product Brand Preferences (See Chapter 7 for full report)
Identifying tobacco brand choices among tobacco users is important for the development of prevention and intervention strategies. Information about brand choices among young smokers is especially important because identifying the factors that influence those choices can help suggest ways to discourage young people from initiating smoking. The 1999 NHSDA asked all persons reporting current tobacco use which brands, by tobacco type, they preferred in the month prior to the survey.
Three brands accounted for most adolescent cigarette smoking: 54.5 percent of current smokers 12 to 17 years of age reported Marlboro as their usual brand, Newport was reported by 21.6 percent of youth smokers, and Camel was reported by 9.8 percent. No other cigarette brand was reported by even 2 percent of youths.
Racial/ethnic differences in usual cigarette brand used were evident among both adult and youth smokers. More than half of white (58.4 percent) and Hispanic (59.7 percent) youth smokers aged 12 to 17 reported Marlboro as their usual brand. About three quarters (73.9 percent) of black adolescent smokers reported Newport as their usual brand.
Two brands accounted for about a third of all cigar brands preferred by smokers aged 12 years old or older: Swisher Sweets and Black & Mild (both were preferred by about 17 percent of cigar smokers). As seen for cigarettes, brand preference for cigars was more concentrated among adolescent and young adult current cigar users. Together, Swisher Sweets and Black & Mild were preferred by approximately half of these two age groups.
As seen with cigarettes, there were notable racial/ethnic differences with regard to brand of cigar smoked most often in the month prior to the 1999 survey. For example, among 18 to 25 year olds, Black & Mild was preferred by 19.1 percent of whites, 15.3 percent of Hispanics, and 69.9 percent of African-American current cigar smokers.
There was less variation by age for brand choice of smokeless tobacco as compared with cigarettes and cigars. For all three age groups, both the number one and the number two favorite choices were the same. The number one choice was Skoal (33.8 percent of 12 to 17 year olds, 36.1 percent of 18 to 25 year olds and 27.1 percent of current smokeless tobacco users aged 26 or older).
To return to the Table of Contents (TOC)
This page was last updated on May 16, 2008. |
|
SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.
* PDF formatted files require that Adobe Acrobat Reader® program is installed on your computer. Click here to download this FREE software now from Adobe. |
