Addition of Prevalence of Cigarette Smoking as a Nationally
Notifiable Condition -- June 1996
NOTE: Historical tables may be viewed using the Acrobat version
of the issue.
On June 6, 1996, by a unanimous vote, the Council of State and
Territorial Epidemiologists (CSTE) added prevalence of cigarette
smoking to the list of conditions designated as reportable by
states to CDC. The addition of prevalence of cigarette smoking
marks the first time a behavior, rather than a disease or illness,
has been considered nationally reportable.
Goals of smoking prevalence surveillance identified by CSTE
include monitoring trends in tobacco use, guiding allocation of
tobacco-use prevention resources, and evaluating public health
interventions to reduce smoking. Given these goals, CSTE selected
population sampling as the appropriate surveillance methodology and
designated the Behavioral Risk Factor Surveillance System (BRFSS)
as the preferred data source. CSTE and CDC are developing the
format to regularly present this information in national disease
reporting statistics. The addition of cigarette smoking prevalence
brings to 56 the number of diseases and conditions designated by
CSTE as reportable by states to CDC.
Reported by: Council of State and Territorial Epidemiologists.
Office on Smoking and Health, National Center for Chronic Disease
Prevention and Health Promotion; Div of Surveillance and
Epidemiology, Epidemiology Program Office, CDC.
Editorial Note
Editorial Note: National notifiable disease surveillance has been
critical to the successful campaign against infectious diseases
throughout this century. By agreement among states, CSTE, in
partnership with CDC, determines the list of conditions reportable
to CDC. The addition of prevalence of cigarette smoking to this
list is a historic step in the evolution of the public health
surveillance in the United States.
Although most conditions reportable by states to CDC have been
acute infectious diseases, and surveillance for such diseases
remains a public health priority, the addition of prevalence of
cigarette smoking reflects shifts in morbidity and mortality
patterns in the United States and therefore the need to expand the
range of nationally reportable conditions. Traditionally,
infectious disease reporting has relied on a single methodology --
mandated reporting of all cases. The decision by CSTE to designate
BRFSS as the recommended data source for reporting of this
condition marks a transition to a more flexible system in which
surveillance methods are determined by surveillance goals. Most
importantly, this action underscores the role of tobacco use as the
leading preventable cause of death in the United States and the
need to conduct national public health surveillance for both
conventional disease outcomes and for underlying causes (e.g.,
smoking and other risky behaviors) amenable to public health
intervention (1).
Reference
McGinnis JM, Foege WH. Actual causes of death in the United
States. JAMA 1993; 270:2207-12.
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