Cigarette Smoking—United States, 2006–2008 and 2009–2010

Supplements / November 22, 2013 / Vol. 62 / No. 3

MMWR Introduction

This report on cigarette smoking and the analysis is part of the CDC Health Disparities and Inequalities Report (CHDIR). To assess the change in smoking prevalence by disparities and selected characteristics during 2006–2008 and 2009–2010, CDC analyzed aggregated data from the National Survey on Drug Use and Health (NSDUH), which is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and provides annual data on alcohol, tobacco, and illegal drug use among the noninstitutionalized US household population aged ≥12 years.

Prevalence of smoking is highest for people aged ≥18 years who do not have a high school diploma. Assessing and reporting the prevalence of smoking among young people aged <18 years who drop out of school is critical because this is the period when problems with academic achievement occur. The findings in this report indicate that during 2009–2010, approximately half of young people who dropped out of school were smokers. To reduce tobacco-related disparities, these findings underscore the need to address tobacco use early in the life span, particularly among school-aged adolescents, who might be more vulnerable. Putting into action key effective strategies known to prevent and reduce tobacco use among young people is needed, including reducing tobacco industry influences towards minors, particularly those in low socioeconomic status (SES) communities.

Among adults, smoking prevalence was 34.6% for those who did not graduate from high school compared with 13.2% among those with a college degree. From 2006–2008 to 2009–2010, smoking declined from 44.7% to 40.9% among adults who were unemployed. Among racial and ethnic groups, smoking prevalence was lowest among black and Asian adolescents aged 12–17 years during both survey cycles. Although smoking prevalence remained highest among American Indian and Alaska Native youths and adults, smoking declined from 17.2% to 13.6% in young people and from 42.2% to 34.4% in adults.

To make progress toward reducing the persistent higher prevalence of smoking among low-SES populations, current tobacco-control interventions should be targeted toward these more vulnerable smokers. Educating the public about the harms of tobacco use through mass media campaigns is an effective strategy for raising awareness and decreasing smoking prevalence in the general population. Advertisements that are that are emotionally provocative and contain personal testimonies are especially effective in reaching low-SES populations. CDC recently put into action its first paid national media campaign to encourage smokers to quit. Mass media campaigns can be most effective in reaching all populations when they are part of a comprehensive tobacco-control program that includes comprehensive smoke-free policies that make all indoor public places 100% smoke-free, increase tobacco price, counter tobacco industry marketing activities, and increase the availability and accessibility of evidence-based cessation services.