Trends in Cigarette Smoking in the United States

doi:10.1006/pmed.1997.0191

Preventive Medicine

Volume 26, Issue 4, July 1997, Pages 447-450

https://doi.org/10.1006/pmed.1997.0191 Get rights and content

Abstract

Cigarette smoking in the United States increased rapidly in the 1930s and 1940s. In the 1950s the first reports of the health effects of cigarette smoking appeared and the increases in tobacco consumption were slowed down by a number of reports. Starting in 1973 cigarette consumption per capita decreased steadily. In 1994, it was at the same level as in 1942. Cigarette smoking prevalence reaches a peak between ages 20 and 40 among both males and females and then decreases. Smoking prevalence is higher among males than among females and higher among blacks than among whites. The differences by level of education are the greatest. By 1993 only 25% of Americans over the age of 18 were currently smoking.

References (28)

B, K, Milmore, A, G, Conover, 1956, Tobacco consumption in the United States 1880–1955 [addendum in: Tobacco smoking...
1962, Tobacco situation, U.S. Department of Agriculture, Economic Research Service,...
1994, Federal Trade Commission report to Congress for 1992: pursuant to the Federal Cigarette Labeling and Advertising...
R Doll et al.
A study of the aetiology of carcinoma of the lung
Br Med J
(1952)
EL Wynder et al.
Tobacco smoking as a possible etiologic factor in bronchogenic carcinoma
JAMA
(1950)
EC Hammond et al.
The relationship between human smoking habits and death rates: a follow-up of 187,766 men
JAMA
(1954)
R Doll et al.
The mortality of doctors in relation to their smoking habits: a preliminary report
Br Med J
(1954)
1964, Surgeon General's Advisory Committee on Smoking and Health. Smoking and health—report, U.S. Department of Health,...
T Hirayama
Nonsmoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan
Br Med J
(1981)
D Trichopoulos et al.
Lung cancer and passive smoking
Int J Cancer
(1981)

D Burns et al.

Tobacco use in California 1990–1991

(1992)

DM Shelton et al.

State laws on tobacco control—United States 1995

MMWR

(1995)

U.S. Department of Health and Human Services, U.S. Environmental Protection Agency, 1993, Respiratory effects of...

Cited by (91)

Cancer mortality in Germany-born Americans and Germans
2024, Cancer Epidemiology
Comparing cancer mortality and associated risk factors among immigrant populations in a host country to those in their country of origin reveals disparities in cancer risk, access to care, diagnosis, and disease management. This study compares cancer mortality between the German resident population and Germany-born individuals who migrated to the US.
Cancer mortality data from 2008–2018 were derived for Germans from the World Health Organization database and for Germany-born Americans resident in four states (California, Florida, Massachusetts, and New York) from respective Departments of Vital Statistics. We calculated age-standardized mortality rates (ASMRs) using the European standard population and standardized mortality ratios (SMR) compared to the German resident population along with 95% confidence intervals (CIs).
Germany-born American males had lower ASMRs (253.8 per 100,000) than German resident population (325.6 per 100,000). The difference in females was modest, with ASMRs of 200.7 and 203.7 per 100,000, respectively. For all cancers, Germany-born American males had an SMR of 0.72 (95% CI: 0.70–0.74) and females 0.98 (95% CI: 0.95–1.00). Male SMRs among Germany-born Americans were significantly below one for oral cavity, stomach, colorectal, liver, lung, prostate, and kidney cancer. Among females, SMRs were below one for oral cavity, stomach, colorectal, gallbladder, breast, cervix uteri, and kidney cancer. For both sexes, SMRs were over one for bladder cancer (1.14 for males, 1.21 for females). Mortality was higher for lung cancer (SMR: 1.68), non-Hodgkin’s lymphoma (1.18) and uterine cancer (1.22) among Germany-born American females compared to the German resident population.
Germany-born American males but not females showed lower cancer mortality than German resident population. Disparities may stem from variations in risk factors (e.g., smoking and alcohol use) as well as differences in screening practices and participation, cancer treatment, besides some residual potential "healthy immigrant effect".
The rising tide of early-onset colorectal cancer: a comprehensive review of epidemiology, clinical features, biology, risk factors, prevention, and early detection
2022, The Lancet Gastroenterology and Hepatology
Citation Excerpt :
Regional variations in early-onset colorectal cancer, such as the higher rates observed in the southern and Appalachian USA29 and decreasing incidence observed in Italy,20,21 might be potentially reflective of differences in diet and lifestyle causing differential burden of medical co-morbidities (such as diabetes and obesity), and the possibility of water supply or ambient exposures.96–98 Although Jung and colleagues reported smoking as a risk factor for early-onset colorectal neoplasia,82 it is unclear whether this factor is causative for early-onset colorectal cancer, given the long induction period for colorectal carcinogenesis, the overall decreasing smoking rates among young individuals in countries where early-onset colorectal cancer incidence is rising,99,100 and conflicting findings about smoking as a risk factor for early-onset colorectal cancer in other studies.86,101 Ongoing research is needed to understand the complex interplay of how these exposures modulate colorectal cancer risk over the lifecourse.
The incidence of early-onset colorectal cnacer—ie, colorectal cancer diagnosed in patients under the age of 50 years— has been increasing around the world. This Series paper provides a comprehensive review on the topic of early-onset colorectal cancer, including examining the epidemiology of early-onset colorectal cancer around the world, clinical and pathological features, genetic and epigenetic landscapes, and emerging data on the clinical risk factors associated with this malignancy. Evidence-based approaches to prevention and early detection are also presented.
Nicotine dependence and psychiatric and substance use disorder comorbidities among American Indians/Alaska Natives: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions
2014, Drug and Alcohol Dependence
Citation Excerpt :
Our findings reinforce analyses drawn from the NESARC comparing gender and race, in which men had higher prevalence of rates of (current) nicotine dependence rates across all ethnic groups (Falk et al., 2006). However, our results contrast with longitudinal studies of tobacco use by age cohorts which have pointed to a “closing of the gap” between differences in nicotine dependence rates for men and women, particularly for younger cohorts who were intentionally oversampled in the NESARC (Breslau et al., 2001; Garfinkel, 1997). Further studies are suggested which analyze gender specific nicotine use behaviors among AI/ANs.
American Indians and Alaska Natives (AI/ANs) have high rates of tobacco use compared to the general population. AI/ANs also have elevated rates of psychiatric and substance use disorders associated with nicotine dependence. However, very few studies have examined the comorbidity between nicotine dependence and psychiatric and substance use disorders within this population.
This study analyzes the comorbidity of lifetime nicotine dependence with both current and lifetime psychiatric disorders and substance use disorders in a nationally representative sample of 701 AI/AN women and men.
Using 95% confidence interval testing, lifetime nicotine dependence (29.5%) was associated with all main diagnostic categories (any mood disorder, any anxiety disorder, any personality disorder, any alcohol use disorder, and any drug use disorder) both at the lifetime level and current (12-month) level. Of the lifetime disorders, the strongest associations were with psychosis and drug dependence. For (current) 12-month disorders, the strongest associations were with alcohol dependence and drug dependence. Differences were noted between genders regarding personality disorders.
Culturally appropriate tobacco screening, prevention, and treatment curricula for adult AI/ANs with dual diagnoses are recommended. Understanding historically based factors that may contribute to psychiatric illness and substance use disorders may assist in more effective nicotine treatments for AI/ANs.
Understanding the links between education and smoking
2014, Social Science Research
This study extends the theoretical and empirical literature on the relationship between education and smoking by focusing on the life course links between experiences from adolescence and health outcomes in adulthood. Differences in smoking by completed education are apparent at ages 12–18, long before that education is acquired. I use characteristics from the teenage years, including social networks, future expectations, and school experiences measured before the start of smoking regularly to predict smoking in adulthood. Results show that school policies, peers, and youths’ mortality expectations predict smoking in adulthood but that college aspirations and analytical skills do not. I also show that smoking status at age 16 predicts both completed education and adult smoking, controlling for an extensive set of covariates. Overall, educational inequalities in smoking are better understood as a bundling of advantageous statuses that develops in childhood, rather than the effect of education producing better health.
Educational inequalities in smoking: The role of initiation versus quitting
2013, Social Science and Medicine
Citation Excerpt :
A large and multidisciplinary literature has examined trends in these educational inequalities in smoking. The existing literature has focused nearly entirely on differences in current smoking and quitting by education (Escobedo & Peddicord, 1996; Fiore et al., 1989; Garfinkle, 1997; Gilpin & Pierce, 2002; Pampel, 2005, 2009; Pierce et al., 1989; Reid, Hammond, Boudreau, Fong, & Siahpush, 2010; Sander, 1995a, 1995b; Smith & Fiore, 1999; de Walque, 2007, 2010). Very few studies, however, have examined the role of never smoking (initiation) in explaining educational gradients in adult smoking (Fiore et al., 1989; Pierce et al., 1989).
The existing literature on educational inequalities in adult smoking has focused extensively on differences in current smoking and quitting, rather than on differences in never smoking regularly (initiation) by education in the adult population. Knowing the relative contribution of initiation versus quitting is critical for understanding the mechanisms that produce educational gradients in smoking because initiation and quitting occur at different points in the life course. Using data from 31 waves of the U.S. National Health Interview Survey (N = 587,174), the analyses show the relative likelihood of being a never versus former smoker by education, sex, and age from 1966 to 2010 and for birth cohorts from 1920 to 1979. The analyses also describe differences in the cumulative probability of quitting over the life course, and the role of initiation versus quitting in producing educational gaps in smoking. The results show that educational gaps in never smoking explain the bulk of the educational inequality in adult smoking. Differences in former smoking play a small and decreasing role in producing these gaps. This is true across the life course, whether measured at age 25 or age 50, and for both men and women. While the prevalence and age patterns of former smoking by education converge across birth cohorts, differences in never smoking by education increase dramatically. At the population level, educational gaps in adult smoking are produced by the combination of inequalities in initiation and quitting, with differences in initiation playing a larger role in producing the observed gaps. The portion of the gap explained by differences in quitting is itself a function of educational differences in initiation. Thus, educational gradients in adult smoking are tethered to experiences in adolescence. These findings have important implications for both understanding and addressing disparities in this important health behavior.
The Gender-Specific Aspects of Lung Cancer
2010, Principles of Gender-Specific Medicine
Cigarette smoking remains the leading cause of lung cancer death and of cancer death in women of the world. While it is not yet clear if women are more susceptible to lung cancer, current evidence does suggest that women with lung cancer have an improved prognosis compared to men with similar cigarette smoke exposure. Potential explanations for observed gender disparities in lung cancer include environmental exposures, molecular genetic factors, and hormonal differences. The gap between male and female smoking prevalence is narrowing and we are likely to see the incidence and death rates from lung cancer in women begin to approach those in men. As research continues to be directed towards understanding gender-specific aspects of lung cancer susceptibility and prognosis, advocacy for public policy initiatives will help prevent and reduce smoking prevalence in girls and women. Exposure to environmental pollutants can be remediated, which is a strategy that may be helpful in lowering the incidence of lung cancer in never-smoking women in developing countries.

View all citing articles on Scopus

^☆: D, BurnsL, GarfinkelJ, M, Samet, editors

¹: Fax: (212) 719-0193.

View full text

Regular ArticleTrends in Cigarette Smoking in the United States☆

Abstract

A study of the aetiology of carcinoma of the lung

Br Med J

Tobacco smoking as a possible etiologic factor in bronchogenic carcinoma

JAMA

The relationship between human smoking habits and death rates: a follow-up of 187,766 men

JAMA

The mortality of doctors in relation to their smoking habits: a preliminary report

Br Med J

Nonsmoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan

Br Med J

Lung cancer and passive smoking

Int J Cancer

Tobacco use in California 1990–1991

State laws on tobacco control—United States 1995

MMWR

Regular Article
Trends in Cigarette Smoking in the United States☆