Elsevier

Annals of Epidemiology

Volume 12, Issue 3, April 2002, Pages 141-150
Annals of Epidemiology

Original article
Demographic Differences in Patterns in the Incidence of Smoking Cessation: United States 1950–1990

https://doi.org/10.1016/S1047-2797(01)00266-6Get rights and content

Abstract

PURPOSE: Current measures of successful quitting are insensitive to changes induced by tobacco control activities. We evaluated whether changes in the incidence of successful quitting, a new measure of cessation, can inform policy makers how population subgroups responded.

METHODS: Smokers from National Health Interview Surveys (NHIS) (1965 through 1992, n = 140,199) were used to determine the number of current smokers eligible to quit at the beginning of each year from 1950 through 1990. Incidence of quitting, computed for different demographic subgroups, was the ratio of those newly successfully quit each year to those eligible to quit.

RESULTS: Overall, incidence increased over fivefold, from < 1% in 1950 to a still low 5% in 1990. When the health risks of smoking were first disseminated, middle-aged men had the highest quitting incidence. Gender differences in younger smokers occurred following the beginning of the public health campaign of the mid 1960s, as the dangers of smoking to the fetus were documented. Younger adult smokers appeared to increase quitting markedly in the 1970s, around the beginning of the nonsmokers' rights movement. Quitting patterns in middle-aged African Americans were similar to whites, although at much reduced levels. Younger African Americans had low quitting incidence until 1989. Incidence differed by educational attainment; regardless of age, during the 1970s and 1980s, those with some college increased their quitting incidence markedly.

CONCLUSION: Incidence of quitting is a sensitive indicator of relatively short-term changes in successful quitting in population subgroups and should facilitate evaluation efforts.

Section snippets

Selected Abbreviations and Acronyms

NHIS = National Health Interview Survey

Data Source

The NHIS, conducted annually by the National Center for Health Statistics, are random cross-sectional surveys of the civilian, noninstitutionalized U.S. population. Periodically since the mid 1960s, a special Tobacco Use Supplement is included yielding sample sizes varying from 10,000 to 80,000 respondents and reported response rates exceeding 85%. The NHIS sampling methods change every decade, and details concerning survey methodology are reported elsewhere 23, 24. Before 1974, surveys

Results

Figure 1 shows the overall incidence of smoking cessation for the entire U.S. population aged 20 through 50 years between 1950 and 1990. Except for 1950, there was little evidence of much quitting activity until 1955, when quitting incidence nearly doubled (significant), but still remained below 1%. Quitting began to increase in the early 1960s; it peaked at 1.8% in 1964, remained high in 1965, but decreased in 1966. In 1967, however, the incidence of smoking cessation increased again, remained

Discussion

From levels generally well under 1%/year in the early 1950s, the incidence of quitting for U.S. smokers increased to just under 5%/year in 1990. Yet the upward trend was not smooth, and there were differences for demographic subgroups of the population.

The early evidence linking smoking to cancer, first published in the 1950s and summarized in the official reports of the early 1960s, was associated with increased quitting, particularly in middle-aged men. Middle-aged and older men were the

Conclusions

The patterns in the incidence of quitting documented in this article point to considerable success for the public health smoking prevention campaigns of the 1970s and 1980s, but an overall annual quitting incidence of 5% for 1990 is still very low. Incidence of quitting appears to be a fairly sensitive indicator of relatively short-term changes in quitting in population subgroups, suggesting that this measure should facilitate evaluation of future tobacco control efforts.

Acknowledgements

Preparation of this article was supported by the Cancer Prevention Research Unit Grant No. CA72092, funded by the National Cancer Institute, National Institutes of Health.

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