Tobacco Use by Adults -- United States, 1987

The 1987 National Health Interview Survey of Cancer Epidemiology and Control (NHIS-CEC) collected information on smoking and other tobacco-use practices from a representative sample of adults in households throughout the United States (1,2). Approximately 44,000 persons greater than or equal to 18 years of age answered questions related to their use of cigarettes, chewing tobacco, snuff, pipes, and cigars. In addition to smoking and other tobacco use, the NHIS-CEC contained questions on a wide range of other factors related to cancer (e.g., dietary practices, cancer screening, occupational exposures, family history of cancer, and alcohol consumption).

In 1987, approximately 33% of U.S. adults regularly used some form of tobacco--38.9% of men and 27.2% of women (1). Most of these persons used only cigarettes, although 4.7% of men and 0.8% of women used cigarettes in combination with some other form of tobacco.Cigarette Smoking

Overall, 28.8% of adults smoked cigarettes--31.2% of men and 26.5% of women (Table 1). Smoking was most prevalent among persons 25-44 years of age (33.2%) and least prevalent among those greater than or equal to 75 years of age (8.9%). Among men, blacks were more likely to smoke (39.0%) than whites (30.5%). In contrast, rates for black (26.7%) and white (28.0%) women were similar.

Separated and divorced persons were more likely to be smokers than were married persons: 45.1% of separated divided by ivorced men smoked compared with 28.7% of married men, and 38.9% of separated divided by ivorced women smoked compared with 24.2% of married women.* Widowed (19.5%) and never-married (24.9%) persons were less likely to smoke than married persons (26.4%).Smokeless Tobacco

Four percent of men chewed tobacco and 3.1% used snuff (Table 2); 6.1% of men used one or both of these forms of tobacco. Of men 18-24 years of age, 8.9% reported using either chewing tobacco or snuff or both, compared with 5.3% of men 25-64 years of age. Smokeless tobacco use was also higher in men greater than or equal to 75 years (7.9%). Use of smokeless tobacco among women was rare: 0.3% of women used chewing tobacco and 0.5% used snuff.Pipes and Cigars

In 1987, 3.4% and 5.3% of men smoked pipes and cigars, respectively (Table 2). Men greater than or equal to 45 years were more likely to smoke pipes. Cigar smoking was most common among men aged 45-64 years (7.0%). Only 1.6% of men less than 25 years of age smoked cigars. The prevalences of pipe and cigar smoking among women were less than or equal to 0.1%.Cigarette Smoking and Alcohol Consumption

Persons who smoked cigarettes were more likely to drink beer frequently (five times or more per week)--10.7% compared with 8.5% of former smokers and 3.0% of never smokers. For all beverage types (i.e., beer, wine, and liquor), smokers were more likely to consume largerquantities of alcohol (three drinks or more per occasion) than were nonsmokers. Reported by: GM Boyd, PhD, National Cancer Institute, National Institutes of Health. Div of Health Interview Statistics, National Center for Health Statistics; Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: The 1987 NHIS-CEC data show that the prevalence of cigarette smoking continues to decline in the United States. NHIS data have shown a consistent decline in cigarette smoking among adults during the past quarter century of approximately 0.50 percentage points per year. The rate of annual decline has been higher among men (0.84 percentage points) than among women (0.21 percentage points) (3).

Despite these declines, cigarette smoking remains the most important preventable cause of death in our society. Smoking is responsible for an estimated 390,000 deaths annually--more than one of every six deaths in the United States. Based on the current rate of decline, the United States will not achieve the 1990 national health objectives for smoking prevalence among adults ( less than 25%) (4,5). However, state-specific projections indicate that seven states will achieve this goal (6).

To achieve health objectives directed against smoking (7), efforts to curb the use of tobacco must be intensified. Important strategies include education in schools about the negative health consequences of smoking; cessation programs in worksites, health-care facilities, and other community settings; mass-media campaigns; economic incentives that encourage nonsmoking; tobacco advertising restrictions; clean indoor air policies; and policies that restrict children's access to tobacco products. Interventions should target groups at high risk of smoking and smoking-related diseases, including minorities, pregnant women, blue-collar workers, and heavy smokers.

References

1. NCHS, Schoenborn CA, Boyd GM. Smoking and other tobacco use: United States, 1987. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no. (PHS)89-1597. (Vital and health statistics; series 10, no. 169).

2. NCHS, Schoenborn CA, Marano M. Current estimates from the National Health Interview Survey: United States, 1987. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, 1988; DHHS publication no. (PHS)88-1594. (Vital and health statistics; series 10, no. 166).

3. CDC. Reducing the health consequences of smoking: 25 years of progress--a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no. (CDC)89-8411.

4. Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM. Trends in cigarette smoking in the United States: projections to the year 2000. JAMA 1989;261:61-5.

5. Public Health Service. Promoting health/preventing disease: objectives for the nation. Wash ington, DC: US Department of Health and Human Services, Public Health Service, 1980.

6. Remington PL, Novotny TE, Williamson DF, Anda RF. State-specific progress toward the 1990 objective for the nation for cigarette smoking prevalence. Am J Public Health 1989;79:1416-9.

7. CDC. Year 2000 national health objectives. MMWR 1989;38:629-33. *Age-adjusted to the 1980 U.S. population.

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