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Trends in Cigarette Smoking Cessation in the United States

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Trends in Cigarette Smoking Cessation in the United States Tobacco Control 1993; 2 (suppl): S3-S16 S3 SESSION I TRENDS IN CESSATION Tob Control: first published as 10.1136/tc.2.suppl1.S4 on 1 January 1993. Downloaded from Introduction Saul Shiftman I'm happy to welcome you here on behalf of of the National Heart, Lung and Blood the Planning Committee. It's a pleasure to see Institute's Smoking Education Program, this actually happening after almost a year of whose job it is to translate findings from planning, and I'm looking forward to the next intervention research into community action day and a half. and education programmes; he was formerly We have 2454 days left until the year 2000, the director of smoking intervention with the at which point the national goals are to have a American Heart Association. smoking prevalence of 15%. We're now at Dr Ellen Gritz is a long-time colleague of roughly 25 %. Put another way, we are 81 % of mine, although I hesitate to remind her in the way to the year 2000 from 1964, the year of public that she and I first started working the first Surgeon General's report, and we together a little over 20 years ago in Los have cut smoking prevalence roughly by half. Angeles. She is certainly one of the leading So we're doing pretty well but still have a bit experts in smoking and smoking cessation, and further to go. has particular interests in smoking among In this morning's panel, we'll be discussing women and in special populations. where we're going and how we're going to get Our last panellist, Dr Patrick O'Malley is there in terms of smoking cessation. Pro Senior Study Director at the University of cedural^, this panel and the panels that follow Michigan's Institute for Social Research, and will have a principal speaker, in this case Dr he is a co-director of a very well-known study Gary Giovino, who will give a talk of about 20 called Monitoring the Future, which is a minutes, and we'll then follow that with continuing study of the lifestyles and values of comments from a group of panellists, about American youth with quite a bit of focus on five minutes each, followed by an opportunity smoking and drug use. for open discussion between you and the panel, And finally our speaker, Dr Gary Giovino, http://tobaccocontrol.bmj.com/ and between you and the speaker. Let me now got his start in psychology as an undergrad introduce the panellists and Dr Giovino. uate, was involved subsequently in clinical Dr Dileep Bal is currently the Chief of treatment of smoking and smoking cessation, Chronic Diseases Control for the State of graduated from psychology to epidemiology, California Department of Health Services. Dr where he got his degree, and is currently the Bal has a hand in administering the monies chief of epidemiology at the Office on Smoking generated by Proposition 99, which is a 25 cent and Health, and he's been involved in projects sales tax on cigarettes, which generates about a too numerous and varied to mention on hundred million dollars a year for smoking smoking and smoking cessation. Dr Giovino research and control activities. will be talking on trends in smoking cessation. Mr Glen Bennett is currently Coordinator on October 1, 2021 by guest. Protected copyright. Smoking Research Group, University of Trends in cigarette smoking cessation in the Pittsburgh, Pittsburgh, United States Pennsylvania, USA S Shif?man Office on Smoking Gary A Giovino*, Dana M Shelton, Michael W Schooley and Health, MS K-50 National Center for Chronic Disease Prevention and Health Promotion, My job today is to update you on trends in Cigarette smoking kills more than 400 000 Centers for Disease Control and cigarette smoking, and, more importantly, Americans annually.2 It is the single most Prevention smoking cessation in the US ; to examine recent important preventable cause of premature Atlanta, Georgia patterns of quitting activity in the nation; and mortality in the US.3 We can reduce this 30333, USA to discuss the issue of the 'hard-core' smoker. GA Giovino annual burden of suffering, as Dr Schelling DM Shelton I will discuss cessation methods and a recent pointed out, by preventing initiation and by MW Schooley report in JAMA by Fiore and colleagues1 on increasing cessation. * Dr Giovino delivered the this topic. I will end my discussion with a look The upcoming report of the Surgeon Gen presentation at the at the opportunities for progress that are eral will focus on preventing the initiation of conference currently available. tobacco use among young people. The 1990 1-2 S4 Giovino, Shelton, Schooley Tob Control: first published as 10.1136/tc.2.suppl1.S4 on 1 January 1993. Downloaded from 1955 1960 1965 1970 1975 1980 1985 1990 Year Source: Current Population Survey, 1955 National Health Interview Survey, 1965,1966,1970,1974,1976,1977,1978, 1979,1980,1983,1985,1987,1988,1990,1991 Figure 1 Trends in cigarette smoking prevalence among persons aged 18 years and older, by sex - United States, 1955-1991 http://tobaccocontrol.bmj.com/ 1965 1970 1975 1980 1985 1990 Year * Percent of ever smokers who are former smokers. Source: National Health Interview Survey, 1965,1966,1970,1974,1976,1977,1978, 1979,1980,1983,1985,1987,1988,1990,1991 on October 1, 2021 by guest. Protected copyright. Figure 2 Trends in quit ratios* among persons aged 18 years and older, by sex - United States, 1965-1991 report of the Surgeon General addressed the attack, stroke, and chronic lung disease. It also health benefits of cessation and stated un has benefits in pregnancy.4 equivocally that smoking cessation represents What is going on in terms of adult preva the single most important step that smokers lence ? We track prevalence in the nation using can take to enhance the length and quality of the National Health Interview Survey. This their lives.4 survey has tracked tobacco use since 1965 and The report demonstrated that smoking cess it has used a fairly standardised method of ation has major and immediate health benefits measuring smoking behaviour.5"7 Many of you for men and women of all ages ; these benefits are aware of a recent MMWR article that apply to persons with and without smoking reported that 1991 was the first year since 1966 related disease. There are benefits in terms of that we didn't see a decline in smoking overall mortality. For example, former prevalence.8 There wasn't an increase, I smokers live longer than do persons who wouldn't interpret it as that, but prevalence continue to smoke. Persons who quit smoking didn't go down. before the age of 50 have half the risk of dying Year 2000 objectives have been established.9 in the next 15 years than do persons who If we project from where we are now in terms continue to smoke. Smoking cessation de of prevalence in the country, we'll attain a creases the risk of lung and other cancers, heart current smoking prevalence of about 19 or Tob Control: first published as 10.1136/tc.2.suppl1.S4 on 1 January 1993. Downloaded from 1965 1970 1975 1980 1985 1990 Year High School Graduate Some College High School Graduate Some College or Less -- Men or More -- Men or Less -- Women or More -- Women Source: National Health Interview Survey, 1965,1966,1970,1974,1976,1977,1978 1979,1980,1983,1985,1987,1988,1990,1991 Figure 3 Trends in cigarette smoking prevalence among persons aged 20-24 years old, by sex and education - United States, 1965-1991 60 50 Blacks ? 40 Whites http://tobaccocontrol.bmj.com/ 0 1965 1970 1975 1980 1985 1990 on October 1, 2021 by guest. Protected copyright. Source: National Health Interview Survey, 1965,1966,1970,1974,1976,1977,1978, 197 9,1980,1983,1985,19 87,1988,1990,1991 Figure 4 Trends in cigarette smoking prevalence among persons aged 18 years and older, by race - United States, 1965-1991 20% by the year 2000 (Centers for Disease 1965 to the late 1970s, and then declined Control and Prevention [CDC], Office on somewhat. Smoking and Health [OSH], unpublished In 1989, investigators used data collected data). from 1974 to 85 and projected that more women Rates of smoking among men and women than men would be smoking by 1995.11 Given have also declined, but the prevalence among what's happened in recent years that's not men has declined more rapidly than the going to happen if current trends continue. If prevalence among women. As shown here, anything, prevalence will be higher among using data from the 1955 Current Population women only after the year 2000. Survey,10 as well as the 1965 through 1991 We're seeing continuing increases in quit National Health Interview Surveys, preva ting. The quit ratio for both men and women lence has consistently declined for men (figure is increasing (figure 2). This ratio is generally 1). The prevalence of smoking among women higher for men than for women, but if we take was higher in 1965 than 1955, fairly level from into account that men who stop smoking S6 Giovino, Shelton, Schooley 60 Tob Control: first published as 10.1136/tc.2.suppl1.S4 on 1 January 1993. Downloaded from 50 Whites U 40 a> M o S CO u 30 o Blacks b # 20 10 1965 1970 1975 1980 1985 1990 Year * Percent of ever smokers who are former smokers. Source: National Health Interview Survey, 1965,1966,1970,1974,1976,1977,1978, 1979,1980,1983,1985,19 87,1988,1990,1991 Figure 5 Trends in quit ratios* among persons aged 18 years and older, by race - United States, 1965-1991 http://tobaccocontrol.bmj.com/ 1965 1970 1975 1980 1985 1990 on October 1, 2021 by guest.
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