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4. Tobacco Use

Tobacco is the second most commonly used substance in the United States next to alcohol. The National Survey on Drug Use and Health (NSDUH) includes a series of questions on the use of several tobacco products, including cigarettes, smokeless tobacco (chewing tobacco and snuff), cigars, and pipe tobacco. This chapter includes State estimates on past month use of tobacco, past month use of cigarettes, and the perceptions of great risk in smoking one or more packs of cigarettes per day.

Most tobacco users are cigarette smokers. Nationally, the use of tobacco and cigarettes in the past month among persons aged 12 or older was 28.0 percent and 23.6 percent, respectively, in 2008-2009 (see Tables B.13 and B.14 in Appendix B). The difference between the two rates (4.4 percentage points) represents persons who did not smoke cigarettes, but who used one or more of the other forms of tobacco (i.e., chewing tobacco, snuff, cigars, or pipe tobacco).

4.1 Tobacco

The State with the highest prevalence rate for tobacco use among persons aged 12 or older was West Virginia (38.4 percent), while Utah had the lowest rate (18.4 percent) (Table B.13). Of the 10 States with the highest rates of past month tobacco use among persons 12 or older, 6 States were in the South region (Alabama, Arkansas, Kentucky, Oklahoma, Tennessee, and West Virginia). Arkansas, Kentucky, West Virginia, and Wyoming ranked in the highest fifth for all three age groups (12 to 17, 18 to 25, and 26 or older) and among persons aged 12 or older (Figures 4.1 to 4.4).

Among the 12 or older age group, decreases in past month tobacco use from 2007-2008 to 2008-2009 were seen in Arizona, Colorado, Florida, Georgia, Minnesota, Ohio, and Rhode Island. Among youths aged 12 to 17, decreases were seen in the Midwest region (from 13.8 to 13.2 percent) the South region (from 12.3 to 11.5 percent), and in Rhode Island (from 12.6 to 10.3 percent). No increases were observed among youths aged 12 to 17 (Table C.13 in Appendix C).

4.2 Cigarettes

Because cigarettes are the main tobacco product, States that ranked high for past month tobacco use also ranked high for past month cigarette use. Of the 10 States in the highest fifth for past month use of tobacco, 8 States also were in the highest fifth for past month cigarette use among persons aged 12 or older (Figures 4.1 and 4.5). Similarly, 9 of the 10 States that were ranked in the lowest fifth among persons 12 or older were the same for both measures. Kentucky had the highest rate of past month cigarette use in the Nation (32.0 percent), and Utah had the lowest rate (16.4 percent) for persons aged 12 or older (Table B.14).

Nationally, the only observed change was a decrease in cigarette use among youths aged 12 to 17 (from 9.5 percent in 2007-2008 to 9.0 percent in 2008-2009) (Table C.14). At the State level, declines in cigarette use from 2007-2008 to 2008-2009 among persons 12 or older were observed in Arizona (from 23.9 to 22.0 percent), Colorado (from 25.1 to 22.3 percent), the District of Columbia (from 27.0 to 24.0 percent), Florida (from 24.0 to 22.7 percent), Ohio (from 28.1 to 26.7 percent), and Rhode Island (from 24.7 to 22.5 percent). Across the 12 to 17, 18 to 25, and 26 or older age groups and across all States, there were 10 declines in cigarette use between 2007-2008 and 2008-2009 (3 States among persons aged 12 to 17, 5 States among persons aged 18 to 25, and 2 States among persons aged 26 or older). The only increase occurred in Massachusetts among young adults aged 18 to 25 (from 31.4 to 34.6 percent).

4.3 Perceptions of Risk of Heavy Cigarette Use

States with high prevalence rates for cigarette use tended to have low rates of perceived great risk of heavy cigarette use (i.e., smoking one or more packs a day). Five States (Alabama, Indiana, Kentucky, Tennessee, and West Virginia) that ranked in the lowest fifth for perceptions of great risk of smoking one or more packs of cigarettes a day also were ranked in the highest fifth for past month cigarette use among persons aged 12 or older (Figures 4.5 and 4.9). Kentucky had the lowest rate of perception of great risk for heavy cigarette use (62.1 percent), and New York had the highest rate (77.9 percent) among persons aged 12 or older (Table B.15).

Nationwide, the rates of perception of great risk of smoking one or more packs of cigarettes a day decreased from 2007-2008 to 2008-2009 among persons aged 12 or older (from 73.7 to 72.3 percent), youths aged 12 to 17 (from 69.3 to 67.7 percent), young adults aged 18 to 25 (from 69.8 to 66.9 percent), and persons aged 26 or older (from 75.0 to 73.9 percent) (Table C.15). Decreases also were observed in all four census regions among youths aged 12 to 17, young adults aged 18 to 25, and among the 12 or older age group. At the State level, there were 54 decreases in the perception of risk of heavy cigarette use across three age groups (12 to 17: 14 States with decreases; 18 to 25: 31 States with decreases; and 26 or older: 9 States with decreases). No increases occurred in any State or age group. This is an indication that there has been an increase across many States in the number of persons who do not think there is great risk in people harming themselves physically or in other ways by smoking one or more packs of cigarettes a day.

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Figure 4.1 Tobacco Product Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.1

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.2 Tobacco Product Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.2

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.3 Tobacco Product Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.3

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.4 Tobacco Product Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.4

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.5 Cigarette Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.5

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.6 Cigarette Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.6

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.7 Cigarette Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.7

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.8 Cigarette Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.8

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.9 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.9

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.10 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.10

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 4.11 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.11

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

Below is a map; click here for the text describing this map.

Figure 4.12 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 4.12

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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