4. Tobacco Use
The National Household Survey on Drug Abuse (NHSDA) includes a series of questions asking about the use of several tobacco products, including cigarettes, chewing tobacco, snuff, cigars, and pipe tobacco. For analysis purposes, data for chewing tobacco and snuff are combined and referred to as "smokeless tobacco." Cigarette use is defined as smoking "part or all of a cigarette." Separate questions on smoking specialty cigarettes were introduced in 2001. Specialty cigarettes include bidi and clove cigarettes. Bidis are small, brown cigarettes from India consisting of tobacco wrapped in a leaf and tied with a thread. Clove cigarettes contain both tobacco and clove flavoring. Findings from the 2001 NHSDA are summarized below.
- An estimated 66.5 million Americans reported current use (past month use) of a tobacco product in 2001, a prevalence rate of 29.5 percent for the population aged 12 or older.
- Among that same population, 56.3 million (24.9 percent of the total population aged 12 or older) smoked cigarettes, 12.1 million (5.4 percent) smoked cigars, 7.3 million (3.2 percent) used smokeless tobacco, and 2.3 million (1.0 percent) smoked tobacco in pipes (Figure 4.1). Between 2000 and 2001, the percentage reporting past month cigar smoking increased from 4.8 to 5.4 percent, which was similar to the rate reported in 1999 (5.5 percent). There were no other significant changes in the rates of current use of other tobacco products.
- Young adults aged 18 to 25 continued to report the highest rates of use of tobacco products. Past month use of cigarettes was reported by 39.1 percent of young adults, smokeless tobacco by 5.4 percent, cigars by 10.4 percent, and pipes by 1.3 percent (Figure 4.2).
- Current cigarette smoking rates increased steadily by year of age up to age 21, from 1.7 percent at age 12 to 43.5 percent at age 21. After age 21, rates generally declined, reaching 18.3 percent for persons aged 60 to 64 years and 9.1 percent for persons aged 65 or older. By age group, the prevalence of cigarette use was 13.0 percent among 12 to 17 year olds, 39.1 percent among young adults aged 18 to 25 years, and 24.2 percent among adults aged 26 or older.
- There were no significant changes in rates of the different forms of tobacco products among youths aged 12 to 17 between 2000 and 2001. However, the rate of youth cigarette use in 2001 was slightly below the rate for 2000, continuing a downward trend observed between 1999 and 2000. Rates were 14.9 percent in 1999, 13.4 percent in 2000, and 13.0 percent in 2001 (Figure 4.3).
- Smokeless tobacco use was most prevalent among young adults aged 18 to 25. Past month use of smokeless tobacco was reported by 5.4 percent of young adults in 2001, which was similar to the rates in 1999 (5.7 percent) and 2000 (5.0 percent). Between 1999 and 2001, rates also were stable among youths aged 12 to 17 (2.1 percent in 2001) and among persons aged 26 or older (3.0 percent in 2001).
- Trends in current cigar use varied between 1999 and 2001 among age groups. Among youths aged 12 to 17, the rate in 2001 (4.3 percent) was not significantly different from 2000 (4.5 percent), but continued to be lower than in 1999 (5.4 percent). A similar downward trend appeared among young adults aged 18 to 25 years old: 10.4 percent in 2001 and 2000 and 11.5 percent in 1999. However, among adults aged 26 or older, the rate in 2001 (4.7 percent) was significantly higher than the rate in 2000, reversing the downward trend between 1999 and 2000 (4.5 and 3.9 percent, respectively).
- As in 2000, males were more likely than females to report past month use of any tobacco product. In 2001, 35.6 percent of males aged 12 or older were current users of any tobacco product, a significantly higher proportion than among females (23.8 percent).
- A higher proportion of males aged 12 or older smoked cigarettes than females in 2001 (27.1 vs. 23.0 percent).
- Between 1999 and 2001, the rate of cigarette use among males aged 12 to 17 decreased significantly from 14.8 to 12.4 percent, although the change between 2000 and 2001 was not significant (12.8 to 12.4 percent). A similar pattern was seen among females between 1999 and 2001 (15.0 percent in 1999 to 13.6 percent in 2001; it was 14.1 percent in 2000) (Figure 4.4).
- Based on 2000 and 2001 combined data, 19.8 percent of pregnant women aged 15 to 44 smoked cigarettes in the past month compared with 29.5 percent of nonpregnant women of the same age group.
- American Indians and Alaska Natives were more likely than any other racial/ethnic group to report the use of tobacco products in 2001. For past month use among persons aged 12 or older, 44.9 percent of American Indians/Alaska Natives reported using at least one tobacco product. This rate was not significantly different from the rate of 55.0 percent reported for this group in 2000. The lowest current tobacco use rate in 2001 was observed for Asians (13.6 percent).
- Current cigarette smoking rates among persons aged 12 or older were 38.0 percent among American Indians/Alaska Natives, 31.1 percent among persons reporting more than one race, 27.7 percent among Native Hawaiians or other Pacific Islanders, 26.1 percent among whites, 23.9 percent for blacks, 20.9 percent for Hispanics, and 12.9 percent for Asians.
- Based on 2000 and 2001 combined data, the rates of current cigarette use in the population aged 12 or older varied across Asian and Hispanic subgroups. The rates for Asians during that period were 23.8 percent for Vietnamese, 21.0 percent for Koreans, 17.7 percent for Japanese, 13.1 percent for Filipinos, 11.9 percent for Asian Indians, and 10.2 percent for Chinese. Among Hispanics aged 12 or older, Puerto Ricans had the highest rate of current cigarette use (26.9 percent). Rates were 20.1 percent for Mexicans, 20.4 percent for people whose ancestry was Central or South American, and 19.2 percent for Cubans (Figure 4.5).
- The prevalence of cigarette smoking decreased with increasing levels of education. Among adults aged 18 or older in 2001, college graduates were the least likely to report smoking cigarettes (13.8 percent) compared with 26.7 percent of adults with some college, 32.1 percent of adults with only a high school diploma, and 33.8 percent of adults who lacked a high school diploma.
- Young adults aged 18 to 22 enrolled full time in college in 2001 were less likely to report current cigarette use than their peers not enrolled full time (this category includes part-time college students and persons not enrolled in college). Past month cigarette use was reported by 32.9 percent of full-time college students compared with 44.6 percent of their peers who were not enrolled full time.
- Rates of current cigarette smoking were 40.6 percent for unemployed adults aged 18 or older in 2001 compared with 28.6 percent of full-time employed adults and 25.9 percent of adults working part time.
- Rates of smokeless tobacco use by employment status in 2001 displayed a somewhat different pattern from the rates of cigarette use. The rates of past month smokeless tobacco use among persons aged 18 or older were 4.3 percent for those employed full time, 3.4 percent among unemployed persons, and 1.9 percent among part-time workers.
- Cigarette use rates among persons aged 12 or older varied by region of the country. Past month cigarette use ranged from a low of 21.6 percent for persons living in the Pacific division to 29.4 percent of persons living in the East South Central part of the country.
- Rates of cigarette use among persons aged 12 or older tended to be higher in less densely populated areas. In large metropolitan areas, 22.9 percent smoked in the past month compared with 26.5 percent in small metropolitan areas, 27.3 percent in nonmetropolitan areas, and 28.5 percent in completely rural nonmetropolitan areas. For youths aged 12 to 17 in large metropolitan areas, 11.0 percent smoked in the past month compared with 19.1 percent of youths in completely rural nonmetropolitan areas.
Frequency of Cigarette Use
- Of the 56.3 million past month cigarette smokers, 62.9 percent (35.4 million) reported smoking every day in the past 30 days; this rate was not significantly different from the rate of 64.6 percent in 2000. Among youths aged 12 to 17 who smoked, 33.7 percent were daily smokers (Figure 4.6).
- Although 53.5 percent of all daily smokers aged 12 or older smoked a pack or more of cigarettes a day, 23.0 percent of daily smokers aged 12 to 17 reported doing so.
Association with Illicit Drug and Alcohol Use
- Current (past month) cigarette smokers were more likely to use other tobacco products, alcohol, and illicit drugs than current nonsmokers. Comparing current smokers with current nonsmokers, rates of binge alcohol use were 40.2 versus 14.0 percent, rates of heavy alcohol use were 14.0 versus 3.0 percent, and rates of current (past month) illicit drug use were 18.2 versus 3.3 percent (Figure 4.7).
- The rate of current illicit drug use (18.2 percent) among current smokers was significantly higher than the rate for this group in 2000 (15.6 percent).
Usual Brand of Cigarettes Smoked
- There were notable racial/ethnic differences with regard to brand of cigarettes smoked most often in the past month. In 2001, almost half of white smokers aged 12 or older (44.5 percent) and more than half of Hispanic smokers (59.5 percent) reported smoking Marlboro cigarettes. Among black smokers, 45.2 percent smoked Newport cigarettes.
- Three brands accounted for most of the youth cigarette smoking in 2001. Among current smokers who were 12 to 17 years of age, 55.2 percent reported Marlboro as their usual brand, 22.8 percent reported Newport, and 9.4 percent reported Camel. No other individual cigarette brand was reported by more than 2.5 percent of these youths. The respective dominance of these three brands among youths has remained unchanged since 1999.
- Racial/ethnic differences in usual cigarette brand used also were evident among youth smokers aged 12 to 17. Marlboro was the most frequently cited brand among more than half of white and Hispanic youth smokers (59.8 and 54.7 percent, respectively). Among black youth smokers, Newport was the most frequently cited brand (69.7 percent).
Youth Access to Cigarettes in the Past Month
- The percentage of youth smokers aged 12 to 17 reporting no cigarette purchase in the past month increased from 19.2 percent in 2000 to 25.4 percent in 2001 (Figure 4.8).
- The proportion of past month youth smokers who reported personally buying cigarettes fell from 59.4 to 51.9 percent.
- The proportion of youth smokers who reported buying cigarettes at a store where a clerk handed out cigarettes fell from 33.8 percent in 2000 to 28.5 percent in 2001. This decline was largely attributable to the decline in this method of access observed among older youth smokers aged 14 to 17.
- About three fifths (61.7 percent) of youth smokers aged 12 to 17 reported that friends or relatives bought cigarettes for them at least one time in the past month. Even though this rate was significantly lower than the rate in 2000, this was still the predominant method of cigarette access among youths in 2001.
Specialty Cigarettes (Bidi and Clove Cigarettes)
- In 2001, an estimated 2.8 million persons aged 12 or older (1.3 percent of the population) smoked bidi or clove cigarettes in the past month. An estimated 1.3 million (0.6 percent) smoked bidis, and 1.9 million (0.9 percent) smoked clove cigarettes.
- The rates of past month specialty cigarette use in 2001 were 2.0 percent among persons aged 12 to 17 years, 4.2 percent among persons aged 18 to 25, and 0.7 percent among persons aged 26 or older.
- By Hispanic origin and race, the reported rates of past month smoking of bidi or clove specialty cigarettes ranged from 1.2 percent among non-Hispanic whites to 2.6 percent among American Indians and Alaskan Natives (Figure 4.9).
- Most specialty cigarette smokers in 2001 (75 percent) were currently smoking tobacco cigarettes. Among past month tobacco cigarette smokers, 3.8 percent also used bidi or clove cigarettes, while among persons who were not current cigarette smokers the rate of specialty cigarette use was 0.4 percent.
This page was last updated on June 16, 2008.