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Cancer Trends Progress Report – 2007 Update

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Age at Smoking Initiation
Youth Smoking
Adult Smoking
Quitting Smoking
Health Professionals’ Advice to Quit Smoking
Secondhand Smoke
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Alcohol Consumption
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Adult Smoking
Prevention: Behavioral Factors

Cigarette smoking by adults has slowly fallen since 1991 with a more accelerated rate reduction for women. However, overall prevalence has not declined since 2004. Among 18–24-year-olds, men have shown non-significant changes, while, for young adult women, there are indications of both an early rising trend over the 1990s and a later falling trend.

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Smoking and Cancer

Cigarette smoking is the most preventable cause of death in the United States . It causes approximately 30 percent (167,895) of all U.S. cancer deaths each year.

Cigarette smoking also causes cancers of the lung, larynx, mouth, esophagus, pharynx, and bladder. In addition, it plays a role in acute myeloid leukemia and cancers of the pancreas, kidney, cervix, stomach, and liver.

Cigar smoking has been found to cause cancers of the larynx, oral cavity (lip, tongue, mouth, and throat), esophagus, lung, pancreas, stomach, and bladder.

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Percentage of adults who were current cigarette smokers: Adults aged 18 and older who reported smoking 100 or more cigarettes in their lifetimes and who, at the time of the interview, continued to smoke every day or some days.

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Period – 1991–2006

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Trends – Long term trend falling for both men and women aged 18 and older with more recent accelerated reduction for women during 2000–2006 in contrast to men, who had a more gradual trend downward over most of the period. However, there has not been a significant overall change in smoking prevalence since 2004.

Falling for ages 25 and older when both genders are combined, similar to the trends for ages 18 and older, both genders combined. In contrast to this is the nonsignificant increase during 1991–1997 and falling during 1997–2006 for young adults 18–24, both genders combined. Unlike the similar patterns for both men and women 25 and older, men and women 18–24 have different patterns. Men 18–24 show a non-significant rising trend over most of the 1990s and a second non-significant trend downward from 1997–2006, while women of the same age show a significant rising trend until 1999 and a significant falling trend from 1999–2006.

Current cigarette smoking among Hispanics, which tends to be lower than both White (non-Hispanic) and Black (non-Hispanic) rates, appeared to show a steeper falling trend than the White (non-Hispanic) trend. The Black (non-Hispanic) pattern shows a falling trend over 1991–2004 and a non-significant change upward between 2004–2006. It will be important to observe whether the recent Black (non-Hispanic) pattern represents a real turning point or just an anomaly.

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Most Recent Estimates

In 2006, 20.8 percent of adults—23.5 percent of men and 18.1 percent of women—were current cigarette smokers. Among 18–24-year-olds, 23.8 percent of young adults—28.5 percent of young men and 19.1 percent of young women—were current cigarette smokers.

In 2005, 2.2 percent of adults—4.2 percent of men and 0.3 percent of women—were current cigar smokers, an increase from earlier in the previous decade (1992). Current cigar smokers have had at least 50 cigars in their lifetimes and, at the time of the interview, continued to smoke every day or some days.

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Healthy People 2010 Targets

Reduce to 12 percent the proportion of adult current cigarette smokers.

Reduce to 1.2 percent the proportion of adult current cigar smokers.

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Groups at High Risk for Smoking

Men are more likely than women to smoke cigarettes. American Indian/Alaska Natives smoke more than White Non-Hispanics and Black Non-Hispanics, who in turn smoke more than Hispanics and Asians.

High-risk groups include American Indian/Alaska Natives and people living below the poverty level who also, typically, are those without health insurance and those with less education than a bachelor's degree.

In 2005, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that 6.9 percent of Blacks, 6 percent of Whites, 4.6 percent of Hispanics, 10.9 percent of American Indian/Alaska Natives, and 1.8 percent of Asian American adults were current cigar smokers, based on any use in the past 30 days.

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Key Issues

Although the rate of smoking has dropped by nearly half since the Surgeon General's first report on smoking in 1964 (42 percent of adults were current smokers in 1965), progress has slowed over the recent decade. Further decreases in tobacco use could vastly improve the public's health.

Concurrent with the decrease in adolescent cigarette smoking since 1997 and general decreases in adult smoking, the tobacco industry has increased its tobacco promotion and advertising, targeting young adults who are price- and brand-sensitive consumers. Among adults 18 and older, the youngest group—18–24-year-olds—has the highest smoking prevalence of any older age group. Another recent phenomenon is the emergence of young adult use of tobacco-filled water pipes, especially at specialty cafes in close proximity to college campuses.

In 2005, cigar sales in the United States rose to 5.1 billion cigars, representing a 3-percent increase from the previous year and generating more than $2.9 billion in retail sales. The production of little cigars went from 1.5 billion in 1997 to about 4.7 billion in 2005. Cigar smoking continues to be a popular trend in the United States where a "cigar culture" is supported by cigar magazines, shops, and bars or clubs, especially among young and middle-aged White men (aged 18 – 44) with higher than average incomes and education.

With declining sales of cigarette products as a result of declining cigarette prevalence, the tobacco industry has increased its interest in and marketing of smokeless tobacco products (oral, chewing, snuff, and spit tobacco). This recent marketing includes existing smokeless products as well as test marketing of new smokeless products. While smokeless tobacco products are less lethal than cigarettes, they are not a safe substitute for tobacco smoking. They can cause cancer of the mouth and pancreas and several other health problems. In addition, these products have not been proven to be effective in helping smokers quit, and smokers who delay or defer quitting altogether by supplementing smoking with smokeless products greatly increase their risk of lung cancer.

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Additional Information on Adult Smoking

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