National Cancer Institute  U.S. National Institutes of Health

Cancer Trends Progress Report – 2009/2010 Update

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In the Report
Summary Tables
Age at Smoking Initiation
Youth Smoking
> Adult Smoking
Quitting Smoking
Clinicians’ Advice to Quit Smoking
Medicaid Coverage of Tobacco Dependence Treatments
Fruit and Vegetable Consumption
Red Meat Consumption
Fat Consumption
Alcohol Consumption
Physical Activity
Sun Protection
Secondhand Smoke
Tobacco Company Marketing Expenditures
Early Detection
Life After Cancer
End of Life

Adult Smoking
Prevention: Behavioral Factors

Adult cigarette smoking has slowly fallen since 1991. While the percentage of current male smokers has constantly trended downward, the percentage of current female smokers has shown a slower downward trend over the first half of the period 1991–2008, followed by an accelerated decline from 2000 to 2006. Among 18–24-year-olds, there was a rise followed by a fall in smoking prevalence.

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Smoking and Cancer

Cigarette smoking is the leading preventable cause of death in the United States. It causes approximately 30 percent of all U.S. cancer deaths each year (more than 168,000 estimated deaths in 2009).

Cigarette smoking causes cancers of the lung, larynx, mouth, esophagus, pharynx, bladder, pancreas, kidney, cervix, stomach, and acute myeloid leukemia.

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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 – 1991–2008

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Trends –Long-term trend falling for both men and women aged 18 years and older. There is a more accelerated reduction in smoking among women from 2000 to 2006 in contrast to men, who had a more gradual trend downward from 1991 to 2008. The most recent data point (2008) is higher than the 2007 point for both males and females; however, the change in prevalence is only significant for females. Among 18–24-year-olds, smoking trends rose and then fell. The decline among women began in 1999, approximately 2 years later than among men. In contrast, men and women 25 years of age and older showed a steady fall over the entire time period.

Current cigarette smoking rates among Hispanics, which tend to be lower than both non-Hispanic White and non-Hispanic Black rates, fell more steeply than those for non-Hispanic Whites. The prevalence among non-Hispanic Blacks fell at the same rate as that for Hispanics.

Among adults 25 years of age and older, smoking rates declined significantly for all three levels of education. However, the rates for those with only a high school education declined the least when compared to rates for those with less than or greater than a high school education. Those above and below 200 percent of the poverty level experienced a similar falling trend.

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Most Recent Estimates

In 2008, 20.6 percent of adults aged 18 and older—22.8 percent of men and 18.5 percent of women—were current cigarette smokers. Cigarette smoking prevalence was 22.6 percent for non-Hispanic Whites, 20.8 percent for non-Hispanic Blacks, and 14.9 percent for Hispanics.

Among 18–24-year-olds, 21.4 percent—23.7 percent of men and 19.0 percent of women—were current cigarette smokers. Among adults 25 years of age and older, 20.5 percent smoked cigarettes—22.6 percent of men and 18.4 percent of women.

In 2008, 29.7 percent of adults aged 25 and older with less than a high school education and 28.1 percent with a high school education smoked cigarettes. Those with greater than a high school education smoked at the lowest level (15.1 percent) among the three education groups.

Among adults living below 200 percent of the federal poverty level, 28.6 percent smoked cigarettes, while among those living at or above 200 percent of the federal poverty level, 17.5 percent smoked cigarettes.

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Healthy People 2010 Targets

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

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Groups at High Risk for Smoking

Men are more likely than women to smoke cigarettes. American Indian/Alaska Natives are more likely to smoke cigarettes than non-Hispanic Whites and non-Hispanic Blacks, who in turn are more likely to smoke cigarettes than Hispanics and Asians.

Persons living at or below 200 percent of the poverty level are also at higher risk of smoking.

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Key Issues

Although the rate of smoking has dropped by 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 past few years, especially for women. It appears that only a few subgroups will reach the Healthy People 2010 goal of 12 percent or fewer smokers. Thus far, Hispanic and non-Hispanic Asian women, those 65 years of age and older, and those with an undergraduate degree or higher level of education have reached the Healthy People 2010 goal. In addition, in 2009, no state funded tobacco control programs were at the level recommended by the Centers for Disease Control and Prevention (CDC). 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 aged 18 years and older, those aged 18–24 have the highest smoking prevalence in most years. Another recent phenomenon is the emergence of young adult use of water pipes to smoke tobacco, especially at specialty cafes near 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, especially among young and middle-aged White men with higher-than-average incomes and education. The "cigar culture" is supported by cigar magazines, shops, bars and clubs.

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Additional Information on Adult Smoking

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Back: Youth Smoking

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