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Drop in Adult Smoking Rate Stalls

U.S. officials cite lack of spending on smoking-cessation programs as a reason

THURSDAY, Oct. 26, 2006 (HealthDay News) -- The number of adult smokers in the United States did not change from 2004 to 2005, suggesting that the decline in smoking over the past seven years has stalled, a new federal report found.

In 2005, 45.1 million adults, or 20.9 percent, were cigarette smokers -- 23.9 percent of men and 18.1 percent of women. In addition, 2.2 percent of U.S. adults were cigar smokers and 2.3 percent used smokeless tobacco, according the report.

"After years of progress, what we are seeing is no change in adult prevalence of smoking between 2004 and 2005," said report author Terry Pechacek, the associate director for science at the U.S. Centers for Disease Control and Prevention's Office on Smoking and Health. "There appears to be a stalling that is similar to what we saw for high school students," he added.

The CDC's Youth Risk Behavior Survey released in June found that 23 percent of high school students smoked in 2005, up from 21.9 percent in 2003.

Pechacek believes several factors are associated with the leveling off of smoking rates, including a cutback in spending on smoking-cessation programs. Spending on these programs peaked in 2002 and has declined by about 25 percent ever since, he said.

In addition, while cigarette taxes have been rising, per-pack retail prices have been only going up very slowly, Pechacek said. "One of the factors that is related to that is the [tobacco] industry is spending about $15 billion a year and about 70 percent of that is in different forms of price rebates and rebates to wholesalers," he said. "There appears to be a much more active process in blunting the effect of tax increases."

Darryl Jayson, a spokesman for the Tobacco Merchants Association, said, "Tobacco manufacturers in the U.S. do have wholesaler programs that do grant discounts." However, these programs only reduce the wholesale price by 15 to 25 cents, which doesn't really affect the retail price, he said.

"This discounting doesn't play much into excise tax strategies," Jayson said. "However, tobacco companies have not raised prices since 2002," he added. So while taxes have been going up, the base price of a pack of cigarettes has remained the same.

Pechacek thinks the trend toward lower smoking rates can be jump-started if states start spending again on smoking-cessation programs. "We hope we will continue to see interventions and counter-marketing," he said.

The study findings are published in the Oct. 27 issue of the CDC's Morbidity and Mortality Weekly Report.

The study also found that the prevalence of smoking varies widely among the states. For example, Kentucky (28.7 percent), Indiana (27.3 percent), and Tennessee (26.8 percent) had the highest rates of smokers, while Utah (11.5 percent), California (15.2 percent), and Connecticut (16.5 percent) were the states with the lowest prevalence, according to the report.

Also, the prevalence of smoke-free homes and smoke-free workplaces varied widely Pechacek said.

Arizona (82.9 percent) and Nevada (79.0 percent) had the highest percentage of smoke-free homes. Kentucky (63.6 percent) and West Virginia (65.4 percent) had the lowest percent, according to the report.

The highest percentage of smoke-free workplaces were found in West Virginia (85.8 percent) and Iowa (77.7 percent). Nevada (54.8 percent) and Arkansas (61.3 percent) had the lowest.

Still, 126 million nonsmoking Americans are exposed to secondhand smoke, Pechacek said.

"When we look at places like California that has maintained a program for more than 16 years, the prevalence of smoking continues to decline," Pechacek said. "Most notably, the proportion of people that are smoking every day and that are smoking heavily is getting very small," he said. "So we know continuing declines are possible. What is necessary is that we continue to implement and fund those interventions that we know work."

One expert thinks the United States needs to redouble its efforts to get people to stop smoking.

"We are simply not doing enough to reduce smoking levels further," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "Funding for tobacco-control programs at the state level have actually declined since 2002," he noted.

"Tobacco is one of the most pernicious scourges ever unleashed on the population," Katz said. "Its toxins kill hundreds of thousands, and contribute to the deaths of millions, annually."

Settling for partial success as the country reaches a tobacco-control "plateau" won't do, Katz said. "This report indicates we must spend more, try harder, and refocus. For the sake of future generations, the target level of smoking in our society should be 0 percent," he said.

More information

For tips on how to quit smoking, visit the CDC.

SOURCES: Terry Pechacek, Ph.D., Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention, Atlanta; David L. Katz, M.D., M.P.H., associate professor, public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Darryl Jayson, spokesman, Tobacco Merchants Association, Princeton, N.J.; Oct. 27, 2006, U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report
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