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Smoking: Glass City Lit, Motor City Quit

Toledo lights up most; Detroit has most quitters, says CDC survey

FRIDAY, Dec. 14, 2001 (HealthDayNews) -- People in Toledo, Ohio, not only smoke more than people in any other U.S. city area, they're also among the most dedicated. Except for people in one other city, they're the least likely to try to quit.

Only people in Charleston, W.Va., are less likely to stop smoking for a day or more, says a first-time look at the smoking habits of those who live in and around 99 major U.S. cities. On the other end of the spectrum, the least number of smokers are in Orange County, Calif., and more people in Detroit, Mich., quit for at least a day than anywhere else.

This city breakdown of smoking habits is part of the Centers for Disease Control and Prevention's (CDC) annual report on adult cigarette smoking in America.

State by state, the percentage of people who smoke is about the same as it has been for the last five years, says the 2000 Behavioral Risk Factor Surveillance System (BRFSS).

A random telephone survey of American adults in all 50 states, the District of Columbia and Puerto Rico found the prevalence of cigarette smokers ranged from a low of 14.5 percent in Utah to a high of 33.4 percent in Kentucky. This is the second year in a row Utah ranked lowest in the BRFSS survey. The findings appear in today's issue of the CDC's Morbidity and Mortality Weekly Report.

"These studies suggest that very few cities and states have met the national health objective for 2000 of less than 15 percent of adults smoking," said Terry Pechacek, associate director of science for the CDC's Office of Smoking and Health at a press conference yesterday in Atlanta. "And in the year 2010, we have set the goal for 12 percent. While we have found few states that have met the 2000 goal, if all states would implement the guidelines, programs and recommendations of the National County and City Health Officials (NCCHO) as well as the CDC's Best Practices for Comprehensive Tobacco Control Programs, I am sure we will be able to meet the 2010 goal."

The CDC says only women in Puerto Rico, Utah and California have met the 2000 national health objective of less than 15 percent, thanks to more social and cultural pressure not to smoke in Puerto Rico and Utah, and massive efforts at social intervention in California.

About one in four adults in the United States smoke cigarettes. The American Lung Association says more 400,000 people die each year from diseases related to smoking cigarettes. The total includes 3,000 deaths from lung cancer and 62,000 from coronary heart disease caused by secondhand smoke, says the CDC.

The states with the highest percentage of smokers were Kentucky, Nevada, Missouri, Indiana, Ohio and West Virginia, each with more than 26 percent. The lowest percentages of adult smokers were in Arizona, Montana, Hawaii, Minnesota, Puerto Rico and Utah, each with less than 20 percent.

People in 20 states were asked about smoking at home in the preceding month, work policies and smoking bans in certain areas. The percentage of people in no-smoking homes ranged from a low of 60.8 percent in West Virginia to a high of 79 percent in Colorado. The percentage of people who said their workplaces has no smoking policies ranged from 61.4 percent in Mississippi to 83.9 percent in Montana. And the percentage of people who thought that smoking should be banned in restaurants ranged from 44.3 percent in North Carolina to 63.6 percent in Montana.

The five metropolitan areas with the highest levels of smoking were, in order: Toledo, Ohio; Knoxville, Tenn.; Indianapolis, Ind.; Cleveland-Lorain-Elyria, Ohio, and Huntington-Ashland, W.Va. The five metropolitan areas with the lowest prevalence of smoking, in order, were Orange County, Calif.; Salt Lake City-Ogden, Utah; San Diego, Calif.; Miami, Fla.; Bergen-Passaic, N.J., and Las Cruces, N.M.

"We don't know why smoking is highest in Toledo," Pechacek said. "This is the first year we have done the survey in the metropolitan areas." But the surveys "suggest broad social and cultural differences. For instance, Utah has strong religious and cultural factors that influence smoking practices. The western portion of this country has stronger anti-smoking policies, stronger clean indoor-air regulations in place than other parts of the country."

"In our analysis, we know that several metropolitan areas are significantly higher [in smoking levels] than other parts of this country. They tend to be in the middle of the country, and that is consistent with the state data," he said.

Pechacek said he hopes the surveys will spur cities and states to action. "We hope all the states and cities will look at their trends and patterns. There's a great opportunity here for public health benefit in applying effective tobacco control measures."

Kentucky has taken a few small steps to combat tobacco use, but they are steps nevertheless, said Dr. Rice Leach, commissioner of the Kentucky Department for Public Health, in Frankfort.

"We're a heavy smoking state," but not because tobacco is a major Kentucky industry, he said. "It's because Kentuckians like to smoke. They don't grow the weed in Nevada, and they are No. 2 this year, and [they] were No. 1 last year."

So will Kentucky reach the 2010 goal of less than 12 percent of adults smoking?

"We are not going to make 12 percent in eight years," Leach said. "But change is beginning to happen. I think the adults of Kentucky are helping their children not to smoke in the first place, and they are accepting increased limitations on the number of places where smoking is not permitted. And for those who don't live here, it's hard to appreciate just how significant a step that is."

What To Do

If you're planning to quit, consider setting up an appointment with your doctor to discuss treatments that can help you win the battle. Pechacek said the best programs combine behavioral counseling with stop-smoking aids, sold both over-the-counter and by prescription.

Online information about smoking is available from the CDC's Tobacco Information and Prevention Source.

Find out about the health impact of tobacco from the World Health Organization's site.

QuitNet is also provides resources.

SOURCES: Interview with Rice Leach, M.D., commissioner, Kentucky Department for Public Health, Frankfort; Terry Pechacek, associate director of science, CDC's Office of Smoking and Health; CDC press conference Dec. 13, 2001, in Atlanta; Dec. 14, 2001, Morbidity and Mortality Weekly Report
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