Smoking Rate Is Declining in U.S.

The percentage of Americans who smoke cigarettes has fallen below 20% for the first time since at least the mid-1960s, according to a new report.

The CDC says in its Morbidity and Mortality Weekly Report that the prevalence of smoking fell in 2007 to 19.8%, nearly a full percentage point from 20.8% in 2006.

"This is good news," Matthew McKenna, MD, MPH, director of the CDC's Office on Smoking and Health, tells WebMD. "But deaths related to cigarette smoking are still increasing. Almost one in five adult Americans smoke, and many former smokers are succumbing to their habit again."

Tom Glynn, PhD, director of International Cancer Control of the American Cancer Society, says the CDC report shows that major progress is being made in the government's war on smoking, but hard battles still loom.

"This is the lowest level since the late 1920s, at least," Glynn tells WebMD. "We've gotten back to where we were more than 80 years ago."

The CDC says cigarette smoking prevalence has been dropping steadily among Americans 18 and older since it began keeping records in 1965, when 42.4% smoked. The proportion dropped below 30% for the first time in 1987, when 28.8% of Americans smoked.

"We think the proportion is dropping because of excise taxes that make cigarettes more expensive, smoke-free laws [that apply to most workplaces], and the availability of counseling and medications ," McKenna says.

In 2007, the CDC says 22.3% of adult males and 17.4% of adult women smoked. It says 19.8% of African-Americans smoked in 2007, and 21.4% of whites.

The CDC says 443,000 deaths annually are attributed to tobacco use.

Lung cancer , the leading cause of cancer death among men and women, kills about 157,000 Americans a year. A greater number of people die of lung cancer than of colon, breast, and prostate cancers combined.

Trying to Quit Smoking

"The most important thing people can do if they are smoking is to quit," McKenna says. "These studies show 30% to 40% of smokers try to quit, but chances of being successful without help are only 4% to 5%."

Progress would be better if more people were aware that their doctors could help and if they knew about a toll-free counseling "quit line" offering advice at 800-QUIT-NOW (800-784-8669), McKenna tells WebMD.

The report also says that:

• 43.4 million Americans are smokers.


• Smoking has declined over at least the past 40 years among all socio-demographic groups.


• Smoking prevalence varies according to education levels. Smokers who had a general education development diploma had the highest prevalence rate at 44%. People with nine to 11 years of education had a prevalence rate of 33.3%, compared with 11.4% of those with college degrees and 6.2% with graduate degrees.


• Mortality rates for people with chronic obstructive pulmonary disease (COPD ) increased 8% from 2000 to 2005.


• COPD deaths among women rose to 60,229 annually between 2000 and 2004, up from 56,363 between 1997 and 2001. Among men, annual deaths remained about the same in both periods at 58,000. COPD, which is treatable, is caused mainly by cigarette smoking, but also occupational hazards, air pollution, and secondhand smoke.


• Exposure to tobacco smoke resulted in 5.1 million years of potential life lost during 2000-2004 and $96.8 billion in annual productivity losses ($64.2 billion for males, $32.6 billion for females.)

Smoking and Disease

McKenna tells WebMD that the three leading causes of smoking-related death are lung cancer, heart disease , and COPD. He says between 30% and 40% of smokers try to quit annually, but the success rate is only one in five.

It's unlikely, he adds, that the U.S. will reach its goal of reducing smoking prevalence to 12% in the next two years. But he says media campaigns, excise txes, and rules implementing smoke-free environments are playing roles in reducing smoking.

Also, he says, "there are now more former smokers than active smokers."

Benefits for those who quit are significant, he says, because stopping smoking drastically reduces risks of cardiovascular disease and COPD.

Glynn says the American Cancer Society fears many people who've quit may start again because "they are thinking they are self-medicating for anxiety and economic difficulties."

He says studies "have shown that smoking in the movies" induces youths to smoke. Glynn also says nonsmoking women are getting lung cancer at higher rates than nonsmoking men, but the reasons aren't clear.

The CDC studies, Glynn says, reinforce that "if we raise taxes [on cigarettes] and continue to widen access to cessation treatment," prevalence will go down more.

By Bill Hendrick
Reviewed by Louise Chang
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