Excise taxes are the primary public health strategy used to increase the price of cigarettes in the United States. Rather than quitting or reducing consumption of cigarettes, some price-sensitive smokers may avoid state and local excise... more
Excise taxes are the primary public health strategy used to increase the price of cigarettes in the United States. Rather than quitting or reducing consumption of cigarettes, some price-sensitive smokers may avoid state and local excise taxes by purchasing cigarettes from Indian reservations. The objectives of this study were to (1) provide the most recent state-specific prevalence of purchases made on Indian reservations by non-American Indians/Alaska Natives (non-AI/ANs) and (2) assess the impact of these purchases on state tax revenues. We used data from a large national and state-representative survey, the 2010-2011 Tobacco Use Supplement to the Current Population Survey, which collects self-reported measures on cigarette use and purchases. Nationwide, 3.8% of non-AI/AN smokers reported purchasing cigarettes from Indian reservations. However, in Arizona, Nevada, New Mexico, New York, Oklahoma, and Washington State, about 15% to 30% of smokers reported making such purchases, resu...
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Although cigarette smoking has substantially declined since the release of the 1964 Surgeon General's report on smoking and health,* disparities in tobacco use exist among racial/ethnic populations (1). Moreover, because... more
Although cigarette smoking has substantially declined since the release of the 1964 Surgeon General's report on smoking and health,* disparities in tobacco use exist among racial/ethnic populations (1). Moreover, because estimates of U.S. adult cigarette smoking and tobacco use are usually limited to aggregate racial or ethnic population categories (i.e., non-Hispanic whites [whites]; non-Hispanic blacks or African Americans [blacks]; American Indians and Alaska Natives [American Indians/Alaska Natives]; Asians; Native Hawaiians or Pacific Islanders [Native Hawaiians/Pacific Islanders]; and Hispanics/Latinos [Hispanics]), these estimates can mask differences in cigarette smoking prevalence among subgroups of these populations. To assess the prevalence of and changes in cigarette smoking among persons aged ≥18 years in six racial/ethnic populations and 10 select subgroups in the United States,(†) CDC analyzed self-reported data collected during 2002-2005 and 2010-2013 from the National Survey on Drug Use and Health (NSDUH) (2) and compared differences between the two periods. During 2010-2013, the overall prevalence of cigarette smoking among the racial/ethnic populations and subgroups ranged from 38.9% for American Indians/Alaska Natives to 7.6% for both Chinese and Asian Indians. During 2010-2013, although cigarette smoking prevalence was relatively low among Asians overall (10.9%) compared with whites (24.9%), wide within-group differences in smoking prevalence existed among Asian subgroups, from 7.6% among both Chinese and Asian Indians to 20.0% among Koreans. Similarly, among Hispanics, the overall prevalence of current cigarette smoking was 19.9%; however, within Hispanic subgroups, prevalences ranged from 15.6% among Central/South Americans to 28.5% among Puerto Ricans. The overall prevalence of cigarette smoking was higher among men than among women during both 2002-2005 (30.0% men versus 23.9% women) and 2010-2013 (26.4% versus 21.1%) (p<0.05). These findings highlight the importance of disaggregating tobacco use estimates within broad racial/ethnic population categories to better understand and address disparities in tobacco use among U.S. adults.
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E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S.... more
E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed reasons included cessation/health, consideration of others, convenience, cost, curiosity, flavoring, and simulation of conventional cigarettes. Among current e-cigarette users, 93% were also current cigarette smokers. The most common reasons for e-cigarette use were cessation/health (84.5%), consideration of others (71.5%), and convenience (56.7%). The prevalence of citing convenience (adjusted prevalence ratio [aPR]=1.49) and curiosity (aPR=1.54) as reasons for e-cigarette use were greater among ...
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IntroductionU.S. data on adult tobacco use and the relationship between such use and tobacco-related health disparities are primarily limited to broad racial or ethnic populations. To monitor progress in tobacco control among adults... more
IntroductionU.S. data on adult tobacco use and the relationship between such use and tobacco-related health disparities are primarily limited to broad racial or ethnic populations. To monitor progress in tobacco control among adults living in the United States, we present information on tobacco use for both aggregated and disaggregated racial and ethnic subgroups.MethodsWe used data from the nationally representative sample of adults aged 18 years or older who participated in the National Survey on Drug Use and Health conducted 4 times during 2002–2005. We calculated 2 outcome measures: 1) use of any tobacco product (cigarettes, chewing or snuff tobacco, cigars, or pipes) during the 30 days before each survey and 2) cigarette smoking during the 30 days before each survey.ResultsThe prevalence of tobacco use among adults aged 18 years or older varied widely across racial or ethnic groups or subgroups. Overall, about 3 of 10 adults living in the United States were tobacco users during the 30 days before being surveyed. The population groups or subgroups with a tobacco-use prevalence of 30% or higher were African Americans, American Indians or Alaska Natives, Native Hawaiians or other Pacific Islanders, Puerto Ricans, and whites.ConclusionThese results indicate that the prevalence of adult tobacco use is still high among several U.S. population groups or subgroups. Our results also support the need to design and evaluate interventions to prevent or control tobacco use that would reach distinct U.S. adult population groups or subgroups.
Research Interests: Epidemiology, Prediction, Adolescent, Humans, Smoking, and 9 moreFemale, Male, Young Adult, Wakefulness, Middle Aged, Adult, Time Factors, Prognosis, and Cotinine
IntroductionLimited data on cigarette smoking among population subgroups hinder the development and implementation of intervention strategies for those subgroups. Because of small sample sizes or inadequate study formats, cigarette... more
IntroductionLimited data on cigarette smoking among population subgroups hinder the development and implementation of intervention strategies for those subgroups. Because of small sample sizes or inadequate study formats, cigarette smoking among youths has been studied mostly among broad racial or ethnic categories (e.g., Asian, Hispanic) instead of subgroups (e.g., Vietnamese, Cuban). The objective of this study was to evaluate cigarette smoking among U.S. youths by racial and ethnic subgroups.MethodsThe study used a nationally representative sample of youths aged 12 to 17 years who participated in the National Survey on Drug Use and Health in 1999, 2000, or 2001. Outcomes measured include prevalence of cigarette smoking, mean age of smoking initiation, and susceptibility to start smoking.ResultsThe prevalence of smoking among youths aged 12 to 17 years varied among racial and ethnic subgroups, ranging from 27.9% for American Indians and Alaska Natives to 5.2% for Japanese. Among youths aged 12 to 17 years, the age of smoking initiation ranged from 11.5 years (American Indians and Alaska Natives) to 13.2 years (Japanese); the overall mean age of initiation was 12.3 years. White and African American youths were the only groups that showed a significant sex difference in age of initiation among all 14 subgroups; white and African American boys initiated smoking a few months earlier than white and African American girls. One of every four never-smokers aged 12 to 17 years was classified as susceptible to becoming a smoker.ConclusionThe prevalence of cigarette smoking among youths varies widely by racial and ethnic subgroup. There is a need for sustained, culturally appropriate interventions to prevent and control cigarette smoking among youths, particularly within racial and ethnic subgroups with a high prevalence of cigarette smoking.
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Research Interests: Adolescent, Humans, Smoking, United States, Female, and 18 moreMale, Regression Analysis, Infant, New Mexico, Risk factors, Sudden Infant Death Syndrome, African Americans, Mexican Americans, Aged, Middle Aged, Adult, Health surveys, Cardiovascular Diseases, European Continental Ancestry Group, Risk Factors, Substance-Related Disorders, JAMA, and Cotinine
To examine workplace exposure to secondhand smoke by occupation, we analyzed data from The Third National Health and Nutrition Examination Survey (NHANES III) (1988 to 1994), a nationally representative sample of the noninstitutionalized... more
To examine workplace exposure to secondhand smoke by occupation, we analyzed data from The Third National Health and Nutrition Examination Survey (NHANES III) (1988 to 1994), a nationally representative sample of the noninstitutionalized population. The analysis was restricted to 4952 employed nonsmoking adults who reported no home exposure to cigarette smoke. Occupations were assigned to 40 groups and 7 categories. Among the categories, geometric mean serum cotinine (ng/mL) ranged from 0.09 for farming/forestry/fishing occupations to 0.22 for operators/fabricators/laborers (median, 0.16). The lowest values were observed among farmers and nursery workers (0.06) and the highest among waiters (0.47). Between 1988 to 1991 and 1991 to 1994, the overall geometric mean cotinine and the proportion reporting that they could smell smoke at work decreased significantly. In conclusion, workplace exposure to secondhand smoke varied by occupation, and decreases in exposure occurred between 1988 to 1991 and 1991 to 1994.
Research Interests: Nursing, Secondhand Smoke Exposure, Environmental Monitoring, Adolescent, Workplace, and 13 moreHumans, Female, Male, Risk factors, Middle Aged, Adult, Occupational Exposure, Public health systems and services research, Health surveys, Risk Factors, Occupations, Cotinine, and Occupational and environmental medicine
Results Many consistent themes emerged across the groups. Nontraditional tobacco use is not common among young adult smokers. Although some products such as Black & Mild and Swisher Sweets cigars are used frequently by some... more
Results Many consistent themes emerged across the groups. Nontraditional tobacco use is not common among young adult smokers. Although some products such as Black & Mild and Swisher Sweets cigars are used frequently by some groups, other products such as ...
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Cigarettes, cigars, and marijuana have generally been studied in isolation yet their use does not occur in isolation. Focus on cigarette smoking may overstate the observation that African American youth and young adults are less likely to... more
Cigarettes, cigars, and marijuana have generally been studied in isolation yet their use does not occur in isolation. Focus on cigarette smoking may overstate the observation that African American youth and young adults are less likely to smoke any combustible product compared with their white counterparts. Assessing cigarette, cigar, and marijuana use trends may help identify the extent of this difference. Data from the 2002-2012 National Survey on Drug Use and Health (N = 25 541 to N = 28 232) were used to investigate past 30-day cigarette, cigar, and marijuana use trends among African American and white youth (12-17) and young adults (18-25). Logistic regressions assessed trends in combustible tobacco (cigarettes and cigars) and marijuana use, alone and in combination. From 2002-2012, the absolute difference in cigarette smoking prevalence between African American and white youth (9.6%-4.2%) and young adults (19.0%-10.5%) narrowed. Any combustible tobacco/marijuana use was signif...
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Research Interests: Adolescent, Social Class, Humans, Child, Smoking, and 7 moreUnited States, Female, Male, Young Adult, Aged, Middle Aged, and Adult
Electronic nicotine delivery system (ENDS) use has increased rapidly in the U.S. in recent years. The availability and use of ENDS raise new issues for public health practice and tobacco regulation, as it is unknown whether patterns of... more
Electronic nicotine delivery system (ENDS) use has increased rapidly in the U.S. in recent years. The availability and use of ENDS raise new issues for public health practice and tobacco regulation, as it is unknown whether patterns of ENDS use enhance, deter, or have no impact on combustible tobacco product use. This study assessed past-month, lifetime, and frequency of ENDS use among current, former, and never adult cigarette smokers. Data were analyzed from the 2014 Styles, a national consumer-based probability-based web panel survey of U.S. adults aged ≥18 years (n=4,269) conducted during June and July. Lifetime ENDS users were defined as those who reported having used ENDS ≥1 day in their lifetime. Past-month ENDS users were defined as those who reported using ENDS in the past 30 days. In 2014, overall lifetime and past-month ENDS use was 14.1% and 4.8%, respectively. By smoking status, 49.5% of current, 14.7% of former, and 4.1% of never cigarette smokers had used ENDS in their lifetime, whereas 20.6% of current, 4.0% of former, and 0.8% of never smokers used ENDS in the past month. Among current and former cigarette smokers who ever used ENDS, 44.1% and 44.7% reported using ENDS >10 days in their lifetime, respectively. Because the effect ENDS use has on combustible tobacco products use is unknown, and lifetime and past-month ENDS use is more common among current than former or never smokers, continued surveillance of ENDS use among adults is critical to programs and policies.
Research Interests: Education, Adolescent, Humans, Electronic Cigarettes, Smoking, and 7 moreUnited States, Female, Male, Young Adult, Aged, Middle Aged, and Adult
Exposure to secondhand smoke (SHS) from burning tobacco products causes sudden infant death syndrome (SIDS), respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung... more
Exposure to secondhand smoke (SHS) from burning tobacco products causes sudden infant death syndrome (SIDS), respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers. No risk-free level of SHS exposure exists. SHS exposure causes more than 41,000 deaths among nonsmoking adults and 400 deaths in infants each year, and approximately $5.6 billion annually in lost productivity. Although population exposure to SHS has declined over the past 2 decades, many nonsmokers remain exposed to SHS in workplaces, public places, homes, and vehicles.
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Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health... more
Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health impacts of raising unit price. The main purpose of this study was to evaluate the retail price impact and the determinants of price-related discount use among US adult smokers by their most commonly used cigarette brand types. Data from the 2009-2010 National Adult Tobacco Survey, a telephone survey of US adults 18 years or older, was used to assess price-related discount use by cigarette brands. Price-related discounts included coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions. Multivariate logistic regression was used to assess sociodemographic and tobacco use determinants of discount use by cigarette brands. Discount use was most common among premium brand users (22.1%), followed by generic (13.3%) and other brand (10.8%) use...
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What is already known on this topic? Since 2010, the proportion of U.S. 12th grade students who reported using marijuana during the preceding 30 days (21.4%) has surpassed the proportion reporting use of cigarettes during the preceding 30... more
What is already known on this topic? Since 2010, the proportion of U.S. 12th grade students who reported using marijuana during the preceding 30 days (21.4%) has surpassed the proportion reporting use of cigarettes during the preceding 30 days (19.2%).What is added by this report? During 1997–2013, the proportion of white, black, and Hispanic high school students overall who were exclusive cigarette or cigar users decreased 64%, from 20.5% to 7.4%. The proportion of white, black, and Hispanic students who were exclusive marijuana users more than doubled from 4.2% to 10.2%, and among cigarette or cigar users, marijuana use increased, with considerable increases identified among black and Hispanic students toward the end of the study period.What are the implications for public health practice? Despite significant declines since 1997, approximately 30% of white, black, and Hispanic U.S. high school students were current users of cigarettes, cigars, or marijuana in 2013. Policy and programmatic efforts might benefit from integrated approaches that focus on reducing the use of tobacco and marijuana among youths.
Research Interests: Adolescent, Schools, Students, Humans, United States, and 4 moreFemale, Male, Ethnic Groups, and Tobacco Products
The use of tobacco products during adolescence increases the risk for adverse health effects and lifelong nicotine addiction. In 2014, an estimated 4.6 million middle and high school students were current users of any tobacco product, of... more
The use of tobacco products during adolescence increases the risk for adverse health effects and lifelong nicotine addiction. In 2014, an estimated 4.6 million middle and high school students were current users of any tobacco product, of whom an estimated 2.2 million were current users of two or more types of tobacco products. Symptoms of nicotine dependence are increased for multiple tobacco product users compared with single-product users. CDC and the Food and Drug Administration (FDA) analyzed data from the 2014 National Youth Tobacco Survey (NYTS) to determine how frequently (the number of days in the preceding 30 days) U.S. middle school (grades 6–8) and high school (grades 9–12) students used cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among current users (≥1 day during the preceding 30 days) in high school, frequent use (≥20 days during the preceding 30 days) was most prevalent among smokeless tobacco users (42.0%), followed by cigarette smokers (31.6%),...
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Problem: Nicotine in cigarettes is what causes smoking to become an addictive behavior. Through understanding nicotine dependence and its potential variations by cigarettes smoked, we can understand specific factors related to nicotine... more
Problem: Nicotine in cigarettes is what causes smoking to become an addictive behavior. Through understanding nicotine dependence and its potential variations by cigarettes smoked, we can understand specific factors related to nicotine dependence among adults. Methods: We used data from the 2001-2004 NHANES, a household survey of the non-institutionalized civilians of the US population. Data were collected on current use of cigarettes, initiation and duration of smoking, and the characteristics and types of cigarettes smoked. Nicotine dependence levels were determined using the Heaviness to Smoke index, which consists of two questions, time after waking of first cigarette and the amount of cigarettes smoked per day. Results: Preliminary unadjusted rates show that smokers of light or ultra-light cigarettes (53.6%) are similarly highly dependent to nicotine than smokers of regular cigarettes (55.5%). Similar to light and ultra light smokers, smokers of menthol cigarettes (41.1%) were ...
Previous studies have suggested that menthol may play a role in nicotine addiction and reinforcement as smoking mentholated cigarettes may increase nicotine absorption and the intake of tobacco smoke by-products. Additionally, those who... more
Previous studies have suggested that menthol may play a role in nicotine addiction and reinforcement as smoking mentholated cigarettes may increase nicotine absorption and the intake of tobacco smoke by-products. Additionally, those who use menthol cigarettes may be less likely to attempt or succeed at quitting than those who smoke non-menthol cigarettes. Through increased understanding of the patterns and use of menthol and non-menthol cigarettes and their relationship to nicotine dependence, it is possible to assist smokers to quit smoking We used data from the 2001-2006 NHANES, a household survey of the non-institutionalized civilians of the US population. Data were collected on current use of cigarettes, initiation and duration of smoking among menthol and non-menthol cigarette smokers. Nicotine dependence levels were determined using the Heaviness to Smoke index, which consists of two questions; time after waking (first cigarette use), and the amount of cigarettes smoked per da...
Objective. To estimate to what extent triers (puffer) who never smoked a whole cigarette differ on non-biological factors from those smoking a whole cigarette in the first year of initiation. Methods. A 2004 and 2006 nationally... more
Objective. To estimate to what extent triers (puffer) who never smoked a whole cigarette differ on non-biological factors from those smoking a whole cigarette in the first year of initiation. Methods. A 2004 and 2006 nationally representative sample of students enrolled in grades 6 through 12 in the U.S. Our analysis included students aged 1218 years who started smoking <1 year since the date of the interview (n=1,884). Analyses were conducted using SUDAAN 9.0.1. Results. Most (72.3%) of the recent initiates tried a few puffs on a cigarette but did not smoke a whole cigarette. Adolescents aged 12 14 years, females, blacks and Other-Non-Hispanics had higher rates of puffers than adolescents aged 15 18 years, males, whites and Hispanics. In the fully adjusted model, whole cigarette smokers were more than twice as likely than puffers to think that smoking makes you look cool (OR=2.14) and to report that their friends smoke cigarettes (O.R.=1.91). Peer smoking was perhaps the most si...
Objective. To determine rates of four selected nicotine dependence symptoms nicotine withdrawal (irritable, restless), cravings, urges, and self-efficacy within different levels of smoking. Methods. A 2004 nationally representative sample... more
Objective. To determine rates of four selected nicotine dependence symptoms nicotine withdrawal (irritable, restless), cravings, urges, and self-efficacy within different levels of smoking. Methods. A 2004 nationally representative sample of students enrolled in grades 6 through 12 in the U.S. Our analysis included students aged 1218 years who smoked at least one day in the past 30 days (n=2,580). We calculated weighted percentages by smoking patterns that were created from the options for quantity (5 levels) and frequency (5 levels). Results. About 26% of current smokers who started smoking less than a year prior to the survey and who in the past month smoked at low levels (<1 cigarette, 1 cigarette, 2-5 cigarettes) on a few days (1 or 2 days, 3-5 days) reported having at least 1 of 4 nicotine dependence symptoms. The more prevalent symptom was withdrawal (19.6%), followed by cravings (13.5%), believing not been able to quit if wanted to (6.4%) and urges (5.2%). About 18% of low...
Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically... more
Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001–2013 Nation...
Research Interests: Adolescent, Schools, Humans, Tobacco Use, United States, and 5 moreFemale, Smokeless tobacco, Male, Athletes, and Tobacco Products
Background: Public health concerns related to menthol cigarettes include that they may promote smoking initiation and prevent cessation. It is well documented that among smokers, African Americans, youth, females, and people with lower... more
Background: Public health concerns related to menthol cigarettes include that they may promote smoking initiation and prevent cessation. It is well documented that among smokers, African Americans, youth, females, and people with lower education have a higher prevalence of menthol cigarette use than their counterparts. However, not much is known about lifetime course of menthol cigarettes use. This study adds 10 years of follow-up to a previous examination of menthol cigarettes in CARDIA. Methods: Using data from CARDIA, a community-based prospective cohort of young adults at baseline, we analyzed data in 2,028 smokers who provided cigarette brand information. The study assessed at each of its 8 exams if the current cigarette brand smoked was menthol or non-menthol. We plan to also determine if menthol cigarette use predicts quitting and relapse. Results: A majority of smokers exclusively smoked either menthol or non-menthol cigarettes over the assessed 25 year period; approximately...
Objective: Implementation of tobacco-free policies in schools has increased from 46.3% in 2000 to 63.6% in 2006. However, a proportion of schools continue to not implement tobacco-free policies. Because youth spend a large proportion of... more
Objective: Implementation of tobacco-free policies in schools has increased from 46.3% in 2000 to 63.6% in 2006. However, a proportion of schools continue to not implement tobacco-free policies. Because youth spend a large proportion of time in schools during their lifetime and because tobacco use prevention is critical in this group, we sought to understand their general knowledge and attitudes about tobacco policies in schools. Methods: Porter Novelli's Youthstyles is a nationally representative consumer mail-in survey of U.S. youth. In 2009 data on various issues about tobacco use and tobacco-free schools were collected from 1,310 children and adolescents (youth) aged 9 to 18 years. Youth were asked questions regarding knowledge about tobacco-free rules at their school and attitudes about them, as well as acceptability of smoking on school grounds. Results: Preliminary data indicate that the vast majority of youth (90%) were knowledgeable about existing tobacco-free school ru...
Research Interests: Adolescent, Social Class, Humans, Child, Smoking, and 7 moreUnited States, Female, Male, Young Adult, Aged, Middle Aged, and Adult
Cigarette and alcohol use are common among youth. We examined sources of cigarettes and alcohol among youth who were current cigarette and alcohol users. We analyzed nationally representative data from the 2009 and 2011 national Youth... more
Cigarette and alcohol use are common among youth. We examined sources of cigarettes and alcohol among youth who were current cigarette and alcohol users. We analyzed nationally representative data from the 2009 and 2011 national Youth Risk Behavior Surveys-biennial, school-based surveys of high school students in the United States. Students completed anonymous, self-administered questionnaires. Overall response rates were 71% for both years. Among the 17.3% of current cigarette users <18 years, 27.3% usually gave someone else money to buy their cigarettes and 27.7% usually borrowed (bummed) them. Fewer (14.1%) usually bought their own cigarettes in a store. Among the 40.3% of current alcohol users, 24.3% usually gave someone else money to buy it and 41.2% usually had someone give it to them. A few (4.5%) usually bought their own alcohol in a store. Age and intensity of use were positively associated with students buying their own cigarettes or alcohol, but negatively associated w...
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Cigarette smoking is the leading cause of preventable disease and death in the United States, resulting in approximately 443,000 deaths and $193 billion in direct health-care expenditures and productivity losses each year. Declines in... more
Cigarette smoking is the leading cause of preventable disease and death in the United States, resulting in approximately 443,000 deaths and $193 billion in direct health-care expenditures and productivity losses each year. Declines in smoking prevalence would significantly impact the health-care and economic costs of smoking. Efforts to accelerate the decline in cigarette smoking include reducing cigarette smoking disparities among specific population groups. Findings from the previous report on cigarette use in the first CDC Health Disparities and Inequalities Report (CHDIR) indicated that progress has been achieved in reducing disparities in cigarette smoking among certain racial/ethnic groups. However, little progress has been made in reducing disparities in cigarette smoking among persons of low socioeconomic status (SES) and low educational attainment.
Research Interests: Adolescent, Humans, Smoking, United States, Female, and 8 moreMale, Young Adult, Ethnic Groups, Aged, Prevalence, Middle Aged, Adult, and Socioeconomic Factors
U.S. data on adult tobacco use and the relationship between such use and tobacco-related health disparities are primarily limited to broad racial or ethnic populations. To monitor progress in tobacco control among adults living in the... more
U.S. data on adult tobacco use and the relationship between such use and tobacco-related health disparities are primarily limited to broad racial or ethnic populations. To monitor progress in tobacco control among adults living in the United States, we present information on tobacco use for both aggregated and disaggregated racial and ethnic subgroups. We used data from the nationally representative sample of adults aged 18 years or older who participated in the National Survey on Drug Use and Health conducted 4 times during 2002-2005. We calculated 2 outcome measures: 1) use of any tobacco product (cigarettes, chewing or snuff tobacco, cigars, or pipes) during the 30 days before each survey and 2) cigarette smoking during the 30 days before each survey. The prevalence of tobacco use among adults aged 18 years or older varied widely across racial or ethnic groups or subgroups. Overall, about 3 of 10 adults living in the United States were tobacco users during the 30 days before bein...
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Limited data on cigarette smoking among population subgroups hinder the development and implementation of intervention strategies for those subgroups. Because of small sample sizes or inadequate study formats, cigarette smoking among... more
Limited data on cigarette smoking among population subgroups hinder the development and implementation of intervention strategies for those subgroups. Because of small sample sizes or inadequate study formats, cigarette smoking among youths has been studied mostly among broad racial or ethnic categories (e.g., Asian, Hispanic) instead of subgroups (e.g., Vietnamese, Cuban). The objective of this study was to evaluate cigarette smoking among U.S. youths by racial and ethnic subgroups. The study used a nationally representative sample of youths aged 12 to 17 years who participated in the National Survey on Drug Use and Health in 1999, 2000, or 2001. Outcomes measured include prevalence of cigarette smoking, mean age of smoking initiation, and susceptibility to start smoking. The prevalence of smoking among youths aged 12 to 17 years varied among racial and ethnic subgroups, ranging from 27.9% for American Indians and Alaska Natives to 5.2% for Japanese. Among youths aged 12 to 17 year...
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Acknowledging the high prevalence of tobacco use among most Alaska Native groups, CDC/OSH developed the Alaska Native Adult Tobacco Survey (AN ATS) in a cooperative agreement effort with the Alaska Native Tribal Health Consortium. The AN... more
Acknowledging the high prevalence of tobacco use among most Alaska Native groups, CDC/OSH developed the Alaska Native Adult Tobacco Survey (AN ATS) in a cooperative agreement effort with the Alaska Native Tribal Health Consortium. The AN ATS is designed to obtain comprehensive information on Alaska Natives' tobacco behaviors, knowledge, attitudes, and opinions in a relevant cultural context. The questionnaire was cognitively tested with all five major Alaska Native ethnic groups (Cupik/Yupik, Aleut/Aluetiiq, Athabascan, Eyak/Tlingit/Tsimschian/Haida and Inupiaq) and was designed to measure the tobacco-related behaviors, knowledge, attitudes, and opinions of specific Alaska Native groups. It can be used to guide Alaska Native tobacco control efforts and to narrow existing gaps in tobacco use among different Alaska Native groups. It collects information on use of the following tobacco products: cigarettes, cigars, pipe, chewing tobacco, iqmik and snuff tobacco as well as informati...
The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used... more
The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used a variety of strategies to mitigate the effect of the rising price of cigarettes on their smoking habits. In particular, 23-34% of adult smokers in the US use cheaper brands, and 18-55% use coupons or promotions. Little is known about the discount use by type of brands. As such, the main purpose of this analysis is to evaluate the uses and price discount effects of these price-related discounts by manufacturers and major brands. An analysis based on the cross-sectional 2009-2010 National Adult Tobacco Survey (NATS). 11 766 current smokers aged 18 or above in the USA. Price-related discount was defined as smokers who used coupons, rebates, buy-one-get-one-free, two-for-one or any other special promotions for their last cigarettes purchase. The use of...
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Exposure to secondhand smoke (SHS) from burning tobacco products causes sudden infant death syndrome (SIDS), respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung... more
Exposure to secondhand smoke (SHS) from burning tobacco products causes sudden infant death syndrome (SIDS), respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers. No risk-free level of SHS exposure exists. SHS exposure causes more than 41,000 deaths among nonsmoking adults and 400 deaths in infants each year, and approximately $5.6 billion annually in lost productivity. Although population exposure to SHS has declined over the past 2 decades, many nonsmokers remain exposed to SHS in workplaces, public places, homes, and vehicles.
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Electronic cigarette (e-cigarette) use is increasing rapidly, and the impact on youth is unknown. We assessed associations between e-cigarette use and smoking intentions among US youth who had never smoked conventional cigarettes. We... more
Electronic cigarette (e-cigarette) use is increasing rapidly, and the impact on youth is unknown. We assessed associations between e-cigarette use and smoking intentions among US youth who had never smoked conventional cigarettes. We analyzed data from the nationally representative 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. Youth reporting they would definitely not smoke in the next year or if offered a cigarette by a friend were defined as not having an intention to smoke; all others were classified as having positive intention to smoke conventional cigarettes. Demographics, pro-tobacco advertisement exposure, ever use of e-cigarettes, and ever use of other combustibles (cigars, hookah, bidis, kreteks, and pipes) and noncombustibles (chewing tobacco, snuff, dip, snus, and dissolvables) were included in multivariate analyses that assessed associations with smoking intentions among never-cigarette-smoking youth. Between 2011 and 2013, the number o...
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Research Interests:
Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report... more
Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age. We used data from the 2009-2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18-49 years. Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds ...
Research Interests:
Research Interests:
In 2002, 16 focus groups with young adult smokers who used or had tried nontraditional tobacco products (e.g., bidis, shisha, herbal cigarettes, kreteks, cigars, herbal smokeless products) were conducted in Dallas, Texas, and Chattanooga,... more
In 2002, 16 focus groups with young adult smokers who used or had tried nontraditional tobacco products (e.g., bidis, shisha, herbal cigarettes, kreteks, cigars, herbal smokeless products) were conducted in Dallas, Texas, and Chattanooga, Tennessee, to gain an understanding of the appeal of these products. In each city, groups were segmented by race or ethnicity and by educational status. Many consistent themes emerged across the groups. Nontraditional tobacco use is not common among young adult smokers. Although some products such as Black & Mild and Swisher Sweets cigars are used frequently by some groups, other products such as shisha, kreteks, and herbal cigarettes are less well known and infrequently used. Among focus group participants, use of nontraditional tobacco products tends to occur in clubs, during social gatherings, or at times when cigarettes are unavailable. More college students than those who were not in college cited cost and inconvenience of purchasing nontradit...