Category Archives: smoking rate

“Tobacco Nation” being left behind

Here’s a really good story from U.S. News and World Report about how the smoking rate in the U.S. has dropped dramatically through much of the country … except for one region.

And that’s this funky swath from the Upper Midwest, beginning in West Virginia and then into the Deep South and even some of the lower Midwest. The U.S. News and World report looks at these 12 states — Missouri, Oklahoma, Tennessee, Arkansas, Mississippi, Alabama, Indiana, Ohio, Michigan, West Virginia and Kentucky.

Two of these states — West Virginia and Kentucky — have the highest smoking rates in the country at over 24 percent. By comparison, the national smoking rate is roughly 16 percent. Every single one of those 12 continguous states has a smoking rate over 20 percent.

From the article:

 Adult smoking rates in “Tobacco Nation” parallel those in some of the most tobacco-heavy countries in the world, including the Philippines (23 percent), China (28 percent) and Indonesia (the highest rate at 35 percent). The high smoking rates have serious health consequences for both individuals and communities; there are 30 percent more preventable hospitalizations for “ambulatory, care-sensitive conditions” for Medicare enrollees in the 12-state bloc than in the other 38 states, the report said.
 “It’s tragic [in a] nation with these resources financially – medical resources, technology resources, et cetera – that we have a part of the country [where] 66 million people live … that looks more like Brazil or Bangladesh or the Philippines than the United States of America, and that’s just wrong,” says Truth Initiative CEO and President Robin Koval.

These states have a couple of other things in common — most of them have no statewide smoking ban and most of them have low cigarette taxes. Michigan and Ohio are the only two states in that swath that have indoor smoking bans.

 

 

 

This graphic shows the average state cigarette tax in those states is just 98 cents a pack, roughly half of the $1.89 a pack in the other 38 states.

It also isn’t a coincidence that most of these states are conservative and vote heavily Republican. Republican legislatures tend to be more averse to taxes and regulation, so you see no statewide smoking bans and low cigarette taxes.

And you also see a very high lung cancer rate in all of these states.

And there is also a lot of tobacco growing in that region, with millions of tobacco dollars contributed to political candidates. To keep those taxes low and keep those regulations away.

It’s something to celebrate the truly impressive inroads that have been made against smoking in the past 10 years. Both the adult and teen smoking rates have plummeted, the majority of states and major cities in the country have smoking bans, cigarette taxes have gone up and lung cancer deaths are going down. But, that’s sobered by the reality that one part of the country is being left behind by all these advances. People there are being betrayed by the people they’re voting into office.

Anyway, here is a link to a very cool interactive map where you can click on each state to see its smoking rate.

 

Smoking rate now down to 15 percent; biggest single-year drop ever recorded

A story from National Public Radio that the smoking rate in the U.S. is now down to 15 percent, the lowest ever recorded.

This also gives me the opportunity to fire up my Excel and make a new smoking rate graph! This is especially cool because it is actually the 50th anniversary of the CDC keeping track of smoking rates. In those 50 years, the smoking rate has dropped by nearly two-thirds from 42.4 percent to 15.1 percent.

u-s-smoking-rate

The last time I wrote about this, almost exactly a year ago, that figure was at 16.8 percent. These numbers released this month by the Centers for Disease Research actually refer to the 2015 smoking rate; it takes several months to put out a report, so that figure could be even lower now.

This is also the biggest single-year drop in the smoking rate ever recorded by the CDC. The next closest was 2009 to 2010, when the smoking rate dropped from 20.6 percent to 19.3 percent.

The news gets better. The smoking rate for people aged 19-24 is just 13 percent. There’s virtually no future smokers after someone turns 24, so that 13 percent figure will just drop as those smokers grow older and wiser.

Another bit of good news — California just passed a $2 a pack cigarette tax increase, which could drop the smoking rate in California down by as much as 20 percent (studies have shown a $1 a pack increase in cigarette taxes drops the smoking rate by roughly 10 percent).

If the California smoking rate drops by 20 percent, that’s 500,000 to 600,000 smokers giving up the habit, and that will have a major effect on the national smoking rate. That all by itself is more than 1 percent of the smokers nationwide.

There’s myriad reasons for the drop in the smoking rate — higher cigarette taxes, indoor smoking bans, more awareness of the health risks, social disapproval of smoking and, to be honest, the rise of e-cigarettes.

From the graph up above, you can see there is actually a pretty frustrating era from 1990 to 2009 in which the drop in the smoking rate was excruciatingly slow — in fact, incredibly, one year (2008) it actually went UP. That’s the effect of Joe Camel and a big increase in tobacco advertising in the 1990s and an increase in smoking in PG-13 and PG movies and cuts to tobacco education in the 2000s, in my opinion.

In those 19 years, the smoking rate only dropped from 25.5 percent to 20.6 percent, an average of 0.26 percent a year. Since 2009, the smoking rate has dropped from 20.6 percent to 15.1 percent, a drop of 0.92 percent a year over the past six years. The rate has actually dropped more during the past six years than it did in the 19 years prior to that. I do think e-cigs have something substantial to do with that, as well as Hollywood stubbing out smoking in PG movies.

If FDA regulations of e-cigarettes go through, and I’m sure it will be tied up in court for a while, it will be interesting to see if there is any effect on the smoking rate, because these regulations are expected to all by wipe out all the small e-cigarette companies, which make up roughly 40 percent to 50 percent of the market. Big Tobacco itself owns the three best-selling e-cig brands — Vuse, Blu and MarkTen.

 

 

 

Washington Post: U.S. smoking rate drops below 17 percent … and other smoking trends

smoking rate

A very nice article in the Washington Post this week about “who stills smokes today.”

First of all, the good news. According to the Post article, which got its numbers from the Centers for Disease Control, the smoking rate in the U.S. has dropped to 16.8 percent. That’s the lowest I’ve ever seen. It was only about  four years ago when the smoking rate finally dropped dropped below 20 percent (officially 2010). When I began blogging about tobacco about 10 years ago, the smoking rate was about 22 percent. The smoking rate dropped below 25 percent for good in 1995 and dropped below 30 percent in 1987 . .. see how slowly the smoking rate was dropping compared to the past few years?

This is fantastic news. I’m guessing one major factor for the escalating drop in the smoking rate is the rising popularity of e-cigs. E-cigs are fine for people trying to quit cigarettes, in my opinion, but it also sucks that so many teenagers are taking up e-cigs rather than cigarettes. Nicotine addiction is nicotine addiction … and it’s never a a good thing.

I made my own smoking chart (I rule … I can use Microsoft Works!) to further parse these numbers year-by-year. Click on it to blow it up. Notice the dramatic drop-off in the smoking rate since 2009. That’s e-cigs and higher cigarette taxes, more smoking bans and a lot less smoking in Hollywood movies all working together to drive down the smoking rate. Notice how the smoking rate flat-lined between 2004 and 2009 (In fact, the smoking rate dropped just 0.3 of a percent in those five years — from 20.9 percent to 20.6 percent.) It was a very, very frustrating time. The tobacco industry was successfully fighting anti-tobacco efforts by spending billions on advertising and marketing. After many, many battles in many state Legislatures, cigarette taxes went up and more states passed smoking bans and smoking was removed from movies marketed to kids — hence, smoking rates started declining.

Smoking rates
I made my own graph. I rule with Microsoft Works.

Also notice a fairly steep drop in the smoking rate between 1999 and 2004 (from 23.5 percent to 20.9 percent.). I believe that’s a direct result of the notorious 1998 Master Settlement Agreement. While this agreement was roundly and justifiably criticized, in the long run, it did a lot of good, such as banning tobacco marketing icons like Joe Camel and banning product placement in Hollywood movies (shockingly, smoking still kept showing up in kids’ movies even after the practise of tobacco product placement was banned.)

Here’s a bunch of other interesting tidbits in the WashPo article. This is another issue I’ve touched but a lot of people don’t think about when it comes to smoking trends. Not only are fewer people smoking today, but those who do smoke smoke less. This is mostly because of smoking bans in most workplaces and more rental residential units not allowing smoking. And generally because smokers have become a lot more savvy about not lighting up around kids and other nonsmokers.

smoking amount

In 2005, 12.7 percent of smokers smoke over 30 cigarettes a day (a pack and a half). Today, that number is down to 6.9 percent of smokers. Those numbers are mind-blowing to me considering that my dad smoked at least 80 cigarettes (four packs) a day and my mom many years ago probably smoked at least 40 cigarettes a day. Between the two of them — roughly six packs a day. Barely anyone smokes even three packs a day anymore. There’s simply not many places left where you can light up cigarettes that constantly.

Another tend touched on by the WashPo article that I was already aware of (but I’m glad the Post is writing about it) … the absolute direct correlation between smoking and education. The smoking rate for people with GEDs is 43 percent. For people with a high school degree — 21.7 percent. College degree, it’s 7.9 percent and for people with post-grad degrees, 5.4 percent.

smoking education

The ethnic group with the lowest smoking rate is Asians, while American Indians have the highest smoking rate at 29.2 percent. (Interestingly, Hispanics and blacks both have a lower smoking rate than whites.) Yikes, I didn’t realize that Native smoking rate was so high. That is a real problem.

smoking ethnicity

Here is something that has changed dramatically from 10 years ago — and this is mostly due to e-cigs, I believe. Teens and young adults have for many years now had the highest smoking rate of any age group. No longer. The smoking rate for people aged 18-24 is now 16.7 percent. The smoking rate for people aged 25-44 is 20 percent; age 45-64 is 18 percent and age 65-over is 8.5 percent (because by that age, many smokers are facing tobacco-related illnesses and are forced to quit.). I like the fact that the smoking rate for teens and young adults is so low, but I wish it was for a better reason than more young people simply taking up e-cigs instead (and I give the WashPo credit for talking about the effect of e-cigs on the young adult smoking rate.)

 

Analysis: The sickest states in the U.S., mostly in the South, do the least to snuff out smoking

southern tobacco

I already knew this, but I’m glad to see USA Today do a story on it.

It’s a fact that the highest rates of lung cancer are in the Deep South — where there are few indoor smoking bans and cigarette taxes are ridiculously low.

From the USA Today article:

States hit hardest by the ravages of tobacco are often the least aggressive at hitting back, a USA TODAY analysis found. So a deadly culture of smoking lingers, which officials say is fueled relentlessly by tobacco companies targeting minorities and the poor.

• Big tobacco-growing states such as Kentucky, Tennessee and Georgia have the poorest and sickest residents, yet spend less than 20% of the federal government’s recommended minimum for tobacco education and enforcement.

• States with the most smokers weaken their own tobacco control efforts with cigarette taxes of 60 cents or less, compared with $3.75 in Rhode Island and $4.35 in New York.

• Hard-hit states also do the least to restrict smoking in places such as restaurants and workplaces and impose penalties of $100 or less on businesses selling tobacco to children, compared with $10,000 in the most aggressive states.

I like to show this phenomena graphically. Here is a map of the states with the highest rates of lung cancer. Darker is bad:

2006_lung_map_deaths

 

 

 

 

 

 

 

Now, here is a map of the states with the lowest cigarette taxes. Red means low taxes:

excise-taxes

 

 

 

 

 

 

 

Now, here is a map with showing indoor smoking bans. White means total smoking bans, black means no statewide smoking bans (yellow means weak smoking bans).800px-US_states_smoking_bans.svg

Wow, it’s absolutely amazing the correlation, isn’t it? Actually, it really is, I’m not trying to be snarky.

Like I said, I’ve been aware of this correlation for some time, Now throw in the other factor of states in the Deep South spending little on tobacco education. Again, I’ve been aware of this for some time, the USA Today article speaks about how little states spend from the $280 billion Master Settlement Agreement on tobacco education, using that money instead to balance their state budgets (In USA Today’s word — “fix potholes.”).

Also, not a coincidence. Where is most of the tobacco in the U.S. grown? In the Deep South.

From USA Today:

Critics say one reason some states aren’t very aggressive is that tobacco is woven tightly into their communities even as the number of tobacco farms continues to shrink. “You can look at a map of tobacco control policies and see that every state that has weaker policies is a tobacco-growing state,” says Yvonne Hunt, who heads the tobacco control research branch of the National Cancer Institute.

Sitting in a cancer education booth at a free health clinic in southwest Virginia this summer, pharmacy student Anesa Hughes tried to explain why smoking is so common in her area. It’s “such a cultural thing,” says Hughes, who walked behind a tiller on her family’s tobacco farm starting at age 8. “It’s like we’re in a time warp.”

It’s a self-destructive culture. A mentality that “tobacco has always been a part of our culture.” Well, so has racism … does that somehow make it a good thing? These states have the highest smoking rates — Kentucky and West Virginia have been the highest for a while now, and places like Alabama and Mississippi aren’t far behind. People literally killing themselves and stubbornly clinging to the idea that somehow the right to kill themselves correlates to “Liberty,” or something… because their cigarette taxes are low and they can light up pretty much anywhere they want, especially outside the big cities. It’s a frustrating, exasperating reality. “Maybe I’m killing myself, but ain’t no Obama telling me what to do…” or some such thing.

As an aside, most of these Southern states also lead the U.S. in rates of diabetes. Part of that is smoking, it’s now known that smoking is a factor in causing diabetes, part of it is poor diet, obesity, lack of health care, high rates of poverty, etc. The sickest part of the country … which does little or nothing about it. And the people there keep voting for the people who do little or nothing about it.

 

 

 

 

Minnesota smoking rate drops to lowest-ever-recorded 14.4 percent — higher cigarette taxes get credit

minnesota

According to a survey of 9,000 people from Clear Way Minnesota and Minnesota Department of Health, the statewide smoking rate has dropped to 14.4 percent, the lowest ever recorded and down from 16.1 percent in 2010. That number is also down a whopping 35 percent from the 1999 smoking rate of 22.1 percent.

When asked what factor played an important role in helping people quit, the No. 1 reason was the increased cost of cigarettes. Minnesota’s state cigarette tax was raised $1.60 in 2013 and is one of the highest in the country at $2.83 a pack (only New York, Connecticut, Rhode Island, Massachusetts and Washington are higher). 63 percent of the survey respondents said the new price of cigarettes helped encourage them to quit smoking.

The survey also found that teens and young adults (18-24), the age group with the highest smoking rate normally, no longer as the highest smoking rate in Minnesota (likely because of e-cigs).

Interesting info in the survey about e-cigarettes. The survey found that 66 percent of people reporting using e-cigs were also smoking cigarettes (telling me they were using e-cigs to get around smoking bans in workplaces, bars, etc.). 22.5 percent were former smokers while 11 percent were people (ie, kids) who had never smoked a cigarette. So, at least according to this one survey, fewer than one-fourth of the people using e-cigs used them as a smoking cessation tool, while over 10 percent were likely kids who had never smoked a cigarette in their lives. To me, that does not bolster the case for e-cigs well.

Smoking rate in New York City goes up

new york city

Weird story and a little troubling, one that goes against the national trend. Recent data shows that the smoking rate in New York City — yes, rabidly anti-smoking New York City, has actually went up from 2010, and not by a tiny amount Officials are blaming budget cuts to education for the rise in smoking rates.

The smoking rate in New York is still relatively low. According to new data, the rate was 16.1 percent in 2013, up from 14 percent in 2010. The national average is around 18 percent, which is down fairly dramatically from about 10 years ago, when it was about 21 percent (thanks to smoking bans, higher cigarettes taxes, less smoking in movies, more kids buying a clue about cigarettes — and frankly, the rise of vaping I think is becoming a big factor in declining smoking rates.).

What is striking about that increase is New York City has some ridiculously high cigarette taxes (on top of some high New York State cigarette taxes), among the highest in the nation, and a pack of cigarettes there can cost up to $12 to $14.

According to the Daily News story:

The city’s annual tobacco control budget, which pays for anti-smoking programs and marketing campaigns, has been cut almost in half since 2009, to $7.1 million from $13.5 million.

Huh, you’d think with the smoking rate going up, New York City would have more tax revenue to fund tobacco education programs.

New York City had one of the most adamantly anti-smoking mayors in the country, Michael Bloomberg. Bloomberg not only signed ordinances banning smoking in bars and restaurants,he raised cigarette taxes in New York and even signed an ordinance outlawing sales to adults under 21.

Here is one of the great New York City funded anti-smoking commercials.