This study surprised me a bit, only because I bet it’s been two or three years since I’ve last had to breath someone else’s cigarette smoke.
The Centers for Disease Research released a report this week that one in four nonsmokers continues to be exposed to secondhand cigarette smoke.
Good news, bad news: While that number is about half the percentage is 1999, 7 out of 10 African-American children are “regularly exposed” to smokers’ secondhand smoke. And two out of five children under the age of 11 continue to be exposed to adults’ cigarette smoke.
From the NBC News articles (NBC is great for stories on tobacco control, BTW):
“Although we’ve made significant progress in reducing smoking rates … some populations are subjected to the deadly impact of tobacco more than others,” said Chris Hansen, president of the American Cancer Society Cancer Action Network. “… Secondhand smoke disproportionately affects African Americans, Hispanics and Native Americans, who are more likely to work in jobs that have the least amount of protection from smoking — such as service, hospitality and manufacturing industries.”
Really good interview I saw on a site called Vox.com (was not familiar with it) with Tom Frieden, head of the Centers for Disease Control, about health in America. The headline talks about legalized pot, but honestly, I didn’t see pot mentioned in the article. Just trying to drive clicks, I guess. Hee, the interview room looks pretty spartan. Did they conduct this interview in an old parking garage somewhere?
Anyway, it’s a wide-ranging interview touching on e-cigs, tobacco, vaccines, prescription drugs, etc. I’m going to focus on the tobacco and e-cig and pot part of the discussion. There’s a lot of other good stuff there if you want to read the whole thing.
Frieden’s comments on tobacco control, when asked if tobacco has become a passe public health issue. The message is, yeah, fewer people might be smoking today than in the past 100 years, but the health crisis caused by the smoking epidemic has not gone away, and we must remain continually vigilant to get the message out to kids that smoking isn’t cool:
What is the single biggest opportunity out there in health?
I would start with tobacco control. You know what, people sometimes think, “Oh, tobacco. That’s yesterday’s issue.” It still kills more people than anything else in this country and around the world. And there’s a lot more that we can do about it. It doesn’t just kill people, it disables, disfigures, causes diseases. It increases our health care cost. Tobacco is really the number one enemy of health in this country and around the world.
When you say that a lot of people think that tobacco is yesterday’s news, what is the next step on policy? At this point you’re dealing with taxes in New York that are high enough that one out of three packs is basically smuggled into the state. When you say there’s a lot more to do, what is there more to do?
First off, there are a lot of places that haven’t yet implemented the things that we know will work, whether that’s protecting people from second-hand smoke at work or increasing tax or reducing smuggling, which there are ways to do. Or running hard hitting ads, which we know make a major impact – they save lives and save money. These are some of the things that work.
Health care system can do much better at helping people quit. Medications will double or triple the chances that you’ll succeed. But the things that are going to make the biggest impact are price, hard hitting ads and smoke-free laws.
Now, some interesting comments about e-cigs. Frieden actually mentions a couple of issues I hadn’t thought about much personally.
E-cigarettes may help in some ways but they are definitely harmful in many ways as well. If they get kids hooked on tobacco and nicotine, which they are doing. If they get smokers to continue smoking rather than quit. If they get smokers who quit to come back to smoking.
What’s your view of the evidence on whether they actually help people quit?
If they re-glamorize the act of smoking or confuse smokers at what works to quit. These are all real problems with only at this point potential benefits from e-cigarettes.
There’s one small well-done study that they helped a little bit. The patches helped a little bit in that study too. The two weren’t statistically different. We do know that people who are using e-cigarettes are not quitting at higher rates than people who aren’t using them now. As we learn more, I have no doubt that an individual here or there can be helped by them, that they might be helpful to some people. As a societal issue, they’re only going to be helpful if they’re well-regulated and if cigarettes are well-regulated.
Compiling data from 2008 (it takes a few years to put this together), in a trend that began in the 1990s, the lung cancer rate for men in the United States continued to drop.
Better news, however, is the lung cancer rate for women dropped for the second straight year. Lung cancer rates for women have been highly stubborn in refusing to drop, even though the smoking rate among women has dropped over the past 30 years. The fact that more non-smoking women get lung cancer than non-smoking men might also have some effect on the lung cancer rate for women being so stubborn.
In 1999, the lung cancer rate for men was about 93 cases per 100,000 population. In 2008, that dropped all the way down to about 79 cases per 100,000.
In 1999, the lung cancer rate for women was about 54 cases per 100,000. That increased to about 57 cases per 100,000 by 2006, but then has dropped back down to about 53 cases per 100,000 in 2008. Finally, that lower smoking rate for women is starting to pay dividends (Remember, there is an infamous “30-year lag” between smoking rate and lung cancer diagnoses. Lung cancer really didn’t become an epidemic in America until the 1930s, after cigarettes became popular in the early 1900s.)
Again, this is outstanding news. Lung cancer is the No. 1 cancer killer in America (about 160,000 people a year), and more than any other cancer, it is almost directly the result of lifestyle choices. About 85 percent of the people who get lung cancer are either smokers or former smokers (about 90 percent of men and 80 percent of women).
The CDC study broke down the lung cancer rates by region:
In the South, among men, the lung cancer rate dropped from about 106 cases per 100,000 population in 1999 to about 88 cases per 100,000 in 2008 (Another way of looking at this is one male out of 940 in the South had lung cancer in 1999; back in the late 90s, the smoking rate among men in the South was still above 40 percent.).
In the South, among women, the lung cancer rate dropped from about 61 cases per 100,000 in 2005 to about 60 cases per 100,000 in 2008. Not much of a drop, but it might be the beginning of a long-term trend.
In the Northeast, among men, the lung cancer rate dropped from about 91 cases per 100,000 in 1999 to about 81 cases per 100,000 in 2008. Among women, the lung cancer rate unfortunately rose from about 55 cases per 100,000 in 1999 to about 59 cases per 100,000 per 2008. This is the one bit of bad news in the study.
In the Midwest, among men, the lung cancer rate dropped from about 97 cases per 100,000 in 1999 to 86 cases per 100,000 in 2008. In the Midwest, among women, the lung cancer rate has dropped from about 59 cases per 100,000 in 2006 to 57 cases per 100,000 in 2008.
In the West, there has been the most dramatic drop in lung cancer rates. The West also has the lowest smoking rates of any region in the country. Hawaii, California, Utah and Idaho are among the four lowest smoking rate states in the country.
In the West, the lung cancer rate for men dropped from about 77 cases per 100,000 in 1999 to about 60 cases per 100,000 in 2008, a decrease of 22 percent. In fact, the lung cancer rate for men in the West was roughly the same as women in the South in 2008.
In the West, among women, the lung cancer rate dropped from 50 cases per 100,000 in 2006 to about 45 cases per 100,000 in 2008. It appears the West is a driving force for that lung cancer rate finally beginning to drop among women nationwide.
This report takes a slightly different tack — breaking down smoking rates by occupation.
Overall, the adult smoking rate in America was 19.6 percent in 2010, down ever so slightly from the 19.8 percent in 2009, but roughly the same as the past 5 years, where it has hovered around 20 percent.
The CDC has been doing these surveys for about 10 years now, and they are very accurate. These entail surveys of tens of thousands of people each year.
The smoking rate among 18-24 year olds is 23.8 percent; among 25-34, it’s 23.5 percent; among 35-44, it’s 21 percent; and among 45-64, it’s 19.8 percent. Among people over 65, it’s only 10.2 percent.
The smoking rate for men is 21.5 percent and for women it’s 17.9 percent.
Here’s the stats I find interesting. Again, these numbers have been pretty consistent over the years. Smoking rate for high school dropouts; 27.1 percent. For high school grads, 21 percent, and for college grads, 9.1 percent.
So lack of education = higher smoking rate.
Another interesting stat. Smoking rate for people living below the poverty line, 27.7 percent; near the poverty line, 26.3 percent; middle income or upper income, 18.1 percent.
It’s not surprising since education level tends to correlate with income. What I find interesting is cigarette taxes have gone up astronomically in the past 10 years. An average pack of cigarettes nationally is about $5. So if you just smoke one pack a day (and that’s not a heavy habit), you’re spending $1,800 a year just on cigarettes. The people who can least afford that expense are the ones buying cigarettes and most hit by cigarette taxes. You can bet a lot of these people don’t have health insurance, as well.
The Midwest has the highest smoking rate, at 21.7 percent, followed by the South at 20.8 percent (bit of a surprise, but Oklahoma and Indiana have high smoking rates and I believe they are included in the Midwest). The Northeast has a smoking rate of 18.7 percent and the healthy and tanned West is lowest at 15.9 percent.
Now, as far as occupation, mining and food services have the highest smoking rates at 30 percent (let’s face it, if you’re breathing coal dust all day, I can understand why miners would feel, “fuck it” about smoking.), followed by construction at 29.7 percent. Everything else is below 25 percent. Interestingly, arts and entertainment has a smoking rate of 14.9 percent. That’s lower than I would expect, because there is a LOT of smoking in the music, film and theatre industries.
Health care and social assistance smoking rate is 15.9 percent, though health care support is 23.7 percent. The lowest smoking rate is in education, at 8.7 percent (not many school campuses allow any smoking anymore.) Interesting, a job classification as “physical,” (I assume this means trainers and people in rehab services) is 9.2 percent.