Epidemiology of Tobacco Use and Cessation

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Epidemiology of Tobacco Use and Cessation
Gary A. Giovino, Ph.D., M.S. Roswell Park Cancer
Institute Buffalo, New York
Consumer Demand Round Table Washington,
DC December 7, 2005
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Oral Cancer in a 20 Year-Old Man Who Used ST
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Tobacco Control Model of Nicotine
Addiction
Tobacco Products
Agent
Environment
Familial, Social, Cultural, Political, Economic,
Historical, Media
Host
Vector
Smoker/Chewer
Tobacco Product Manufacturers Other Users
Incidental Host
Involuntary Smoker
Source Orleans Slade, 1993
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Russells Motivation/Dependence Model of Quitting
Source Progress in Smoking Cessation Schwartz
JL (ed) ACS/WHO, 1978
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• Trends in Per Capita Consumption of Various
  Tobacco Products United States, 1880-2003

Source Tobacco Situation and Outlook Report,
U.S. Department of Agriculture, U.S.
Census Note Among persons gt 18 years old.
Beginning in 1982, fine-cut chewing tobacco was
reclassified as snuff. Estimates for 2002 and
2003 are preliminary.
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Current Use Among U.S. Adults of Various Tobacco
Products, by Sex National Health Interview
Survey, 2000
31.3
25.7
21.3
21.0
4.5
2.5
0.1
2.5
1.0
0.2
0.1
0.1
0.1
0.2
Note Current users report using either every
day or on some days

Source National Center for Health
Statistics
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• Men

Women
23.4
18.5
Source 1955 Current Population Survey 1965-2004
National Health Interview Surveys.
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51.4
49.7
Men
Women
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Percentage of Ever Smokers Who Have Quit , by
Age United States, 1965 -2004
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Percentage of Ever Smokers Who Have Quit , by
Education, Adults Aged gt 25 Years United
States, 1966 -2002
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Percentage of Adults Who Smoke Cigarettes by
Race/Ethnicity - United States, 2004
Source National Center for Health Statistics,
2004 National Health Interview Survey
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Cigarette Use and Nicotine Dependence, by Age
2003 (National Survey on Drug Use and Health)
Percent in Past Month
41.6
38.1
36.8
30.9
31.1
29.0
28.9
25.0
23.2
21.8
16.5
11.0
10.0
21.4
20.3
19.1
19.2
18.1
18.1
16.7
16.5
15.9
12.0
2.5
9.7
6.4
3.8
0.6
12-13
14-15
16-17
18-20
21-25
26-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65
Age in Years
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The good news ismost smokers want to quit

• 90 regret ever having started to smoke
• 89 plan to quit only 3 dont want to quit
• 89 believe health will improve if quit
• 84 have tried to quit in the past
• 27 try to quit each year

2004/2005 Assessing Hard Core Smoking Survey of
US smokers ages 25 years (n 1,000)
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Intentions to quit

• 22 within next 30 days
• 38 within 6 months, but not in next 30 days
• 29 after 6 months
• 6 dont have plans, but believe should quit
• 6 dont have plans, happy to remain smoking

2004/2005 Assessing Hard Core Smoking Survey of
US smokers ages 25 years (n 1,000)
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Have you ever used/tried
Percent of baseline smokers (ages 25 years)
Assessing Hard Core Smoking Survey
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Smokers are very concerned about
Percent of baseline smokers (ages 25 years)
Assessing Hard Core Smoking Survey
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Smoking helps
Percent of baseline smokers (ages 25 years)
Assessing Hard Core Smoking Survey
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Smokers Beliefs that May Impede Quitting -
United States, 2004/2005
Source Assessing Hard Core Smoking Survey (ages
25 years) n 1,000
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Only one-third of smokers correctly report that
patches are less likely to cause a heart attack
than cigarettes...
Smoker Misperceptions About the Characteristics
of Different Nicotine Delivery Devices. Hyland A,
Cummings KM, Giovino GA, Bansal M, Bauer J,
Hastrup J, Yost B. Society for Research Nicotine
on Tobacco Annual Meeting, February 2002.
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Atlanta Tampa
Human experimentation without consent