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CDC: Fewer than 18% of American adults smoke cigarettes, a new low

The proportion of U.S. adults who smoke cigarettes is at the lowest level in nearly 50 years

The proportion of American adults who smoke cigarettes has hit a new low, new federal data show. And among those who do smoke, fewer are lighting up every day, and even they are smoking fewer cigarettes.

A national health survey conducted by the Centers for Disease Control and Prevention found that 17.8% of U.S. adults – or 42.1 million people – were “current cigarette smokers” in 2013. That’s the lowest percentage since the annual survey began keeping track in 1965, according to the authors of a study published Wednesday in the CDC’s Morbidity and Mortality Weekly Report.

But Americans still have a ways to go to meet the nation’s Healthy People 2020 target, the study notes. That target, set by the U.S. Department of Health and Human Services, aims to limit the adult smoking rate at no more than 12%.

Smoking is the leading cause of premature death in the U.S., killing 480,000 Americans each year and costing the economy $289 billion in annual health costs and lost productivity, the report's authors noted.

The data in the report come from the National Health Interview Survey, an in-person survey conducted every year with a representative sample of American adults who aren’t serving in the military or institutionalized. Participants were considered current smokers if they said they’d smoked at least 100 cigarettes in their lifetime and at the time of the interview smoked some days or every day. (The surveyors didn’t attempt to verify smoking status by analyzing tobacco metabolites in blood or urine samples, but other studies have found that self-reports are accurate.)

The data show not only that fewer Americans are smoking cigarettes but also that the ones who are smoking are smoking less. The proportion of current smokers who are daily smokers fell from 80.8% in 2005 to 76.9% in 2013, researchers found. That translates to 32.4 million adults who smoke every day.

And even those daily smokers are smoking less. In 2007, daily smokers puffed on an average of 16.7 cigarettes per day. By 2013, that figure had dropped to 14.2.

Here’s another way to look at it: The proportion of daily smokers who smoked between 1 and 9 cigarettes each day grew from 16.4% in 2005 to 23.3% in 2013, and the proportion who smoked 10 to 19 cigarettes each day rose from 36% to 40.3% during the same period. As a result, the share of daily smokers who smoked 20 or more cigarettes per day dropped from 47.6% to 36.4% over those eight years.

Americans who smoke cigarettes are demographically different from Americans who don’t, the study found. They were more likely to be multiracial or to classify themselves as “American Indian/Alaska Natives” and much less likely to be Asian Americans. Men were slightly overrepresented and women were slightly underrepresented.

Smokers were more likely to live in the U.S. Census Bureau’s Midwest or South regions. They were also more likely to be between the ages of 25 and 44, and much less likely to be 65 years old or older.

Compared with Americans as a whole, smokers were far more likely to have a GED certificate and far less likely to have a postgraduate degree. They were also more likely than Americans as a whole to live below the poverty level, according to the study.

The study's authors also reported that gay, lesbian and bisexual adults smoked cigarettes at higher rates (26.6%) than straight adults (17.6%). And although there was a smoking gender gap among straight adults, no such gap was seen among the LGB adults. (Last year was the first year that the National Health Interview Survey included questions about sexual orientation.)

In one caveat, the researchers (from the CDC’s Office on Smoking and Health) noted that they did not analyze any data on cigar smoking or the use of other forms of combustible tobacco. Unlike cigarettes, these forms of smoking haven’t declined in recent years “and have even increased in some populations,” they wrote.

To reduce smoking rates further, the study's authors endorsed the use of "proven" interventions, including higher cigarette prices, easy access to quit lines, smoke-free polices for public places and anti-tobacco mass-media efforts like the CDC's "Tips From Former Smokers" campaign.

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