From tobacco we have learned that: knowledge is power; opponents who profit will not give up without a fight; advertising and marketing is a powerful weapon; the fight is protracted, difficult and filled with risk; federal, state and local legislation is critical to victory – as is egagement of the legal system; when opposed in the US market, purveyors of poor health move their product overseas; and finally – you can never let up, because if you do, the problem resurfaces immediately.

Thankfully, the CDC remains vigilant when it comes to tobacco use. How are we doing? Here 10 facts everyone should know from their latest report:

1. Tobacco use by kids under 18 has decreased 42% since 1965, but progress is slowing. 21% smoked in 2005. But we’ve only dropped an additional 2% in the last five years.(1,2,3)

2. Tobacco control interventions in work settings have targetted secondhand smoke and that’s helping(4,5).

3. Cigarette smoking among working adults was 19.6% in 2010 and was highest among those with less than a high school education (28.4%), those with no health insurance (28.6%), those living below the federal poverty level (27.7%), and those aged 18–24 years (23.8%). (6)

4. Education and profession affect smoking levels. Cigarette use among adults ranged from about 10% in education services to 30.0% in mining; and by occupation from about 9% in education, training, and library to about 31% in construction. (6)

5. Proven strategies to improve the numbers with adults include ‘health insurance coverage for cessation treatments, easily accessible help for those who want to quit, and smoke-free workplace policies”.(6)

6. Cigarette smoking decreaseds with increasing age.  About 24% of adults 18 to 24 smoke compared to  only 10% of those over 65.(6)

7. Socio-economics, gender and race play a role.  Highest rates: About 22% in males, 22% in non-Hispanic whites, 28% if you lack a high school diploma, 28% if you are below the federal poverty level, and 29% if you have no health insurance.(6)

8. Depending on occupation, prevalence varies some 300%. Here’s an abbreviated list: librarian(9%),educator(10%),finance(14%),healthcare(16%),farming(19%),entertainment(20%),real estate(23%), transportation(24%), constuction(30%), food services(30%), miners(30%).Table

9. Coverage for tobacco dependence treatment in the workplace has been shown to improve overall worker health, decrease health care costs, and lower rates of absenteeism.(7).

10. “The Patient Protection and Affordable Care Act of 2010 requires new private health insurance plans to offer their members evidence-based smoking cessation services without cost-sharing and should result in increased cessation among working adults.”(6)

For HealthCommentary, I’m Mike Magee

References:

1. CDC. How tobacco smoke causes disease: the biology and behavioral basis smoking-attributable disease: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2010:647–54. Available at http://www.surgeongeneral.gov/library/tobaccosmoke/report/full_report.pdf . Accessed August 16, 2011.
2. CDC. Vital Signs: current cigarette smoking among adults aged ≥18 years—United States, 2009. MMWR 2010;60:1207–12.
3. US Department of Health and Human Services. Objective 27-1a: reduce smoking rates among adults. Healthy People 2010. Washington DC: US Department of Health and Human Services; 2000. Available at ftp://ftp.cdc.gov/pub/health_statistics/nchs/datasets/data2010/focusarea27/o2701a.pdf
4. Cahill K, Moher M, Lancaster T. Workplace interventions for smoking cessation. Cochrane Database Syst Rev 2008;(4):CD003440.
5. Task Force on Community Preventive Services. The guide to community preventive services: what works to promote health: part 1: changing risk behaviors and addressing environmental challenges. Tobacco [Chapter 1]. New York, NY: Oxford University Press; 2005. Available athttp://www.thecommunityguide.org/tobacco/tobacco.pdf . Accessed August 16, 2011.
6. CDC MMWR: Current Cigarette Smoking Prevalence Among Working Adults – Prevalence From 2004 to 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6038a2.htm?s_cid=mm6038a2_w
7. Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2008. Available at http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf . Accessed

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