One in five Americans still addicted to tobacco


One in five adults in the United States still uses tobacco on a regular basis, and 15 percent of the population smokes cigarettes, according to US government data released Thursday.

The smoking rate has stayed steady in recent years despite public health efforts to reduce tobacco use, said the report by the US Centers for Disease Control and Prevention.

The CDC’s report is based on its first coordinated effort with the FDA to use the annual National Health Interview Survey (NHIS) to collect data on Americans’ use of a variety of tobacco products, rather than just combustible tobacco. 

The US Centers for Disease Control and Prevention say the smoking rate in America has stayed steady in recent years despite public health efforts to reduce tobacco use

The US Centers for Disease Control and Prevention say the smoking rate in America has stayed steady in recent years despite public health efforts to reduce tobacco use

The US Centers for Disease Control and Prevention say the smoking rate in America has stayed steady in recent years despite public health efforts to reduce tobacco use

The report comes as e-cigarettes and other alternative tobacco products become more popular, but found that because the vast majority – 87.4 percent – of tobacco users still used some form of smokable tobacco as of 2015, efforts to discourage smoking are still very much necessary.

‘Too many Americans are harmed by cigarette smoking, which is the nation’s leading preventable cause of death and disease,’ said CDC director Brenda Fitzgerald.

It has been more than 50 years since the US Surgeon General first officially recognized smoking as a direct cause of disease and death, and yet the CDC estimates that more than 480,000 people die of causes related to the habit each year. 

The vast majority of tobacco-users reported using a combustible product such as cigarettes, cigars, or pipes.

Just 3.5 percent said they used e-cigarettes, and 3.4 percent used cigars, cigarillos, or filtered little cigars.

Smokeless tobacco – such as chewing tobacco and snuff – was reported by 2.3 percent of adults. Just 1.2 percent used pipes, water pipes, or hookahs.

‘We usually hear only one side of the story, that combustible tobacco use is down,’ says Dr Amy Lukowski,clinical director at National Jewish Health hospital’s health initiative programs. 

Meanwhile, the ‘sky-rocketing’ e-cigarette industry comes with ‘a notion of implied safety,’ because these products don’t contain the 4,000 or so hazardous chemicals that cigarettes do, she says. 

But the long-term health effects of these products are not yet known, Dr Lukowski says. 

In fact, there is evidence that e-cigarettes-users develop the same dangerous proteins linked to lung diseases that cigarette-smokers do, according to a University of North Carolina Chapel Hill study published last month. 

Dr Amy Lukowski’s four step plan for tacking tobacco dependence

  1. Taxes. ‘It’s proven that when we increase taxes, tobacco use goes down,’ Dr Lukowski says. 
  2. Clean indoor air policies.  ‘We know that when our clean indoor air policies are strong, we see decreases in hospitalizations for tobacco-related illnesses,’ she says. 
  3. Prevention at the use level. Dr Lukowski says that ‘tobacco dependency is a pediatric epidemic, not an adult problem.  We know that 90 percent of  people who are addicted to tobacco had their first encounter before 18, so it’s crucial [to delay the age people take it up] and somewhere that we don’t spend our dollars in this country.’ 
  4. Cessation efforts. Dr Lukowski and her team approach dependence with a combination of coaching and medication. ‘Dependence is complex,’ she says. ‘It is physiological, behavioral and psychological; we have to address all of those components.’ 

No matter what the delivery method, ‘we know that nicotine is a drug and tobacco dependence is an addiction,’ says Dr Lukowski. ‘Once people start, it’s an addiction, not a habit, it’s a chronic disease,’ she adds. 

According to the CDC’s report, men are far more likely than women to smoke. One quarter of men use tobacco, compared to 15 percent of women, said the report.

‘Tobacco product use ranged from nine percent among Asians to 26.6 percent among American Indians/Alaska Natives,’ it added.

The highest smoking rates were seen in people earning less than $35,000 per year, and those without a high school diploma. 

The report also found that people without access to insurance were more likely to use tobacco, as were people who were not straight, lived in the Midwest, were disabled or had some form of psychological distress.

‘Every day I see people walking around with oxygen tanks and walkign outside to use tobacco,’ says Dr Lukowski. ‘Their brains have been chemically altered to crave this, even in light of terminal illness,’ she says. 

‘We need to keep the story relevant. The conversation about smoking isn’t sexy any more,’ especially in the face of the opioid epidemic, ‘but the numbers are staggering, and this story has to bubble to the top because it has a significant impact on our health overall,’ she says.  

‘These results make clear that more action is needed to reduce the disease and death caused by cigarette use — and the FDA has announced a comprehensive approach to do just that,’ said FDA Commissioner Scott Gottlieb.

He said the FDA is ‘seeking to regulate the nicotine content in cigarettes to render them minimally or non-addictive.’



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