There are 5 million fewer adult cigarette smokers in the United States today than there were 10 years ago, a dramatic shift from a lethal addiction that still claims 480,000 American lives annually, the federal Centers for Disease Control and Prevention revealed Thursday.
“This report shows real progress helping American smokers quit and that more progress is possible,” said CDC Director Dr. Tom Frieden in a press release. The CDC reported results of a large national survey showing there were 40 million adult smokers in the U.S. in 2014, compared to 45.1 million in 2005. That puts adult smoking prevalence at 16.8 percent, a remarkable 20 percent decline in smoking rates in that period.
“The reduction in smoking prevalence over the last decade is a major victory for public health,” said Dr. Jaimee L. Heffner, a Fred Hutchinson Cancer Research Center expert in tobacco cessation.
Indeed, the pace of Americans kicking the habit seems to be picking up. Prevalence dropped a full percentage point in 2014 alone.
“One percent may sound small,” Heffner said, but the number of people that represents is not small, and “approximately half of all smokers will die of smoking-related causes.”
In one of the more encouraging findings, cigarette smoking rates among young adults aged 18-24 showed the highest rate of decline (31.6 percent) among all age groups.
But the cancer and heart disease prevention and health benefits accruing to millions of Americans who have stopped smoking are still eluding large segments of the nation’s population: among minorities, the poor and those without adequate insurance ― sectors where smoking rates remain stubbornly high.
The survey showed that when education level rises, smoking levels fall. Respondents with a high school equivalency certificate (GED) had a high smoking prevalence of 43 percent, compared to 5.4 percent for those with graduate degrees.
There was a strong association between smoking rates and the type of insurance, or lack of it, available to those who were surveyed. Those enrolled in the Medicaid program, the joint state and federal health plan for the poor, had higher smoking rates (29.1 percent) than those who were uninsured (27.9 percent), while those with private insurance smoked substantially less, at a rate of 12.9 percent.
Smoking rates also differed among ethnic and racial groups. Prevalence was highest among American Indian/Alaska natives (29.2 percent), and lowest among Asians (9.5 percent), the survey found. The report was based on results of the National Health Interview Survey, which in 2014 interviewed 36,697 adults 18 years of age and older.
Men still smoke more than women and people on the West Coast smoke the least. Prevalence among lesbian, gay or bisexual adults was 23.9 percent compared to 16.6 percent for those who are heterosexual.
As someone who has devoted her career to reducing tobacco use, Heffner said she was surprised at just how far smoking rates have fallen. The goal of the public health community, codified in Healthy People 2020, is to reduce that rate to 12 percent or less by that date, and now it is 16.8 percent.
"It was unthinkable to me in 2009,” she said. “I thought there was no way we would make it there … I have renewed hope now. We really can make this happen, and we should make this happen.”
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Sabin Russell is a staff writer at Fred Hutchinson Cancer Research Center. For two decades he covered medical science, global health and health care economics for the San Francisco Chronicle, and wrote extensively about infectious diseases, including HIV/AIDS. He was a Knight Science Journalism Fellow at MIT, and a freelance writer for the New York Times and Health Affairs. Reach him at srussell@fredhutch.org.
