The national survey on tobacco use recently published in the American Journal of Public Health shows that tobacco use remains high among U.S. adults and use varies greatly among populations and geographic regions. The study found that 19.3% of adults smoke cigarettes and one in four adults use tobacco products. Use of other tobacco products, although dwarfed by cigarette use, may also be increasing. This increase threatens the gains made in curbing tobacco use through cigarette tax policy, aggressive anti-smoking media campaigns, smoke-free air policies, and access to tobacco cessation services.
Tobacco products, such as chewing tobacco, snuff, cigars and cigarillos, and pipes, still cause negative health consequences, but are often overshadowed by efforts to reduce smoking. By including other tobacco products in the survey, there was a noteworthy expansion in how researchers view the tobacco epidemic and highlights the need for public health strategies to include these products in tobacco control efforts.
Patterns of tobacco use were uncovered by categorizing 118,581 respondents by gender, age, race/ethnicity, educational attainment, annual household income, and sexual orientation. Kentucky had the highest rate of tobacco use (37.4% of adults) while Utah had the lowest (14.1% of adults). Men smoke much more than women, and two-thirds of adults identifying as ‘non-Hispanic other’ reported using any tobacco product. This study is also the first national assessment of tobacco use in the Lesbian, Gay, Bisexual and Transgender community (LGBT). Tobacco use among LGBT individuals is 38.5%, compared to 25.3% among heterosexual respondents.
The study underscores the importance of addressing disparities in tobacco use to effectively implement tobacco control programs. All at-risk populations should be represented in evidence-based studies and they must have access to cessation programs and services. By focusing on the populations and regions with the highest use, we can work toward truly comprehensive policy and system changes to ensure a tobacco-free future for all Americans.