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• Cigarette Smoking Among Adults and Trends in Smoking Cessation --- United States, 2008 

Cigarette smoking continues to be the leading cause of preventable morbidity and mortality in the United States (1). Full implementation of population-based strategies (2) and clinical interventions can educate adult smokers about the dangers of tobacco use and assist them in quitting (3,4). To assess progress toward the Healthy People 2010 objective of reducing the prevalence of cigarette smoking among adults to <12% (objective 27-1a) (5), CDC analyzed data from the 2008 National Health Interview Survey (NHIS). This report summarizes the results of that analysis, which indicated that during 1998--2008, the proportion of U.S. adults who were current cigarette smokers declined 3.5% (from 24.1% to 20.6%). However, the proportion did not change significantly from 2007 (19.8%) to 2008 (20.6%). In 2008, adults aged ≥25 years with low educational attainment had the highest prevalence of smoking (41.3% among persons with a General Educational Development certificate [GED] and 27.5% among persons with less than a high school diploma, compared with 5.7% among those with a graduate degree). Adults with education levels at or below the equivalent of a high school diploma, who comprise approximately half of current smokers, had the lowest quit ratios (2008 range: 39.9% to 48.8%). Evidence-based programs known to be effective at reducing smoking should be intensified among groups with lower education, and health-care providers should take education level into account when communicating about smoking hazards and cessation to these patients. . . .

Although comprehensive tobacco control programs have been effective in decreasing tobacco use in the United States, they remain underfunded. . . .

Effective population-based strategies for preventing tobacco use and encouraging tobacco use cessation (including enforcing bans on advertisement) are outlined in the World Health Organization's MPOWER package.� Despite partial bans on some forms of advertisement, the tobacco industry continues to conduct targeted marketing toward socially disadvantaged subgroups and vulnerable populations, such as persons with low socioeconomic status and youths (10).

Offering and providing effective cessation counseling and treatments are integral to reducing the smoking epidemic, especially in subpopulations with high rates of smoking. Because persons with lower educational attainment generally have higher rates of smoking, are less likely to quit, and have less knowledge about the health effects of smoking but are interested in quitting, health-care providers should take education level into account when communicating with such patients (3,4).

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