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• Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years --- United States, 2009 

Conclusions: Previous declines in smoking prevalence in the United States have stalled during the past 5 years; the burden of cigarette smoking continues to be high, especially in persons living below the federal poverty level and with low educational attainment. Sustained, adequately funded, comprehensive tobacco control programs could reduce adult smoking.

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Conclusions and Comment

The results of these analyses indicate that the national estimates for the prevalence of current cigarette smoking among adults aged ≥18 years did not decline from 2008 (20.6%) (2) to 2009, and during the past 5 years (2005--2009) virtually no change has been observed, even by region. In 2009, certain population subgroups (e.g., Hispanic and Asian women, persons with higher levels of education, and older adults) continue to meet the Healthy People 2010 target of ≤12% prevalence of smoking. Although smoking prevalence was found to be lowest among Asian and Hispanic women, the findings in this report cannot assess specific Asian and Hispanic subgroups. In a previous report, variations in smoking prevalence were observed within specific Asian and Hispanic subgroups and between the sexes within these subgroups, suggesting that overall prevalence for Asians and Hispanics do not accurately represent the wide variability across subgroups (3).

Differences in understanding the health hazards of smoking and receptivity to antismoking messages might be related to the prevalence variations observed by education level (4). For example, persons with higher levels of education might have a better understanding of the health hazards of smoking and might be more receptive to health messaging about the dangers of smoking (4). Nonetheless, most population subgroups, particularly those with low education and income levels, will not meet the Healthy People 2010 target.

Differences also were noted by state and region. In 2009, the lowest prevalence was observed in the West, with lowest prevalence in Utah, followed by California. California traditionally has been cited for its success in tobacco control because of its long-running comprehensive tobacco control program (5). California's adult smoking prevalence declined approximately 40% during 1998--2006, and consequently lung cancer incidence in California has been declining four times faster than in the rest of the nation (5). Similarly, Maine, New York, and Washington have seen 45%--60% reductions in youth smoking with sustained comprehensive statewide programs (5).

Youth smoking is an important indicator to monitor because most adult established smokers (>80%) begin before the age of 18 years.§§ In 2009, one in five U.S. high school students (19.5%) reported smoking cigarettes in the preceding 30 days (6). Moreover, declines in current smoking among high school students have slowed, with an 11% decline from 21.9% in 2003 to 19.5% in 2009 compared with a 40% decline observed from 1997 (36.4%) to 2003 (21.9%) (7). The slowing in the decline observed for youth cigarette smoking indicates that cigarette smoking among adults and the associated morbidity and mortality will continue to be important public health issues for the foreseeable future.

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