Changing age-specific patterns of cigarette consumption in the United States, 1992–2002: Association with smoke-free homes and state-level tobacco control activity

Abstract

That this reduction is offset by an increase in light and intermittent smoking in young adults suggests the effectiveness of tobacco industry marketing and needs further research. IntroductionIn the early 1990s, the key smoking questions in national surveys in the United States were changed to better capture the cross-sectional prevalence of light or intermittent smoking behavior ( Giovino et al., 1994 ). Although cigarette consumption levels below 5 cigarettes/day (CPD) have been labeled as insuffi cient for nicotine regulation and physiological dependence ( Benowitz, Jacob, Kozlowski, & Yu, 1986 ), some smokers may maintain stable behavior at these low levels because of psychological dependence. Alternatively, for heavier smokers, a period of light or intermittent smoking may be part of a dynamic process of attempting to quit ( Zhu, Sun, Hawkins, Pierce, & Cummins, 2003 ).Using a longitudinal population survey, Zhu et al. (2003) observed that the majority of light smokers (defi ned as intermittent or daily and smoking less than 5 CPD) identifi ed in California in the early 1990s did not maintain a stable consumption level over a 20-month period. The changes in consumption observed in these longitudinal data could be represented by a dynamic model of quitting and relapse, in which heavier smokers reduced smoking prior to making a quit attempt ( Farkas, 1999 ) and relapse among former smokers began with a period of light smoking. However, the population trend was an increasing Abstract Introduction: During the 1990s, both prevalence and average cigarette consumption declined in the United States, but agespecifi c changes have not been reported. Method:All four of the nationally and state representative U.S. Current Population Surveys -Tobacco Use Supplements from 1991 -2002 ( n = 542,470) were analyzed for trends in cigarette consumption among smokers in three age groups: 18 -29, 30 -44, and 45 -64 years. A strength of tobacco control index ranking state of residence was added and weighted logistic regression analyses undertaken.Results: Over the decade, both prevalence and average consumption declined. Moderate-heavy smoking ( ≥ 15 cigarettes/day [CPD]) prevalence fell strongly over the period in all three age groups. For those aged ≥ 30 years, this reduction was accompanied by a similar drop in total smoking prevalence. For those aged 18 -29 years, this reduction was associated with an increase in very light smoking (<5 CPD; 12% daily and 88% intermittent smokers) to 22.5% of current smokers with a much smaller reduction in prevalence. Smoke-free homes more than doubled in each age group and mediated the increase in very light smoking levels. Smoke-free workplaces and the strength of tobacco control in the state were also important predictors. Very light smoking was particularly prevalent among college students and graduates. Discussion:The marked reduction in prevalence of moderateheavy smoking across age groups should translate into a reduced population risk of smoking-related disease in the near term.

The association of smoking with drinking pattern may provide opportunities to reduce smoking among students

“…This finding follows a similar trend among young people in the general population (Pierce et al 2009), and university students in the USA (Moran et al 2004). Occasional smokers were also found to be heavier drinkers than daily smokers.…”

Preventing Smoking Progression in Young Adults: the Concept of Prevescalation

“…Individuals on these smoking trajectories comprised 28% of the sample (12% early, 16% late) compared to 60% who remained non-smokers over time, 6% who experimented with smoking in adolescence and reported no smoking after age 20, and 5% whose smoking progressed rapidly from middle to late adolescence, peaked around age 20-21, then declined to zero after age 25. Consistent with evidence on the increase in light or intermittent smoking among young adults (Pierce et al 2009) and smoking initiation after age 18 (Foldes et al 2010;Thompson et al 2017), stable, lower-level smoking was added as a distinct trajectory in two 2008 studies (Brook et al 2008;Costello et al 2008). In a study from 1975 to 2002 of participants aged 14-32 years, Brook et al found that Boccasional smokers^escalated their smoking between ages 16 and 22, maintaining a pattern of non-daily smoking through their thirties (approximately 10% of the sample).…”

Differences between intermittent and light daily smokers in a population of U.S. military recruits

“…Studies have shown that smoking in adolescents is related to a social context more permissive of smoking ( Buller et al, 2003 ) and living with smokers ( Robinson et al, 2006 ). In one recent study ( Pierce et al, 2009 ), a smoke-free home signifi cantly increased the odds of being a light or intermittent smoker. Additionally, smoke-free environments (e.g., home, workplace) increase the likelihood of abstinence ( Fiore et al, 2008 ).…”

“…Despite a decrease in smoking among middle-aged and older adults, young adult smoking prevalence declines are smaller, and reductions in moderate to heavy smoking have been accompanied by an increase in prevalence of light and intermittent smoking ( Pierce, White, & Messer, 2009 ). One group of young adults who demonstrate high rates of smoking are individuals serving in the military ( Bray et al, 2006 ;Nelson & Pederson, 2008 ).…”