Trends in tobacco use among US adults with chronic health conditions: National Survey on Drug Use and Health 2005–2013

Abstract

Introduction Chronic conditions are among the most common and costly of all health problems. Addressing tobacco use among adults with chronic conditions is a public health priority due to high prevalence as well as greater potential harm from continued use. Methods Data were drawn from 9 years (2005–2013) of the U.S. National Survey on Drug Use and Health. Adult (≥18 years) tobacco use included any past 30-day use of cigarettes, cigars, pipes, or smokeless tobacco. Chronic conditions examined included anxiety, asthma, coronary heart disease, depression, diabetes, hepatitis, HIV, hypertension, lung cancer, stroke, and substance abuse. Controlling for sociodemographics, trends in product use for most conditions and a composite of any condition among those with chronic conditions were compared to respondents with no condition in weighted logistic regression analyses. Results Cigarette smoking declined significantly over time among adults with no chronic condition. Adults with one or more chronic condition showed no comparable decrease, with cigarette smoking remaining especially high among those reporting anxiety, depression, and substance abuse. Cigar and pipe use remained stable and more prevalent among those with any chronic condition, with the exception of pipe use declining among those with heart disease. Smokeless tobacco use increased over time, with higher prevalence among those with asthma, mental health, and substance abuse conditions. Conclusions These findings have tobacco control and regulatory implications for addressing higher tobacco use among adults with chronic conditions. Provider advice and cessation resources targeting tobacco use among those with chronic conditions are recommended.

A growing geographic disparity: Rural and urban cigarette smoking trends in the United States

“…To keep current, measures in the NSDUH occasionally change. To ensure consistency of measures across time and with recent work examining trends of tobacco use in vulnerable populations (Stanton et al, 2016), we limited our analysis to adults (≥ 18 years) who responded during the years 2007 through 2014. We used the provided participant weights in all analyses, unless stated otherwise, to ensure that the results were representative of the U.S. population by correcting for selection probabilities, non-response bias, and post-stratification (Center for Behavioral Health Statistics and Quality, 2015).…”

“…Department of Health and Human Services, 2014; Warner et al, 2014). However, a closer look reveals that the many vulnerable populations—such as those of a lower socioeconomic status and those suffering from mental health conditions—have not experienced equitable declines in prevalence of cigarette smoking (Cook B et al, 2014; Stanton et al, 2016). Rural populations may be among the populations being left behind, although typically they are not mentioned along with other groups.…”

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