Risky Behavior - Smoking Trends: Adults

Of all the risky behaviors one can indulge in, smoking must be the riskiest. It is the source of more disease and death than any other cause. One out of five deaths each year is linked to smoking — 442,000 deaths a year (264,000 men, 178,000 women). The average male smoker sacrifices more than 13 years of life; the average female smoker gives up 14.5 years. According to the Centers for Disease Control (CDC): "If current smoking patterns continue, an estimated 25 million persons in the United States who are alive today will die prematurely from smoking-related illnesses, including an estimated 5 million persons now under age 18 years."

In light of this ominous information, a hint of which must have permeated the consciousness of every American, who among us cannot summon the grit to quit? The chart shows that in 2000, 25.7% of men, 21% of women, 24.1% of the white population, and 23.2% of the black population were smokers. That's about 46.5 million adult Americans who may be addicted to tobacco. Half of them will die of it if they continue.

Concerning addiction, back in 1997, Harvard Mental Health Letter bluntly stated: "By now everyone knows that nicotine is addictive, and only tobacco salesmen deny it…. Spokesmen for the tobacco industry, using their own special definitions, prefer to say that their product is merely 'habituating.' If they are correct, and nicotine is not addictive, then nothing is."

Before research in the 1950s showed that cigarette smoking caused heart disease and lung cancer, it was seen as glamorous, though not without risk. Surgeon General Luther Terry's 1964 Report on Smoking and Health "hit the country like a bombshell," Terry stated. "It was front page news and the lead story on every radio and television station in the United States." The report seems to have sparked a brief rise in smoking behavior (see graphic), followed by a decline among all groups by 2000 (50% for men, 38% for women, 43% for whites, 49% for blacks).

Not shown on the graphic are 1955-1965 statistics (available for men/women only). In 1955, 56.9% of men and 28.4% of women smoked. By 1965 more men had given up smoking (men down 9%), but more women took it up (women up 19%).

Did something happen in the decade between 1955 and 1965 to cause more women to take up smoking? Actually, the increase in women smokers had already started. In the early 20th century, tobacco companies began a successful campaign to hook women on smoking; later women started working in smoke-filled offices. The 1920s slogan "Reach for a Lucky instead of a sweet" linked smoking with staying thin. Lucky Strike sales allegedly went up 300% in the first year of the campaign. "The number of women aged 18-21 years who smoked tripled between 1911 and 1925 and more than tripled again by 1939" (Powers). In 1968 Philip Morris got on the women's movement bandwagon when it introduced Virginia Slims cigarettes with the slogan: "You've Come a Long Way" ("Baby" was added later). Indeed, we had come a long way since a Civil War-era etiquette book admonished: "Ladies should NEVER smoke in public; it is shocking and unheard of!" Congress banned TV and radio ads for cigarettes in 1971. In 1982 Surgeon General C. Everett Koop announced that smoking was the major cause of cancer death.

Here's the good news and the bad news about smoking from Harvard Health Letter: "The good news is that heart disease risk is cut in half within a year of quitting and lung cancer risk is halved within 10 years. The not-so-good news is that former smokers are still much more likely than nonsmokers to develop these diseases for at least 15 years after they've stopped smoking."

The CDC breaks down smoker demographics in many ways. This is what the agency tells us about the groups who have a "disproportionately high" smoking prevalence: "In 1998, more than one of three American Indians/Alaska Natives, people with low income, and people with less than a high school education smoked cigarettes." CDC reports that 7 in 10 smokers want to quit; the higher one's education level, the more likely one is to succeed. The CDC also knows a great deal about teen smokers. We look at that issue next.

Sources: Chart: "Smoking Prevalence Among U.S. Adults," CDC, retrieved August 6, 2002, from http://www.cdc.gov/tobacco/research_dataadults_prev/prevali.htm. Pamela Powers, MPH, Women & Smoking: Historical & National Trends & Issues, retrieved August 6, 2002, from http://128.196.174.132/bigfiles/maternalhealth.pdf. Howard Bell, "Surgeons General: Defenders of Public Health," New Physician, Jan./Feb. 2002, p10+. CDC, Healthy People 2000 Final Review, retrieved August 6, 2002, from http://www.cdc.gov/nchs/. "Will You Pay for Your Past As a Smoker?," Harvard Health Letter, June 1998, p1-3.