Patterns of tobacco use
- Nancy A Rigotti, MD
Nancy A Rigotti, MD
- Professor of Medicine
- Harvard Medical School
Cigarette smoking is the leading preventable cause of mortality in the United States and worldwide. Most smoking-related mortality is due to atherosclerotic cardiovascular disease (CVD), lung cancer, and chronic obstructive pulmonary disease (COPD) [1-3]. Tobacco use also increases the risk of many other acute and chronic diseases, including cancers at many sites other than the lung (table 1). Smoking cessation is associated with clear health benefits and should always be a major health care goal .
Tobacco products are used by 28 percent of United States adults, according to the initial report (2013 to 2014) of a large longitudinal United States study involving over 45,000 adults and youth. Cigarettes remain the most common tobacco product used in the United States. However, an increasing proportion of tobacco users are using multiple products, most often cigarettes and electronic cigarettes (e-cigarettes) .
Screening all patients for tobacco use and providing all smokers a brief smoking cessation intervention are among the most cost-saving clinical preventive services . (See "Overview of smoking cessation management in adults".)
Usage of non-cigarette forms of tobacco is increasing in the United States, and 40 percent of users of tobacco use tobacco in more than one form .
The prevalence and patterns of tobacco use in adults are reviewed here. Patterns of smoking in children and adolescents are presented separately. (See "Prevention of smoking initiation in children and adolescents", section on 'Epidemiology'.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Centers for Disease Control and Prevention (CDC). Smoking-attributable mortality, years of potential life lost, and productivity losses--United States, 2000-2004. MMWR Morb Mortal Wkly Rep 2008; 57:1226.
- Centers for Disease Control and Prevention (CDC). Cigarette smoking among adults and trends in smoking cessation - United States, 2008. MMWR Morb Mortal Wkly Rep 2009; 58:1227.
- Scientific Committee on Emerging and Newly Identified Health Risks. Health effects of smokeless tobacco products. Available at: ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_o_013.pdf (Accessed on October 17, 2011).
- Health benefits of smoking cessation. A report of the Surgeon General. DHHS Publication No. (CDC) 90-8416, Department of Health and Human Services, Washington, DC 1990.
- Kasza KA, Ambrose BK, Conway KP, et al. Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014. N Engl J Med 2017; 376:342.
- Maciosek MV, Coffield AB, Edwards NM, et al. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med 2006; 31:52.
- GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet 2017; 389:1885.
- Jamal A, King BA, Neff LJ, et al. Current Cigarette Smoking Among Adults - United States, 2005-2015. MMWR Morb Mortal Wkly Rep 2016; 65:1205.
- Turner L, Mermelstein R, Flay B. Individual and contextual influences on adolescent smoking. Ann N Y Acad Sci 2004; 1021:175.
- Auer R, Concha-Lozano N, Jacot-Sadowski I, et al. Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name. JAMA Intern Med 2017; 177:1050.
- US Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Center for Disease Control, Washington 2004. CDC Publication No. 7829. Available at: www.cdc.gov/tobacco/sgr/sgr_2004/index.htm (Accessed on March 07, 2005).
- Primack BA, Sidani J, Agarwal AA, et al. Prevalence of and associations with waterpipe tobacco smoking among U.S. university students. Ann Behav Med 2008; 36:81.
- Akl EA, Gaddam S, Gunukula SK, et al. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol 2010; 39:834.
- Raad D, Gaddam S, Schunemann HJ, et al. Effects of water-pipe smoking on lung function: a systematic review and meta-analysis. Chest 2011; 139:764.
- Wang TW, Kenemer B, Tynan MA, et al. Consumption of Combustible and Smokeless Tobacco - United States, 2000-2015. MMWR Morb Mortal Wkly Rep 2016; 65:1357.
- Mazurek JM, Syamlal G, King BA, et al. Smokeless tobacco use among working adults - United States, 2005 and 2010. MMWR Morb Mortal Wkly Rep 2014; 63:477.
- Cheng YC, Rostron BL, Day HR, et al. Patterns of Use of Smokeless Tobacco in US Adults, 2013-2014. Am J Public Health 2017; 107:1508.