Despite the development of new products purportedly reducing smokers’ exposure to tobacco toxins, Americans have greatly reduced their tobacco consumption since the publication of the first Surgeon General’s report on the harmful effects of cigarette smoking in 1964. In fact, cigarette consumption has declined substantially since the mid-1960s (see Figure 1-1 for annual trends). By 1983, the annual per-capita consumption of cigarettes had declined approximately 20 percent from the 1963 level to 3,494 cigarettes per adult; by 2004, it had declined an additional 49 percent to 1,791 cigarettes, its lowest level in 67 years (ALA 2006; Capehart 2005). The halving of per-capita consumption of cigarettes over the last 20 years stems from a decline in smoking prevalence coupled with a decline in the number of cigarettes smoked per day among those who smoke.3
The percentage of adults who currently smoke (see Box 1-2 for a definition of this and other terms) has also declined in the past 40 years, as indicated in Figure 1-2. In 1965, 41.9 percent of Americans ages 18 years and over, or approximately 52.2 million adults, smoked either every day or on some days (National Center for Health Statistics 2005). The percentage of adults who are current smokers declined steeply between 1965 and 1991, with an estimated 39 percent drop in the prevalence of cigarette smoking. By 2005, the prevalence of adult cigarette smoking had declined to half the 1965 rate. An estimated 20.9 percent of American adults, or 45.1 million people, were current smokers in 2005 (CDC 2006b).
The reduction in the prevalence of current smokers was driven by an increase in the rate of smoking cessation as well as a decrease in the rate of smoking initiation. Between 1965 and 2005, the percentage of adults who once smoked and who had quit more than doubled from 24.3 to 50.8 percent, as shown in Figure 1-3 (CDC 2006b; TIPS 2005a). Furthermore, the percentage of adults who have never smoked more than 100 lifetime cigarettes increased by approximately 23 percent from 1965 (44 percent) to 2005 (54 percent) (CDC 2005c; TIPS 2005b).
Smoking initiation among adolescents and young adults has also declined since the mid-1960s, as estimated by the National Survey on Drug Use and Health (NSDUH) (SAMHSA 2005). In 1965, among adolescents aged 12 to 17 years, 125.5 of every 1,000 smoked a cigarette for the first time. In 2003, 102.1 per 1,000 youths in the same age range had smoked a cigarette for the first time (Figure 1-4). The reduction in smoking initiation saved more than half a million adolescents from having a first cigarette between 1965 and 2004. Young adults (individuals ages 18 to 25 years) have
See Box 1-1 for a list of commonly used data sets regarding tobacco use.
As discussed in a subsequent section, mean number of cigarettes per day consumed by current smokers rose steadily until 1979, when the trend reversed.