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Moreover, the modest successes in reducing smoking initiation rates among adolescents during the past two decades have been offset by net increases in initiation among young adults (between 18 and 25 years of age) during the same time period. Figure 1-4 reveals that between 1985 and 2003, smoking initiation rates among young adults increased 4.3 percent, from 64.7 per 1,000 individuals to 67.5 per 1000 (SAMHSA 2005). The reduction in smoking initiation among adolescents and the increase in smoking initiation among young adults thus indicate delayed smoking initiation rather than pure abstinence, which could signify a moving target for antismoking campaigns. This conclusion is supported by prevalence data as well (Johnston et al. 2006).

Smoking Cessation

The rate at which smoking cessation increased in the 1960s and 1970s has slowed over time, as evidenced by the flattening of Figure 1-3. A comparison of the annual smoking cessation rates7 between 1992 and 2005 reveals that the largest annual increase occurred between 1992 and 1993, at 5.32 percent. During four periods (1993–1994, 1994–1995, 1995–1996, and 1999–2000), the smoking cessation rate actually declined from the previous year. The rates of cessation increased approximately 4 percent in the first five years of the 2000s. In 2000, 48.8 percent of adult ever smokers had quit smoking (TIPS 2005a). In 2005, 50.8 percent of adults who had ever smoked had quit smoking (CDC 2006b). Cessation seems to be approaching an asymptote, however, because the rate has increased an average of only 0.50 annually since 2002 (CDC 2004b, 2005a, 2005b, 2006b).

Correlates of Current Smoking

Tobacco use varies among individuals according to socioeconomic and demographic characteristics as well as by geography. Although smoking prevalence has declined overall since the 1960s, large disparities in rates of tobacco use among racial and ethnic groups and by socioeconomic status persist. The most vulnerable subpopulations—young people who start smoking early, individuals who are poor or uneducated, and some racial and ethnic minorities—are at the highest risk of being lifelong smokers. This section compares the differences in the prevalence of current smoking compared by age, race, sex, educational attainment, poverty status, and


The percentage of ever smokers who are former smokers. Although this term technically refers to results from a cohort study, it is used in this chapter more generally to refer to results from any study design.

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