Sandbox:smoke

Template:Smoking cessation Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2],Usama Talib, BSc, MD [3],Aravind Kuchkuntla, M.B.B.S[4]

Epidemiology

• Tobacco use is the leading cause of preventable disease, disability, and death in the United States, accounting for more than 480,000 deaths every year, or 1 of every 5 deaths.
• In 2015, about 15 of every 100 U.S. adults aged 18 years or older (15.1%) currently smoked cigarettes, this means an estimated 36.5 million adults in the United States currently smoke cigarettes.
• Current smoking has declined from nearly 21 of every 100 adults (20.9%) in 2005 to about 15 of every 100 adults (15.1%) in 2015.
• Nearly 40 million US adults still smoke cigarettes, and about 4.7 million middle and high school students use at least one tobacco product, including e-cigarettes.
• Every day, more than 3,800 youth younger than 18 years smoke their first cigarette.
• Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke and more than 16 million Americans live with a smoking-related disease.
• Each year, the United States spends nearly $170 billion on medical care to treat smoking-related disease in adults.

The epidemiology of the current smoking status based on different descriptive characteristics is as follows:

Gender

• Nearly 17 of every 100 adult men (16.7%).
• More than 13 of every 100 adult women (13.6%).

Age

• 13 of every 100 adults aged 18–24 years (13.0%).
• Nearly 18 of every 100 adults aged 25–44 years (17.7%)
• 17 of every 100 adults aged 45–64 years (17.0%).
• More than 8 of every 100 adults aged 65 years and older (8.4%).

Race

• Nearly 22 of every 100 non-Hispanic American Indians/Alaska Natives (21.9%).
• More than 20 of every 100 non-Hispanic multiple race individuals (20.2%).
• Nearly 17 of every 100 non-Hispanic Blacks (16.7%).
• More than 16 of every 100 non-Hispanic Whites (16.6%).
• More than 10 of every 100 Hispanics (10.1%).
• 7 of every 100 non-Hispanic Asians* (7.0%).

Education

• More than 24 of every 100 adults with 12 or fewer years of education (no diploma) (24.2%).
• About 34 of every 100 adults with a GED certificate (34.1%).
• Nearly 20 of every 100 adults with a high school diploma (19.8%).
• More than 18 of every 100 adults with some college (no degree) (18.5%).
• More than 16 of every 100 adults with an associate's degree (16.6%).
• More than 7 of every 100 adults with an undergraduate college degree (7.4%).
• More than 3 of every 100 adults with a graduate degree (3.6%).

Socio-economic status

• About 26 of every 100 adults who live below the poverty level (26.1%).
• Nearly 14 of every 100 adults who live at or above the poverty level (13.9%).

Geographical Area

• Nearly 19 of every 100 adults who live in the Midwest (18.7%).
• More than 15 of every 100 adults who live in the South (15.3%).
• More than 13 of every 100 adults who live in the Northeast (13.5%).
• More than 12 of every 100 adults who live in the West (12.4%).

The effect of various factors on smoking can be explained as follows:

Gender

Men were more likely to be current cigarette smokers than women.

• Nearly 17 of every 100 adult men (16.7%)
• More than 13 of every 100 adult women (13.6%)

Age

Current cigarette smoking was higher among persons aged 18–24 years, 25–44 years, and 45–64 years than among those aged 65 years and older.

• 13 of every 100 adults aged 18–24 years (13.0%)
• Nearly 18 of every 100 adults aged 25–44 years (17.7%)
• 17 of every 100 adults aged 45–64 years (17.0%)
• More than 8 of every 100 adults aged 65 years and older (8.4%)

Race

Current cigarette smoking was highest among non-Hispanic American Indians/Alaska Natives and people of multiple races and lowest among Asians.

• Nearly 22 of every 100 non-Hispanic American Indians/Alaska Natives (21.9%)
• More than 20 of every 100 non-Hispanic multiple race individuals (20.2%)
• Nearly 17 of every 100 non-Hispanic Blacks (16.7%)
• More than 16 of every 100 non-Hispanic Whites (16.6%)
• More than 10 of every 100 Hispanics (10.1%)
• 7 of every 100 non-Hispanic Asians* (7.0%)

Education

Current cigarette smoking was highest among persons with a graduate education degree certificate (GED) and lowest among those with a graduate degree.

• More than 24 of every 100 adults with 12 or fewer years of education (no diploma) (24.2%)
• About 34 of every 100 adults with a GED certificate (34.1%)
• Nearly 20 of every 100 adults with a high school diploma (19.8%)
• More than 18 of every 100 adults with some college (no degree) (18.5%)
• More than 16 of every 100 adults with an associate's degree (16.6%)
• More than 7 of every 100 adults with an undergraduate college degree (7.4%)
• More than 3 of every 100 adults with a graduate degree (3.6%)

Socioeconomic status

Current cigarette smoking was higher among persons living below the poverty* level than those living at or above this level.

• About 26 of every 100 adults who live below the poverty level (26.1%)
• Nearly 14 of every 100 adults who live at or above the poverty level (13.9%)

Region

Current cigarette smoking was highest in the Midwest and lowest in the West.

• Nearly 19 of every 100 adults who live in the Midwest (18.7%)
• More than 15 of every 100 adults who live in the South (15.3%)
• More than 13 of every 100 adults who live in the Northeast (13.5%)
• More than 12 of every 100 adults who live in the West (12.4%)

Disability

Current cigarette smoking was higher among persons with a disability/limitation than among those with no disability/limitation.

• More than 21 of every 100 adults who reported having a disability/limitation (21.5%)
• Nearly 14 of every 100 adults who reported having no disability/limitation (13.8%)

Sexual Orientation

Lesbian/gay/bisexual adults were more likely to be current smokers than straight adults.

• More than 20 of every 100 lesbian/gay/bisexual adults (20.6%)
• Nearly 15 of every 100 straight adults (14.9%)

Smoking cessation

General Principles

The 5As are an evidence-based framework for structuring smoking cessation in health care settings. The 5As include: Ask, Assess, Advise, Assist and Arrange follow-up.