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1.
Prev Chronic Dis ; 16: E71, 2019 06 06.
Artículo en Inglés | MEDLINE | ID: mdl-31172916

RESUMEN

INTRODUCTION: Our objective was to identify social and physical environmental factors associated with current cigarette smoking among adults by metropolitan county in the United States. METHODS: We linked cigarette smoking data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan Area Risk Trends (SMART) data set to 7 social and physical environmental characteristics: county type (metropolitan designation), primary care physician density, income inequality, percentage of the population that was a racial/ethnic minority, violent crime rate, education, and percentage of county residents with low income and no health insurance, all obtained from several county data sets. Spatial regression and hierarchical logistic regression modeling were performed. RESULTS: Results showed that metropolitan counties with a high proportion of non-Hispanic white adults (P < .001), lower education levels (high school graduate or less) (P < .001), and high violent crime rates (P < .001) had a higher adult cigarette smoking prevalence than other metropolitan counties. Spatial models showed 63.3% of the variability in county cigarette smoking prevalence was explained by these 3 factors as well as county type (based on population size of the of metropolitan area), primary care physician density, and percentage of county residents with low income and no health insurance. At an individual level, results showed that as the density (population) of primary care physicians increased in a county, the odds of being a current smoker decreased (OR, 0.980; P = .02). CONCLUSION: We found a significant association between adult cigarette smoking and county social and physical environmental factors. These place-based factors, especially social environmental characteristics, may reveal tobacco-related disparities to be considered when developing strategies to reduce tobacco use.


Asunto(s)
Fumar Cigarrillos/epidemiología , Medio Social , Demografía , Escolaridad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Violencia
2.
Prev Chronic Dis ; 16: E74, 2019 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-31198164

RESUMEN

We examined variations in cigarette smoking by socioeconomic status (education and poverty status) in relation to population sociodemographic characteristics (age, race/ethnicity, region and sex). We analyzed data from a nationally representative sample of US adults by using combined data from the National Survey on Drug Use and Health (2011-2014). Low socioeconomic status was generally associated with increased cigarette smoking prevalence by age, race/ethnicity, and region, irrespective of sex. The only exceptions were for Asian and Hispanic women, where low educational attainment was not associated with a high prevalence of cigarette smoking, and among Hispanic men and Asian women, where there was no association between poverty status and smoking. Efforts to reach smokers of low socioeconomic status by using proven tobacco control strategies could reduce disparities in cigarette smoking and smoking-related disease and death.


Asunto(s)
Fumar Cigarrillos/economía , Fumar Cigarrillos/psicología , Pobreza , Clase Social , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Fumadores , Estados Unidos , Adulto Joven
3.
Am J Prev Med ; 56(1): 66-73, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30467092

RESUMEN

INTRODUCTION: Prior studies suggest overuse of nonrecommended lung cancer screening tests in U.S. community practice and underuse of recommended tests. METHODS: Data from the 2010 and 2015 National Health Interview Surveys was analyzed from 2016 to 2018. Prevalence, populations, and number of chest computed tomography (CT) and chest x-ray tests were estimated for people who did and did not meet U.S. Preventive Services Task Force (USPSTF) criteria for lung cancer screening, among people aged ≥40 years without lung cancer. RESULTS: In 2015, among those who met USPSTF criteria, 4.4% (95% CI=3.0%, 6.6%), or 360,000 (95% CI=240,000, 535,000) people reported lung cancer screening with a chest CT; and 8.5% (95% CI=6.5%, 11.1%), or 689,000 (95% CI=526,000, 898,000) people reported a chest x ray. Among those who did not meet USPSTF criteria, 2.3% (95% CI=2.0%, 2.6%), or 3,259,000 (95% CI=2,850,000, 3,724,000) people reported a chest x ray; and 1.3% (95% CI=1.1%, 1.5%), or 1,806,000 (95% CI=1,495,000, 2,173,000) people reported a chest CT. The estimated population meeting USPSTF criteria for lung cancer screening in 2015 was 8,098,000 (95% CI=7,533,000, 8,702,000), which was smaller than the 9,620,000 people (95% CI=8,960,000, 10,325,000) in 2010. CONCLUSIONS: The number of adults inappropriately screened for lung cancer greatly exceeds the number screened according to USPSTF recommendations, the prevalence of appropriate lung cancer screening is low, and the population meeting USPSTF criteria is shrinking. To realize the potential benefits of screening, better processes to appropriately triage eligible individuals to screening, plus screening with a USPSTF-recommended test, would be beneficial.


Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Neoplasias Pulmonares/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Detección Precoz del Cáncer/normas , Encuestas Epidemiológicas , Humanos , Tamizaje Masivo/normas , Persona de Mediana Edad , Radiografía Torácica/estadística & datos numéricos , Tomografía Computarizada por Rayos X/estadística & datos numéricos
4.
Prev Med ; 117: 107-114, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-29684418

RESUMEN

While much is known about the demand for cigarettes, research on the demand for non-cigarette tobacco products and the cross-price impacts among those products is limited. This study aims to comprehensively examine the own- and cross-price elasticities of demand for tobacco and nicotine replacement products (NRPs) in the U.S. We analyzed market-level quarterly data on sales and prices of 15 different types of tobacco products and NRPs from 2007 to 2014, compiled from retail store scanner data. Fixed effects models with controls were used to estimate their own-price elasticities and cross-price elasticities between cigarettes and the other 14 products. Our results show that, except for cigars, the demand for combustible tobacco products was generally elastic, with the estimated own-price elasticity >1 (10% increase in prices reduces sales by >10%). The own-price elasticities for smokeless tobacco products were smaller than those for combustible tobacco, although not always significant. The demand for electronic cigarettes and NRPs was found to be elastic. The cross-price elasticities with respect to cigarettes were positive for cigarillos, little cigars, loose tobacco, pipe tobacco, electronic cigarettes and NRPs, but only results for little cigars, loose tobacco, pipe tobacco, and dissolvable lozenges were consistently significant. Our findings suggest demand for tobacco products and NRPs was responsive to changes in their own prices. Substitutions or positive cross-price impacts between cigarettes and certain other products exist. It is important that tobacco control policies take into account both own- and cross-price impacts among tobacco products and NRTs.


Asunto(s)
Comercio/estadística & datos numéricos , Economía del Comportamiento , Sistemas Electrónicos de Liberación de Nicotina/economía , Productos de Tabaco/economía , Dispositivos para Dejar de Fumar Tabaco/economía , Humanos , Nicotina , Fumar/economía , Tabaco , Estados Unidos
5.
MMWR Morb Mortal Wkly Rep ; 67(6): 196-200, 2018 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-29447148

RESUMEN

Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among U.S. middle school and high school students in 2016 (1). CDC and the Food and Drug Administration (FDA) analyzed data from the 2016 National Youth Tobacco Survey (NYTS) to assess self-reported reasons for e-cigarette use among U.S. middle school (grades 6-8) and high school (grades 9-12) student e-cigarette users. Among students who reported ever using e-cigarettes in 2016, the most commonly selected reasons for use were 1) use by "friend or family member" (39.0%); 2) availability of "flavors such as mint, candy, fruit, or chocolate" (31.0%); and 3) the belief that "they are less harmful than other forms of tobacco such as cigarettes" (17.1%). The least commonly selected reasons were 1) "they are easier to get than other tobacco products, such as cigarettes" (4.8%); 2) "they cost less than other tobacco products such as cigarettes" (3.2%); and 3) "famous people on TV or in movies use them" (1.5%). Availability of flavors as a reason for use was more commonly selected by high school users (32.3%) than by middle school users (26.8%). Efforts to prevent middle school and high school students from initiating the use of any tobacco product, including e-cigarettes, are important to reduce tobacco product use among U.S. youths (2).


Asunto(s)
Estudiantes/psicología , Vapeo/psicología , Adolescente , Niño , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Estados Unidos , Vapeo/estadística & datos numéricos
6.
Prev Chronic Dis ; 14: E32, 2017 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-28409740

RESUMEN

To quantify the prevalence of 10 quit methods commonly used by adult cigarette smokers, we used data from a nationally representative longitudinal (2014-2016) online survey of US adult cigarette smokers (n = 15,943). Overall, 74.7% of adult current cigarette smokers used multiple quit methods during their most recent quit attempt. Giving up cigarettes all at once (65.3%) and reducing the number of cigarettes smoked (62.0%) were the most prevalent methods. Substituting some cigarettes with e-cigarettes was used by a greater percentage of smokers than the nicotine patch, nicotine gum, or other cessation aids approved by the US Food and Drug Administration. Further research into the effectiveness of e-cigarettes as a cessation aid is warranted.


Asunto(s)
Fumar Cigarrillos/epidemiología , Sistemas Electrónicos de Liberación de Nicotina , Cese del Hábito de Fumar/métodos , Dispositivos para Dejar de Fumar Tabaco , Adulto , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Estados Unidos
7.
Public Health Rep ; 132(3): 304-308, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28395142

RESUMEN

Excise taxes are the primary public health strategy used to increase the price of cigarettes in the United States. Rather than quitting or reducing consumption of cigarettes, some price-sensitive smokers may avoid state and local excise taxes by purchasing cigarettes from Indian reservations. The objectives of this study were to (1) provide the most recent state-specific prevalence of purchases made on Indian reservations by non-American Indians/Alaska Natives (non-AI/ANs) and (2) assess the impact of these purchases on state tax revenues. We used data from a large national and state-representative survey, the 2010-2011 Tobacco Use Supplement to the Current Population Survey, which collects self-reported measures on cigarette use and purchases. Nationwide, 3.8% of non-AI/AN smokers reported purchasing cigarettes from Indian reservations. However, in Arizona, Nevada, New Mexico, New York, Oklahoma, and Washington State, about 15% to 30% of smokers reported making such purchases, resulting in annual tax revenue losses ranging from $3.5 million (Washington State) to $292 million (New York) during 2010-2011. Strategies to reduce the sale of non- or lower-taxed cigarettes to non-AI/ANs on Indian reservations have the potential to decrease smoking prevalence and recoup lost revenue from purchases made on reservations.


Asunto(s)
Comercio/economía , Indios Norteamericanos , Fumar/epidemiología , Impuestos/economía , Productos de Tabaco/economía , Adulto , Humanos , Encuestas y Cuestionarios , Estados Unidos/epidemiología
8.
MMWR Surveill Summ ; 66(5): 1-8, 2017 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-28151923

RESUMEN

PROBLEM/CONDITION: Persons living in rural areas are recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than for the overall population of the United States. Surveillance data about health-related behaviors are rarely reported by urban-rural status, which makes comparisons difficult among persons living in metropolitan and nonmetropolitan counties. REPORTING PERIOD: 2013. DESCRIPTION OF SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. BRFSS data were analyzed for 398,208 adults aged ≥18 years to estimate the prevalence of five self-reported health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations) by urban-rural status. For this report, rural is defined as the noncore counties described in the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties. RESULTS: Approximately one third of U.S. adults practice at least four of these five behaviors. Compared with adults living in the four types of metropolitan counties (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan), adults living in the two types of nonmetropolitan counties (micropolitan and noncore) did not differ in the prevalence of sufficient sleep; had higher prevalence of nondrinking or moderate drinking; and had lower prevalence of current nonsmoking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations. The overall age-adjusted prevalence of reporting at least four of the five health-related behaviors was 30.4%. The prevalence among the estimated 13.3 million adults living in noncore counties was lower (27.0%) than among those in micropolitan counties (28.8%), small metropolitan counties (29.5%), medium metropolitan counties (30.5%), large fringe metropolitan counties (30.2%), and large metropolitan centers (31.7%). INTERPRETATION: This is the first report of the prevalence of these five health-related behaviors for the six urban-rural categories. Nonmetropolitan counties have lower prevalence of three and clustering of at least four health-related behaviors that are associated with the leading chronic disease causes of death. Prevalence of sufficient sleep was consistently low and did not differ by urban-rural status. PUBLIC HEALTH ACTION: Chronic disease prevention efforts focus on improving the communities, schools, worksites, and health systems in which persons live, learn, work, and play. Evidence-based strategies to improve health-related behaviors in the population of the United States can be used to reach the Healthy People 2020 objectives for these five self-reported health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations). These findings suggest an ongoing need to increase public awareness and public education, particularly in rural counties where prevalence of these health-related behaviors is lowest.


Asunto(s)
Conductas Relacionadas con la Salud , Vigilancia de la Población , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Enfermedad Crónica , Femenino , Disparidades en el Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Asunción de Riesgos , Estados Unidos/epidemiología , Adulto Joven
9.
MMWR Morb Mortal Wkly Rep ; 65(30): 753-8, 2016 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-27491017

RESUMEN

Although cigarette smoking has substantially declined since the release of the 1964 Surgeon General's report on smoking and health,* disparities in tobacco use exist among racial/ethnic populations (1). Moreover, because estimates of U.S. adult cigarette smoking and tobacco use are usually limited to aggregate racial or ethnic population categories (i.e., non-Hispanic whites [whites]; non-Hispanic blacks or African Americans [blacks]; American Indians and Alaska Natives [American Indians/Alaska Natives]; Asians; Native Hawaiians or Pacific Islanders [Native Hawaiians/Pacific Islanders]; and Hispanics/Latinos [Hispanics]), these estimates can mask differences in cigarette smoking prevalence among subgroups of these populations. To assess the prevalence of and changes in cigarette smoking among persons aged ≥18 years in six racial/ethnic populations and 10 select subgroups in the United States,(†) CDC analyzed self-reported data collected during 2002-2005 and 2010-2013 from the National Survey on Drug Use and Health (NSDUH) (2) and compared differences between the two periods. During 2010-2013, the overall prevalence of cigarette smoking among the racial/ethnic populations and subgroups ranged from 38.9% for American Indians/Alaska Natives to 7.6% for both Chinese and Asian Indians. During 2010-2013, although cigarette smoking prevalence was relatively low among Asians overall (10.9%) compared with whites (24.9%), wide within-group differences in smoking prevalence existed among Asian subgroups, from 7.6% among both Chinese and Asian Indians to 20.0% among Koreans. Similarly, among Hispanics, the overall prevalence of current cigarette smoking was 19.9%; however, within Hispanic subgroups, prevalences ranged from 15.6% among Central/South Americans to 28.5% among Puerto Ricans. The overall prevalence of cigarette smoking was higher among men than among women during both 2002-2005 (30.0% men versus 23.9% women) and 2010-2013 (26.4% versus 21.1%) (p<0.05). These findings highlight the importance of disaggregating tobacco use estimates within broad racial/ethnic population categories to better understand and address disparities in tobacco use among U.S. adults.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Fumar/etnología , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Americanos Asiáticos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Hispanoamericanos/estadística & datos numéricos , Humanos , Indios Norteamericanos/estadística & datos numéricos , Masculino , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Prevalencia , Estados Unidos/epidemiología
10.
Nicotine Tob Res ; 18 Suppl 1: S41-8, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26980863

RESUMEN

INTRODUCTION: For years, national US surveys have found a lower prevalence of cigarette smoking among non-Hispanic (NH) black adolescents and young adults than their NH white counterparts while finding either similar or higher prevalence in NH blacks among older adults. We present results from four US surveys, including one supplemented by cotinine data, to determine if a race-gender-age crossover effect exists between NH black and NH white current cigarette smokers. METHODS: We present NH black and NH white current cigarette smoking estimates in the National Youth Tobacco Survey (2004-2013), National Survey on Drug Use and Health (2002-2013), National Health Interview Survey (2001-2013), and National Health and Nutrition Examination Survey (2001-2012). RESULTS: All surveys consistently found that NH black females aged 12-25 years had a lower smoking prevalence than NH white females of the same age while NH black males aged 26 years or older had a higher smoking prevalence than NH white males of the same age. Results were inconsistent between surveys for current smoking estimates for males 12-25 years and females aged 26 years or older. CONCLUSION: Our results are inconclusive in consistently detecting the existence of a race-gender-age crossover effect for current cigarette smoking between NH blacks and NH whites. National birth cohort studies are better suited to detect a race-gender-age crossover effect in smoking prevalence between these two racial groups.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Fumar/etnología , Adolescente , Adulto , Afroamericanos/psicología , Distribución por Edad , Factores de Edad , Niño , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Prevalencia , Distribución por Sexo , Factores Sexuales , Estados Unidos/epidemiología , Adulto Joven
11.
Nicotine Tob Res ; 18 Suppl 1: S65-72, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26980865

RESUMEN

INTRODUCTION: Cigarettes, cigars, and marijuana have generally been studied in isolation yet their use does not occur in isolation. Focus on cigarette smoking may overstate the observation that African American youth and young adults are less likely to smoke any combustible product compared with their white counterparts. Assessing cigarette, cigar, and marijuana use trends may help identify the extent of this difference. METHODS: Data from the 2002-2012 National Survey on Drug Use and Health (N = 25 541 to N = 28 232) were used to investigate past 30-day cigarette, cigar, and marijuana use trends among African American and white youth (12-17) and young adults (18-25). Logistic regressions assessed trends in combustible tobacco (cigarettes and cigars) and marijuana use, alone and in combination. RESULTS: From 2002-2012, the absolute difference in cigarette smoking prevalence between African American and white youth (9.6%-4.2%) and young adults (19.0%-10.5%) narrowed. Any combustible tobacco/marijuana use was significantly lower among African Americans than whites but, relative to cigarettes, the absolute difference was much smaller among youth (7.2%-2.2%) and young adults (15.8%-5.6%). Among any combustible tobacco/marijuana users, using two or more substances ranged from 31.4% to 40.3% among youth and 29.1% to 39.8% among young adults. CONCLUSION: Any combustible tobacco/marijuana use trends suggest the smoking prevalence difference between African American and white youth and young adults is real, but less pronounced than when assessing cigarette smoking alone. Policies and programs addressing smoking behaviors may benefit from broadening focus to monitor and address cigar and marijuana use as well. IMPLICATIONS: Trends in any use of cigarettes, cigars, and/or marijuana suggest the difference in smoking prevalence between African American and white youth and young adults is real, but less pronounced than when cigarette smoking is assessed alone. In 2012, more than 10% of African American and white youth, more than a third of African American young adults, and nearly half of white young adults reported past 30-day use of cigarette, cigars, and/or marijuana. Public health programs aimed at reducing these behaviors among youth and young adults could be informed by considering detailed, race-specific information regarding tobacco and marijuana use patterns.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Fumar Marihuana/etnología , Fumar/etnología , Adolescente , Adulto , Afroamericanos/psicología , Factores de Edad , Niño , Comorbilidad , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Fumar Marihuana/tendencias , Prevalencia , Fumar/tendencias , Estados Unidos/epidemiología , Adulto Joven
12.
J Public Health Manag Pract ; 22(1): 20-8, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26598952

RESUMEN

CONTEXT: Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health impacts of raising unit price. OBJECTIVE: The main purpose of this study was to evaluate the retail price impact and the determinants of price-related discount use among US adult smokers by their most commonly used cigarette brand types. METHODS: Data from the 2009-2010 National Adult Tobacco Survey, a telephone survey of US adults 18 years or older, was used to assess price-related discount use by cigarette brands. Price-related discounts included coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions. Multivariate logistic regression was used to assess sociodemographic and tobacco use determinants of discount use by cigarette brands. RESULTS: Discount use was most common among premium brand users (22.1%), followed by generic (13.3%) and other brand (10.8%) users. Among premium brand users, those who smoked 10 to 20 cigarettes per day were more likely to use discounts, whereas elderly smokers, non-Hispanic blacks, those with greater annual household income, dual users of cigarettes and other combustible tobacco products, and those who had no quit intentions were less likely to do so. Among generic brand users, those who had no quit intentions and those who smoked first cigarette within 60 minutes after waking were more likely to use discounts. CONCLUSIONS: Frequent use of discounts varies between smokers of premium and generic cigarette brands. Setting a high minimum price, together with limiting the use of coupons and promotions, may uphold the effect of cigarette excise taxes to reduce smoking prevalence.


Asunto(s)
Comercio/economía , Competencia Económica/economía , Fumar/economía , Adolescente , Adulto , Anciano , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Fumar/epidemiología , Encuestas y Cuestionarios , Adulto Joven
13.
Am J Prev Med ; 50(2): 226-9, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26687190

RESUMEN

INTRODUCTION: Electronic nicotine delivery system (ENDS) use has increased rapidly in the U.S. in recent years. The availability and use of ENDS raise new issues for public health practice and tobacco regulation, as it is unknown whether patterns of ENDS use enhance, deter, or have no impact on combustible tobacco product use. This study assessed past-month, lifetime, and frequency of ENDS use among current, former, and never adult cigarette smokers. METHODS: Data were analyzed from the 2014 Styles, a national consumer-based probability-based web panel survey of U.S. adults aged ≥18 years (n=4,269) conducted during June and July. Lifetime ENDS users were defined as those who reported having used ENDS ≥1 day in their lifetime. Past-month ENDS users were defined as those who reported using ENDS in the past 30 days. RESULTS: In 2014, overall lifetime and past-month ENDS use was 14.1% and 4.8%, respectively. By smoking status, 49.5% of current, 14.7% of former, and 4.1% of never cigarette smokers had used ENDS in their lifetime, whereas 20.6% of current, 4.0% of former, and 0.8% of never smokers used ENDS in the past month. Among current and former cigarette smokers who ever used ENDS, 44.1% and 44.7% reported using ENDS >10 days in their lifetime, respectively. CONCLUSIONS: Because the effect ENDS use has on combustible tobacco products use is unknown, and lifetime and past-month ENDS use is more common among current than former or never smokers, continued surveillance of ENDS use among adults is critical to programs and policies.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Fumar/epidemiología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
14.
MMWR Morb Mortal Wkly Rep ; 64(44): 1233-40, 2015 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-26562061

RESUMEN

Tobacco smoking is the leading cause of preventable disease and death in the United States, resulting in approximately 480,000 premature deaths and more than $300 billion in direct health care expenditures and productivity losses each year (1). To assess progress toward achieving the Healthy People 2020 objective of reducing the percentage of U.S. adults who smoke cigarettes to ≤12.0%,* CDC assessed the most recent national estimates of smoking prevalence among adults aged ≥18 years using data from the 2014 National Health Interview Survey (NHIS). The percentage of U.S. adults who smoke cigarettes declined from 20.9% in 2005 to 16.8% in 2014. Among daily cigarette smokers, declines were observed in the percentage who smoked 20­29 cigarettes per day (from 34.9% to 27.4%) or ≥30 cigarettes per day (from 12.7% to 6.9%). In 2014, prevalence of cigarette smoking was higher among males, adults aged 25­44 years, multiracial persons and American Indian/Alaska Natives, persons who have a General Education Development certificate, live below the federal poverty level, live in the Midwest, are insured through Medicaid or are uninsured, have a disability or limitation, or are lesbian, gay, or bisexual. Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, high impact mass media campaigns, and barrier-free access to quitting assistance, are critical to reduce cigarette smoking and smoking-related disease and death among U.S. adults.


Asunto(s)
Fumar/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Factores Socioeconómicos , Estados Unidos/epidemiología , Adulto Joven
15.
MMWR Morb Mortal Wkly Rep ; 64(38): 1061-5, 2015 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-26422781

RESUMEN

The use of tobacco products during adolescence increases the risk for adverse health effects and lifelong nicotine addiction. In 2014, an estimated 4.6 million middle and high school students were current users of any tobacco product, of whom an estimated 2.2 million were current users of two or more types of tobacco products. Symptoms of nicotine dependence are increased for multiple tobacco product users compared with single-product users. CDC and the Food and Drug Administration (FDA) analyzed data from the 2014 National Youth Tobacco Survey (NYTS) to determine how frequently (the number of days in the preceding 30 days) U.S. middle school (grades 6­8) and high school (grades 9­12) students used cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among current users (≥1 day during the preceding 30 days) in high school, frequent use (≥20 days during the preceding 30 days) was most prevalent among smokeless tobacco users (42.0%), followed by cigarette smokers (31.6%), e-cigarette users (15.5%), and cigar smokers (13.1%); a similar pattern was observed for those who used during all 30 days. Among current users in middle school, frequent use was greatest among smokeless tobacco users (29.2%), followed by cigarette smokers (20.0%), cigar smokers (13.2%) and e-cigarette users (11.8%). Current use of two or more types of tobacco products was common, even among students who used tobacco products 1­5 days during the preceding 30 days: 77.3% for cigar smokers, 76.9% for cigarette smokers, 63.4% for smokeless tobacco users, and 54.8% for e-cigarettes users. Preventing youths from initiating the use of any tobacco product is important to tobacco use prevention and control strategies in the United States. Monitoring the frequency and patterns of tobacco use among youths, including the use of two or more tobacco products, is important to inform evidence-based interventions to prevent and reduce all forms of tobacco use among youths.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Estudiantes/psicología , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco/epidemiología , Adolescente , Niño , Estudios Transversales , Encuestas Epidemiológicas , Humanos , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Estados Unidos/epidemiología
16.
MMWR Morb Mortal Wkly Rep ; 64(34): 935-9, 2015 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-26334565

RESUMEN

Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001­2013 National Youth Risk Behavior Surveys. Current use of any tobacco (combustible or smokeless tobacco) significantly declined from 33.9% in 2001 to 22.4% in 2013; however, current smokeless tobacco use significantly increased from 10.0% to 11.1% among athletes, and did not change (5.9%) among nonathletes. Furthermore, in 2013, compared with nonathletes, athletes had significantly higher odds of being current smokeless tobacco users (adjusted odds ratio [AOR] = 1.77, p<0.05), but significantly lower odds of being current combustible tobacco users (AOR = 0.80, p<0.05). These findings suggest that opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes regarding the health risks associated with all forms of tobacco use.


Asunto(s)
Atletas/psicología , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco/epidemiología , Tabaco sin Humo/estadística & datos numéricos , Adolescente , Atletas/estadística & datos numéricos , Sistema de Vigilancia de Factor de Riesgo Conductual , Femenino , Humanos , Masculino , Instituciones Académicas , Estados Unidos/epidemiología
17.
MMWR Morb Mortal Wkly Rep ; 64(14): 381-5, 2015 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-25879896

RESUMEN

Tobacco use and addiction most often begin during youth and young adulthood. Youth use of tobacco in any form is unsafe. To determine the prevalence and trends of current (past 30-day) use of nine tobacco products (cigarettes, cigars, smokeless tobacco, e-cigarettes, hookahs, tobacco pipes, snus, dissolvable tobacco, and bidis) among U.S. middle (grades 6-8) and high school (grades 9-12) students, CDC and the Food and Drug Administration (FDA) analyzed data from the 2011-2014 National Youth Tobacco Surveys (NYTS). In 2014, e-cigarettes were the most commonly used tobacco product among middle (3.9%) and high (13.4%) school students. Between 2011 and 2014, statistically significant increases were observed among these students for current use of both e-cigarettes and hookahs (p<0.05), while decreases were observed for current use of more traditional products, such as cigarettes and cigars, resulting in no change in overall tobacco use. Consequently, 4.6 million middle and high school students continue to be exposed to harmful tobacco product constituents, including nicotine. Nicotine exposure during adolescence, a critical window for brain development, might have lasting adverse consequences for brain development, causes addiction, and might lead to sustained tobacco use. For this reason, comprehensive and sustained strategies are needed to prevent and reduce the use of all tobacco products among youths in the United States.


Asunto(s)
Fumar/epidemiología , Estudiantes/estadística & datos numéricos , Adolescente , Niño , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Estados Unidos/epidemiología
18.
Addict Behav ; 45: 104-9, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25658771

RESUMEN

BACKGROUND: On April 1, 2009, the federal government raised cigarette taxes from $0.39 to $1.01 per pack. This study examines the impact of this increase on a range of smoking behaviors among youth aged 12 to 17 and young adults aged 18 to 25. METHODS: Data from the 2002-2011 National Survey on Drug Use and Health (NSDUH) were used to estimate the impact of the tax increase on five smoking outcomes: (1) past year smoking initiation, (2) past-month smoking, (3) past year smoking cessation, (4) number of days cigarettes were smoked during the past month, and (5) average number of cigarettes smoked per day. Each model included individual and state-level covariates and other tobacco control policies that coincided with the tax increase. We examined the impact overall and by race and gender. RESULTS: The odds of smoking initiation decreased for youth after the tax increase (odds ratio (OR)=0.83, p<0.0001). The odds of past-month smoking also decreased (youth: OR=0.83, p<0.0001; young adults: OR=0.92, p<0.0001), but the odds of smoking cessation remained unchanged. Current smokers smoked on fewer days (youth: coefficient=-0.97, p=0.0001; young adults: coefficient=-0.84, p<0.0001) and smoked fewer cigarettes per day after the tax increase (youth: coefficient=-1.02, p=0.0011; young adults: coefficient=-0.92, p<0.0001). CONCLUSIONS: The 2009 federal cigarette tax increase was associated with a substantial reduction in smoking among youths and young adults. The impact of the tax increase varied across male, female, white and black subpopulations.


Asunto(s)
Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Impuestos/estadística & datos numéricos , Productos de Tabaco , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Niño , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Humanos , Masculino , Prevalencia , Factores Sexuales , Productos de Tabaco/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto Joven
19.
MMWR Morb Mortal Wkly Rep ; 64(4): 103-8, 2015 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-25654612

RESUMEN

Exposure to secondhand smoke (SHS) from burning tobacco products causes sudden infant death syndrome (SIDS), respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers. No risk-free level of SHS exposure exists. SHS exposure causes more than 41,000 deaths among nonsmoking adults and 400 deaths in infants each year, and approximately $5.6 billion annually in lost productivity. Although population exposure to SHS has declined over the past 2 decades, many nonsmokers remain exposed to SHS in workplaces, public places, homes, and vehicles.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Disparidades en el Estado de Salud , Americanos Mexicanos/estadística & datos numéricos , Contaminación por Humo de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Cotinina/sangre , Femenino , Vivienda/estadística & datos numéricos , Humanos , Alquiler de Propiedad/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Pobreza , Estados Unidos , Adulto Joven
20.
Nicotine Tob Res ; 17(2): 228-35, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25143298

RESUMEN

INTRODUCTION: Electronic cigarette (e-cigarette) use is increasing rapidly, and the impact on youth is unknown. We assessed associations between e-cigarette use and smoking intentions among US youth who had never smoked conventional cigarettes. METHODS: We analyzed data from the nationally representative 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. Youth reporting they would definitely not smoke in the next year or if offered a cigarette by a friend were defined as not having an intention to smoke; all others were classified as having positive intention to smoke conventional cigarettes. Demographics, pro-tobacco advertisement exposure, ever use of e-cigarettes, and ever use of other combustibles (cigars, hookah, bidis, kreteks, and pipes) and noncombustibles (chewing tobacco, snuff, dip, snus, and dissolvables) were included in multivariate analyses that assessed associations with smoking intentions among never-cigarette-smoking youth. RESULTS: Between 2011 and 2013, the number of never-smoking youth who used e-cigarettes increased 3-fold, from 79,000 to more than 263,000. Intention to smoke conventional cigarettes was 43.9% among ever e-cigarette users and 21.5% among never users. Ever e-cigarette users had higher adjusted odds for having smoking intentions than never users (adjusted odds ratio = 1.70, 95% confidence interval = 1.24-2.32). Those who ever used other combustibles, ever used noncombustibles, or reported pro-tobacco advertisement exposure also had increased odds for smoking intentions. CONCLUSION: In 2013, more than a quarter million never-smoking youth used e-cigarettes. E-cigarette use is associated with increased intentions to smoke cigarettes, and enhanced prevention efforts for youth are important for all forms of tobacco, including e-cigarettes.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Intención , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/psicología , Estudiantes/estadística & datos numéricos , Adolescente , Servicios de Salud del Adolescente , Niño , Femenino , Humanos , Masculino , Servicios de Salud Escolar , Encuestas y Cuestionarios , Estados Unidos
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