Cigarette smoking has reached its lowest level ever recorded among adults in the United States, report the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and National Cancer Institute (NCI). This is good news for oral health, as smoking can lead to stained teeth, dulled taste and smell, slow healing, difficulties in correcting dental issues, periodontitis, and oral cancer.
About 47 million adults or one in five used a tobacco product in 2017, including a variety of smoked, smokeless, and electronic tobacco products. About 14% or 34 million adults were “every day” or “some days” smokers in 2017, compared to 15.5% in 2016, representing a 67% decline since 1965. Also, about 10% of young adults aged 18 to 24 smoked cigarettes in 2017, down from 13% in 2016.
“This new all-time low in cigarette smoking among US adults is a tremendous public health accomplishment, and it demonstrates the importance of continued proven strategies to reduce smoking,” said CDC director Robert Redfield. “Despite this progress, work remains to reduce the harmful health effects of tobacco use.”
In 2017, cigarettes were the most commonly used product (14%), followed by cigars, cigarillos, or filtered little cigars (3.8%), e-cigarettes (2.8%), smokeless tobacco (2.1%), and pipes, water pipes, or hookahs (1%). Of the 47 million adults who use tobacco products, about 9 million or 19% reported use of two or more tobacco products. The most common tobacco product combinations were cigarettes and e-cigarettes.
By subgroups, use of any tobacco product was highest among:
- People with a General Education Development or GED certificate (42.6%)
- People who were uninsured (31.0%), insured by Medicaid (28.2%), or received some other public insurance (26.8%)
- Non-Hispanic American Indian/Alaska Native (29.8%), multiracial (27.4%), white (21.4%), or black adults (20.1%)
- Lesbian, gay, or bisexual adults (27.3%)
- People with an annual household income under $35,000 (26.0%)
- People living with a disability (25.0%)
- Adults living in the Midwest (23.5%) or the South (20.8%)
- People divorced, separated, or widowed (23.1%) or people who were single, never married, or not living with a partner (21.0%)
About two in five adults (40.8%) who reported serious psychological stress used any tobacco product, representing one of the most marked disparities in tobacco use, compared with about one in five (18.5%) of those without serious psychological distress.
“For more than half a century, cigarette smoking has been the leading cause of cancer mortality in the United States. Eliminating smoking in America would, over time, eliminate about one-third of all cancer deaths,” said NCI director Norman E. Sharpless, MD. “The persistent disparities in adult smoking prevalence described in this report emphasize the need for further research to accelerate reductions in tobacco use among all Americans.”
Full implementation of comprehensive tobacco control programs can accelerate progress toward reducing tobacco-related death and disease, the agencies report. Such strategies include the CDC’s Tips from Former Smokers campaign, the FDA’s Every Try Counts campaign, and the NCI’s Smokefree.gov and (80) QUIT-NOW hotline.
“The continued drop in adult smoking rates to historic lows is encouraging, and the FDA is committed to accelerating declines in smoking and shifting the trajectory of tobacco-related disease and death through our comprehensive approach to tobacco and nicotine regulation,” said FDA commissioner Scott Gottlieb, MD.
“We’ve taken new steps to ultimately render combustible cigarettes minimally or non-addictive and to advance a framework to encourage innovation of potentially less harmful products such as e-cigarettes for adults who still seek access to nicotine, as well as support the development of novel nicotine replacement drug therapies. At the same time, we’re also working to protect kids from the dangers of tobacco product use, including e-cigarettes,” Gottlieb said.
Cigarette smoking remains the leading preventable cause of death and disease in the United States and is responsible for the overwhelming burden of death and disease from tobacco use, the agencies report. Cigarette smoking kills about 480,000 Americans each year, and about 16 million Americans suffer from a smoking-related illness. No form of tobacco use is risk-free, the agencies add.
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