Epidemology of Tobacco Smoking

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Tobacco Kills !!!		Over 480,000 people die in the USA each year from smoking. Tobacco kills as many Americans as in all our wars combined. Over 1,000,000 people. Tobacco kills that many in a little over 2 years.
	Each year, smoking kills more people than AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires---combined!
Kentucky has the highest rate of smoking in the United States -- 29.0% of the adults (2011). http://www.cdc.gov/tobacco/data_statistics/state_data/state_highlights/ 2012/states/kentucky/index.htm

Smoking Incidence and Disparities !!! View Surgeon General's 2014 Report on the Health Consequences of Smoking

Nationwide 20.5% of men and 15.8% of women smoke. 24.7% of adults with less than a high school education smoke compared to only 6% of adults with a college graduate degree smoke. 17% at or above the poverty level smoke compared to 27.9% below the poverty level.
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Smokers are hooked when they are children !!!

Approximately 80% of adult smokers started smoking before the age of 18. Every day, nearly 3,000 young people under the age of 18 become regular smokers. Among adults in the United States who have ever smoked daily, 91.3% tried their first cigarette and 77.0% became daily smokers before age 20 years (2). Among high school seniors who had ever tried smokeless tobacco (SLT), 73% did so by the ninth grade (2). Cigarette usage in Kentucky is well established by the 8th grade (3). A survey of 20 life-time smokers at Somerset High School in 2002 showed the average grade of starting smoking is 8.8.

CDC. The health consequences of smoking: Nicotine addiction -- a report by the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1988; DHHS publication no. (CDC)88-8406.
US Department of Health and Human Services. Preventing tobacco use among young people: a report by the Surgeon General. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994.
Kentucky Youth Tobacco Survey 2000. Kentucky Epidemiology Notes & Reports. March 2002, page 2.

Children will imitate their piers and role models. If they see a teacher or sports figure smoking, they will be motivated to smoke. Thus, keeping children from not smoking can largely be achieved by presenting to them community models of not smoking. This is called the "Paradigm Shift" theory of smoking prevention. As one child said to me after a non-smoking school presentation "If smoking is really that bad for you wouldn't it be illegal".

The 2010 Kentucky youth tobacco survey evaluated middle school children and showed a 40% decline in smoking and a 29% decline in overall tobacco use between the years of 2002 and 2019. However, 17% of middle school children still used tobacco products and nine percent still smoked. In addition 48% of middle school children who are non-smokers are exposed to secondhand smoke. In Kentucky, 37% of high school students use tobacco products, 27% smoke and 17% use smokeless tobacco. Thus, 63% of childhood smokers started in or before middle school.

Reference: Kentucky High School and Middle School Youth Tobacco Survey 2010

The following is from a survey of 46 Somerset, KY High School Students (Year 2000):

	Males	Females	Total
Lifetime Tobacco Users	85%	50%	70%
Current Tobacco Users	73%	20%	50%

Lifetime Smokers	77%	50%	65%
Current Smokers	58%	20%	41%
Frequent Smokers	46%	20%	35%

The following terms are defined by the CDC:

Lifetime Smoker: Ever smoked even if just one puff.

Current User: Smoked in last 30 days.

Frequent User: Smoked 20 or more cigarettes in last 30 days.

Established User: Smoked more than 100 cigarettes in their lifetime.

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