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The National Survey on Drug Use and Health continues with this section on Tobacco Use:

4. Tobacco Use

The National Survey on Drug Use and Health (NSDUH) includes a series of questions about the use of tobacco products, including cigarettes, chewing tobacco, snuff, cigars, and pipe tobacco. Cigarette use is defined as smoking "part or all of a cigarette." For analytic purposes, data for chewing tobacco and snuff are combined as "smokeless tobacco."

• In 2007, an estimated 70.9 million Americans aged 12 or older were current (past month) users of a tobacco product. This represents 28.6 percent of the population in that age range. In addition, 60.1 million persons (24.2 percent of the population) were current cigarette smokers; 13.3 million (5.4 percent) smoked cigars; 8.1 million (3.2 percent) used smokeless tobacco; and 2.0 million (0.8 percent) smoked tobacco in pipes (Figure 4.1).
• The rate of current use of any tobacco product among persons aged 12 or older decreased from 29.6 percent in 2006 to 28.6 percent in 2007, but the rates of current use of cigarettes, smokeless tobacco, cigars, and pipe tobacco did not change significantly over that period. Between 2002 and 2007, past month use of any tobacco product decreased from 30.4 to 28.6 percent, and past month cigarette use declined from 26.0 to 24.2 percent. Rates of past month use of cigars, smokeless tobacco, and pipe tobacco were similar in 2002 and 2007.

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Figure 4.1 Past Month Tobacco Use among Persons Aged 12 or Older: 2002-2007

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

Age

• Young adults aged 18 to 25 had the highest rate of current use of a tobacco product (41.8 percent) and of each specific product compared with youths aged 12 to 17 and adults aged 26 or older. In 2007, the rates of past month use among young adults were 36.2 percent for cigarettes, 11.8 percent for cigars, 5.3 percent for smokeless tobacco, and 1.2 percent for pipe tobacco. The rate of current use of a tobacco product by young adults decreased from 2006 to 2007 (43.9 vs. 41.8 percent), as did the rate of cigarette use (38.4 vs. 36.2 percent). These decreases from 2006 to 2007 in current use of any tobacco product and cigarettes continue declines seen from 2002 to 2006 among young adults; in 2002, the rates were 45.3 and 40.8 percent, respectively. However, the rate of current use of cigars by young adults was higher in 2007 than in 2002 (11.8 vs. 11.0 percent).
• Among youths aged 12 to 17 in 2007, 3.1 million (12.4 percent) used a tobacco product in the past month, 2.5 million (9.8 percent) used cigarettes, and 1.1 million (4.2 percent) used cigars (Figure 4.2). The rate of past month cigarette use among 12 to 17 year olds declined from 13.0 percent in 2002 to 9.8 percent in 2007. Past month use of smokeless tobacco, however, was higher in 2007 (2.4 percent) than in 2002 (2.0 percent).

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Figure 4.2 Past Month Tobacco Use among Youths Aged 12 to 17: 2002-2007

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

• In 2007, 1.8 percent of 12 or 13 year olds, 8.4 percent of 14 or 15 year olds, and 18.9 percent of 16 or 17 year olds were current cigarette smokers (Figure 4.3). Across age groups, current cigarette use peaked at 38.5 percent among persons aged 21 to 25. Less than a quarter (22.0 percent) of persons aged 35 or older in 2007 smoked cigarettes in the past month. From 2006 to 2007, the rate of current cigarette use decreased among persons aged 18 to 20 (from 35.6 to 32.7 percent) and among persons aged 21 to 25 (from 40.2 to 38.5 percent).

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Figure 4.3 Past Month Cigarette Use among Persons Aged 12 or Older, by Age: 2007

Gender

• In 2007, current use of a tobacco product among persons aged 12 or older was reported by a higher percentage of males (35.2 percent) than females (22.4 percent). Males also had higher rates of past month use than females of each specific tobacco product: cigarette smoking (27.1 percent of males vs. 21.5 percent of females), cigar smoking (9.1 vs. 1.8 percent), use of smokeless tobacco (6.3 vs. 0.4 percent), and use of pipe tobacco (1.5 vs. 0.2 percent).
• Among youths aged 12 to 17, the rate of current cigarette smoking in 2007 did not differ significantly for males (10.0 percent) and females (9.7 percent). The rate declined for females between 2006 and 2007 (10.7 vs. 9.7 percent), but remained unchanged for males (10.0 percent in each year). From 2002 to 2007, the rate of current cigarette smoking among youths decreased for both males (from 12.3 to 10.0 percent) and females (from 13.6 to 9.7 percent) (Figure 4.4).

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Figure 4.4 Past Month Cigarette Use among Youths Aged 12 to 17, by Gender: 2002-2007

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

• Among female young adults aged 18 to 25, current cigarette smoking decreased from 34.9 percent in 2006 to 31.8 percent in 2007. Between 2002 and 2007, the rate of cigarette use among young adults declined for both males (from 44.4 to 40.5 percent) and females (from 37.1 to 31.8 percent). Among male young adults, however, there was an increase in the rate of current cigar smoking over that period (from 16.8 percent in 2002 to 18.4 percent in 2007).

Pregnant Women

• Among women aged 15 to 44, combined data for 2006 and 2007 indicated that the rate of past month cigarette use was lower among those who were pregnant (16.4 percent) than it was among those who were not pregnant (28.4 percent). This pattern was evident among women aged 18 to 25 (23.3 vs. 33.9 percent for pregnant and nonpregnant women, respectively) and among women aged 26 to 44 (11.6 vs. 28.3 percent, respectively). However, among those aged 15 to 17, the rate of cigarette smoking for pregnant women was higher than for nonpregnant women (24.3 vs. 16.0 percent). A similar pattern in cigarette smoking was observed in the combined 2004-2005 data, although the difference among those aged 15 to 17 was not statistically significant in the data for those years.
• Two-year moving average rates from 2002-2003 to 2006-2007 indicate that current cigarette use among women aged 15 to 44 decreased from 30.7 to 28.4 percent for those who were not pregnant and from 18.0 to 16.4 percent for those who were pregnant, although the latter difference was not statistically significant (Figure 4.5).

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Figure 4.5 Past Month Cigarette Use among Women Aged 15 to 44, by Pregnancy Status: Combined Years 2002-2003 to 2006-2007

⁺ Difference between this estimate and the 2006-2007 estimate is statistically significant at the .05 level.

Race/Ethnicity

• In 2007, the prevalence of current use of a tobacco product among persons aged 12 or older was 15.4 percent for Asians, 22.7 percent for Hispanics, 26.8 percent for blacks, 30.7 percent for whites, 35.2 percent for persons who reported two or more races, and 41.8 percent for American Indians or Alaska Natives. There were no statistically significant changes in past month use of a tobacco product between 2006 and 2007 for any of these racial/ethnic groups. Among the specific tobacco products, smokeless tobacco use in the past month among blacks decreased from 1.7 percent in 2006 to 0.7 percent in 2007.
• In 2007, current cigarette smoking among youths aged 12 to 17 and young adults aged 18 to 25 was more prevalent among whites than blacks (12.2 vs. 6.1 percent for youths and 40.8 vs. 26.2 percent for young adults). Among adults aged 26 or older, however, whites and blacks used cigarettes at about the same rate (24.8 and 25.7 percent, respectively). The rates for Hispanics were 6.7 percent among youths, 29.5 percent among young adults, and 21.0 percent among those aged 26 or older.

• From 2006 to 2007, current cigarette use among whites aged 18 to 25 decreased from 44.4 to 40.8 percent, and current use of smokeless tobacco among blacks aged 26 or older decreased from 2.2 to 0.8 percent.

Education

• Cigarette smoking in the past month was less prevalent among adults who were college graduates compared with those with less education. Among adults aged 18 or older, current cigarette use in 2007 was reported by 32.9 percent of those who had not completed high school, 31.9 percent of high school graduates who did not attend college, 26.8 percent of persons with some college, and 14.0 percent of college graduates (Figure 4.6). Past month cigarette smoking among adults who had not completed high school decreased from 35.6 percent in 2006 to 32.9 percent in 2007.
• In 2007, the use of smokeless tobacco in the past month was reported by 3.5 percent of persons aged 18 or older who had not completed high school, 4.4 percent of those who completed high school but did not attend college, and 3.3 percent of those who attended some college. The prevalence among college graduates, 2.1 percent, was lower than among the other groups.

Below is a bar graph. Click here for the text describing this graph.

Figure 4.6 Past Month Tobacco Use among Adults Aged 18 or Older, by Education: 2007

College Students

• Among young adults 18 to 22 years old, full-time college students were less likely to be current cigarette smokers than their peers who were not enrolled full time in college. Cigarette use in the past month in 2007 was reported by 25.6 percent of full-time college students, less than the rate of 41.2 percent for those not enrolled full time.
• Among males aged 18 to 22 in 2007, full-time college students and those not enrolled full time in college did not differ significantly in their rates of past month cigar smoking (19.1 and 21.7 percent, respectively) or past month smokeless tobacco use (9.8 and 10.7 percent). A similar pattern was seen among females aged 18 to 22.

Employment

• In 2007, current cigarette smoking was more common among unemployed adults aged 18 or older than among adults who were working full time or part time (44.6 vs. 27.6 and 24.5 percent, respectively). Cigar smoking followed a similar pattern, with 11.2 percent of unemployed adults reporting past month use compared with 6.4 percent of full-time workers and 5.3 percent of part-time workers.
• Current use of smokeless tobacco in 2007 was higher among adults aged 18 or older who were employed full time (4.4 percent) and those who were unemployed (4.9 percent) than among adults who were employed part time (2.0 percent) and those in the "other" employment category, which includes persons not in the labor force (1.9 percent).

Geographic Area

• In 2007, current cigarette smoking among persons aged 12 or older was lowest in the West (21.1 percent) and Northeast (22.1 percent), higher in the South (25.5 percent), and highest in the Midwest (27.2 percent). Use of smokeless tobacco was higher in the Midwest and South (4.0 and 3.8 percent, respectively) than in the West (2.8 percent); the lowest rate was in the Northeast (1.8 percent).
• Among persons aged 12 or older, the rate of current cigarette use was associated with county type in 2007. The rates of cigarette smoking were 22.7 percent in large metropolitan areas, 24.8 percent in small metropolitan areas, 28.0 percent in urbanized nonmetropolitan areas, and 29.5 percent in less urbanized nonmetropolitan areas. In completely rural counties, 23.6 percent of persons aged 12 or older were current cigarette smokers in 2007, which is lower than the rate in 2006 (30.1 percent) and similar to the rate in 2005 (23.3 percent).
• Use of smokeless tobacco in the past month in 2007 among persons aged 12 or older was lowest in large metropolitan areas (2.0 percent). In small metropolitan areas, the rate was 3.5 percent; in nonmetropolitan areas, it was 6.7 percent; and in completely rural nonmetropolitan counties, the rate was 7.0 percent.

Association with Illicit Drug and Alcohol Use

• Use of illicit drugs and alcohol was more common among current cigarette smokers than among nonsmokers in 2007, as in 2002 through 2006. Among persons aged 12 or older, 20.1 percent of past month cigarette smokers reported current use of an illicit drug compared with 4.1 percent of persons who were not current cigarette smokers. Past month alcohol use was reported by 66.9 percent of current cigarette smokers compared with 46.1 percent of those who did not use cigarettes in the past month. The association also was found with binge drinking (45.0 percent of current cigarette users vs. 16.4 percent of current nonusers) and heavy drinking (16.4 vs. 3.8 percent, respectively).

Frequency of Cigarette Use

• Among the 60.1 million current cigarette smokers aged 12 or older in 2007, 36.8 million (61.3 percent) used cigarettes daily. The percentage of daily cigarette smokers increased with age, with 26.3 percent among past month cigarette users aged 12 to 17, 49.3 percent among those aged 18 to 25, and 66.3 percent among those aged 26 or older. In addition, over half (50.9 percent) of daily smokers aged 12 or older reported smoking 16 or more cigarettes per day; this is approximately one pack or more. The percentage of daily smokers who used a pack of cigarettes or more per day was steadily higher with age from 18.5 percent among those aged 12 to 17 to 33.1 percent among those aged 18 to 25 to 55.0 percent among those aged 26 or older.

The next section of the survey addresses "The Initiation of Substance Use."