CDC has just released current smoking prevalence data showing that about 21% of Americans smoke daily or some days on a regular basis. This number has not changed in three years, so we seem to have plateaued. Since everyone knows what a deadly habit smoking is, this is disturbing. The operative word, of course, is "habit," although addiction would seem to be a better choice. We persist in using the word "voluntary" to describe smoking, but CDC data also show that almost half of all smokers quit for a day or more -- unsuccessfully. Since I'm a native English speaker I think I know what the word "voluntary" means and any habit in which half of the actors can't stop doing it doesn't sound "voluntary" to me, but maybe that's just me. I know lots of non-smokers have little sympathy for smokers. I am very annoyed by smoking near me (which happens very infrequently these days) but I'm sympathetic to the plight of many smokers.
And there are 45 million smokers in the US, 80% of them daily puffers. Asians and Hispanics had the lowest prevalence of smoking (10% and 15%) while non-Hiospanic whites were just a bit above the average (22%), as were blacks (23%). Just as Asians were outliers on one end, Native Americans were the outliers on the other at 32%. Education was a powerful predictor, with GED recipients high at 46%, while those with graduate degrees were at the bottom with 7%. Income was not as powerful a predictor as education and there was a lot of missing data for this variable. The US set 12% smoking prevalence as a 2010 goal, and it is obvious we will never make it. But several subgroups are already there, including Hispanic and Asian women (10% and 5%), women with undergraduate or graduate degrees (8% and 6%), men with undergraduate or graduate degrees (11% and 7%) and women over the age of 65 (8%).
Which is good for them and too bad for the others because a comparison of the age-adjusted prevalence of smoking of people with smoking-related chronic disease (other than lung cancer) compared to those without was 37% versus 19%, a two fold difference.
The stalled progress in killing the smoking danger may be related to the state and federal governments taking their eyes off the ball at the same time that the tobacco industry has adapted with new ways to promote its deadly product:
Most notably, funding for comprehensive state programs for tobacco control and prevention decreased by 20.3% from 2002 to 2006 (6), and tobacco-industry marketing expenditures nearly doubled from 1998 ($6.7 billion) to 2005 ($13.1 billion) (7). In 2005, approximately 81% ($10.6 billion) of tobacco-industry marketing expenditures were related to discounting strategies (e.g., coupons, two-for-one offers, or promotional discounts for retailers or wholesalers) (7) that reduce the impact of increases in the unit price of tobacco, which are effective in preventing initiation of smoking and increasing cessation. (MMWR, CDC)
Bad habits die hard. So do those who have them. Meanwhile the ones who are killing them seem to be doing just fine.
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"Bad habits die hard. So do those who have them."
In that case I seem to be missing your point ...
christian: Smoking is a tough habit to break but a deadly one. And the ones who caused it are doing fine.
Well, so am I, and while agreeing that smoking may damage my health, and shouldn't damage yours, I don't exactly care about how the industry is doing. That's just money, and if amassing lots of it is 'doing fine', then that's fine with me.
Do I burden society with the cost of medical care? If stats have me die twenty years early, how would living on as an old man burden society? People go to some length avoiding death, despite pittoreque religious descriptions thereof, yet this ambition is the one truly pointless one.
I LOVE to smoke my marihuana with Philip Morris #1 tobacco. I've done so for over forty years. I'm 60, that's three quarters down the road, according to the inevitable stats. No problems whatsoever so far.
I think people should mind their own business.
christian: I have no quarrel with you. You've made your decision. But I see too many people, many of them very young, who have gotten hooked. Yes, we all have to go sometime. But there are some ways I'd rather not exit and for your sake, I hope you don't take one of them either. Most smokers don't die a horrible death from lung cancer or emphysema, so the odds are with you. But 160,000 deaths in the US a year from lung cancer, most of which are tobacco induced, is something to ponder. So the fact they are making money peddling the cause of that suffering isn't fine with me.
You mention "some subgroups are already there." Are there data to show that the rates in these groups have dropped? Or is it possible that smoking rates are stable or even rising in some subgroups that traditionally had extremely low rates. I'm not challenging, just wondering.
Lots of interesting numbers there. I was surprised at the high percentage of Native Americans who smoke. I wonder if part of the reason for this is the low cost of cigarettes on reservations; I remember reading someplace that smoking goes down by a few percentage points every time taxes on tobacco are raised. It also interested me because I've known many members of the Yakama Nation here in eastern Washington and I don't remember any of them being smokers.
Margaret: Don't know. Good question. Anybody?
I agree with you about being annoyed Revere when there are smokers about. Tennessee, Arkansas and towns in MS have outlawed it. Rightfully so. If I wanted to inhale all that crap I would just ride a bike behind a bus. I want the air in my restaurant to be the same air from out on the street.
But as to smoking and 21% the Dems want to fund SCHIP with yet a new tax on smokers. Each and every time they raise a tax on this group they get my sympathy. Why? Not because they are being forced farther and farther into a back room, but because they are in particular be subjected to a specific tax. A sin tax if you will but werent we all created equal? This too is a redistribution by taking from the poor and addicted by the Dems in most cases and giving to another group. But SCHIP also means that its a states program so if and when the last smoker croaks the states are going to be asked to pony more again, or the Dems will have to come up with yet another tax to replace the other.
Its all about the money. I dont think the Dems give one big rats butt whether people quit smoking. They tried it here to fund part of TennCare. The public response? Cross the state lines into Arkansas, Kentucky, Alabama, Miss. GA, VA, W. VA. They buy cigarettes in those states now like it was smuggled Coors beer from the 70's. Yep, they are now arresting Pop and Granny and a few others as they cross over the state lines for not paying the taxes on it. State revenooers sit back with high powered binocs and take pictures of them loading them butts by the cases into their cars. Then when they cross they have probable cause. Seizure of car, possessions and anything of value under the state tax laws. Criminals by condition and if they are worth anything, they go after their homes, their land and anything else they can find.... You know, gotta pay for that health care somehow. Well TennCare is gone, but they still enforce that law.
What will they think of next? I can hardly wait.
Christian-My only rub is that MJ is illegal, cigarettes are almost. Go ahead, smoke your stuff. Dont get caught. If you do then you pay the price for it. Revere as a rule only beats up on Bush and the post padron doesnt beat up on the patrons.
STH-Whiskey, beer, cigs are all on the reservations down in Miss. with the Choctaws and Cherokees. They do them all and there is a standing order (its an unlaughable joke), that military personnel in Meridian MS are not to ride highway 19 into Philadelphia MS on Friday and Saturday nights. The Indians get tanked and come off the reservation and try to straighten the bends in the road. But to answer your question, alcoholism and smoking are the big fun things for the Indians down this way. I read somewhere that the alcoholism might be genetic. Both are gifts from the white man, along with smallpox and TB. I know that the CRITS (Colorado River Indian Tribes) have a HUGE problem with smoking and the related problems with it.
Dont really know why though.
Randolph, I'm living ('still', considering the context :) in the Netherlands. Though growing or dealing marihuana is illegal, to a degree, smoking isn't.
As to the CRITS, usually if a group's position is bad, smoking and drinking go up. So I figure their position is less than flourishing.
We're all equiped with 'single-puppose modules', mental atoms if you like, and one of them is 'self-destruction'. Its parameter is usually near-zero, but it's always part of the equation. Care less and it rises. Don't care at all and it'll kill you.
If the mind were subject to rationality, arguments against bad habits would easily win over the masses. But at the core of mental activity are these spm's that don't care about whatever is outside their intent. They're like the terminator: "They can't be bargained with. They can't be reasoned with. They don't feel pity, or remorse, or fear. And they absolutely will not stop - ever."
So what can rationality do? It can push the 'bad-habit graph'.
Down, if you're lucky, but rationality can't even guarantee that.
Needless to say that prohibition doesn't work either. Remember the Dry Law of 1920.
Watch out Randolph, "the Dems" are coming! If only we could elect Bush for a third term, everything would be alright! Wait, we don't have to follow those silly old documents any more, do we?
The first step is to stop treating nicotine use as a deadly sin. The second is to reformulate nicotine gum so it has less nicotine and can be chewed. Finally, make the new nicotine gum available freely and for a low price. We do that and we're likely to see a serious drop in tobacco use.
BTW, do you know how Herman Goring killed himself the night before his scheduled execution?
Every night, after his conviction on war crimes charges at Nuremberg, he would ask for a glass of water and a cigarette before going to bed. When done smoking the cigarette and drinking the water he would leave the butt in the glass.
That last night he asked for the glass of water and the cigarette as usual, but this time when the guards left he put the cigarette in the glass to soak. After a few hours the water was loaded with nicotine, and that amount of nicotine, in a single gulp, is fatal. And we're talking 1945 German cigarettes here. Though even modern American cigarettes would produce a parlous amount of nicotine of this situation.
Thus no need for a poison pill smuggled in by some mysterious conspirator.
Why relate this tale?
To illustrate another way in which cigarettes can be hazardous to your health. So support cheap, over the counter, low nicotine gum, it would be a lot safer than what we have now. Not to mention a lot less annoying to those near the user.
I am intrigued by your comment about smoking tobacco not being voluntary. I think you bring up a good point, but I am willing to argue it. I think for the months that an individual initially begins to smoke, this is the voluntary behavior. For whatever reason, to be accepted socially (whatever that means), or to receive the initial nicotine buzz, it is all voluntary. People are not born addicted to nicotine, so at some point they need to make a "choice" to smoke or not to smoke.
Even after addicted to nicotine, choosing to quit is also another voluntary behavior, because the individual can choose to quit, if they really wanted to. However, many people fail because they ultimately use smoking tobacco as their main coping mechanism. Whenever they encounter feelings such as sadness, anger, and most notably stress, they light up that cigarette for relief. If they learned new coping skills to help manage these feelings, they could quit, but only if they are willing to put forth the necessary effort.
Seems like smoking tobacco is a voluntary behavior to me--Let me know what you think!
KWeav: I'd say it was as voluntary as drug addiction or alcoholism. It may be for some people there is no addiction. I smoked a half pack a day in medical school for a couple of years (before the Surgeon General's report -- I'm that old) and quit cold turkey without a problem. But that's not true for a lot of people. They are different in some way and not because they are weaker than I am. I've seen it up close in my family. So the idea that smoking is voluntary may be true initially but for many people stops being true and those are the ones we worry about.