PIPE SMOKING IN THE UNITED-STATES, 1965-1991 - PREVALENCE AND ATTRIBUTABLE MORTALITY

Background. National pipe-smoking prevalence data have rarely been rep orted, and mortality associated with pipe smoking has not been estimat ed. Methods. We analyzed National Health Interview Survey data from 19 65, 1966, 1970, 1987, and 1991 to estimate adult pipe-smoking prevalen ce in the United States. For each of these years, we estimated pipe sm oking-attributable mortality from chronic obstructive pulmonary diseas e and cancers of the oral cavity, larynx, esophagus, and lung. Results . From 1965 to 1991, the prevalence of current pipe smoking for men de clined 12.1 percentage points (from 14.1% to 2.0%) while pipe smoking remained very uncommon among women. By 1991, pipe smoking was a behavi or found primarily among men age 45 years or older, Most men who smoke d pipes also used other tobacco products, especially cigarettes, About 830 deaths (range 720-2,495) in 1965 and 1,095 deaths (range 655-2,82 0) in 1991 were attributable to pipe smoking. Conclusions. If current trends continue, pipe smoking will become extremely rare in the United States by the year 2000, Reasons for the decline in pipe smoking may include the lack of appeal of pipe smoking to women and adolescents or the increasingly unfavorable image of smoking behavior in general. Pr evention and cessation efforts need to be directed against all forms o f tobacco, including smokeless tobacco use, cigar smoking, and pipe sm oking.