CIGARETTE-SMOKING AMONG US ADULTS BY STATE AND REGION - ESTIMATES FROM THE CURRENT POPULATION SURVEY

Background: Cigarette smoking is responsible for at least one third of all cancer deaths annually in the United States. Few sources exist in the peer-reviewed literature documenting state and regional differenc es in smoking behavior, despite the fact that cancer prevention and co ntrol efforts are increasingly being implemented below the national le vel. Purpose: Our goals were to determine smoking prevalence rates amo ng men and women, by region, and for each of the 50 states and the Dis trict of Columbia from census survey data collected in 1992 and 1993 a nd to compare these rates with rates determined in 1985. Methods: Ever y month, the U.S. Bureau of the Census collects labor force statistics on more than 100 000 individuals on its Current Population Survey (CP S). For the September 1992, January 1993, and May 1993 CPS, the Nation al Cancer Institute sponsored a 40-item Tobacco Use Supplement. The de finition of a current smoker changed slightly between 1985 and 1992-19 93. For the 1985 CPS, individuals were considered current smokers if t hey had smoked 100 cigarettes in their lifetime and were smoking at th e time of interview; for the 1992-1993 CPS, current smokers included a nyone who had smoked 100 cigarettes and was currently smoking every da y or just an some days. We calculated current smoking rates (every day and some days combined) based on more than a quarter million adults ( n = 266 988) interviewed in 1992-1993. Results: Substantial geographic variation exists in rates of current cigarette use among adults withi n the United States. In general, adults in the southern United States have higher rates of smoking and adults in the western states have low er rates of smoking than adults in the rest of the country, although d ifferences in smoking behavior between men and women and among various racial and ethnic populations strongly influence these patterns. Only two states, Kentucky and West Virginia, exhibited adult smoking rates (men and women combined) of 30% or higher in 1992-1993; in contrast, in 1985, such rates were reported from 20 states. The only states in w hich the prevalence was below 20% in 1992-1993 were Utah (17.1%) and C alifornia (19.5%). Rates approaching 20% were reported from New Jersey (20.7%), Massachusetts (21.5%), and Nebraska, New York, and Hawaii (2 2.0% each) in 1992-1993. Rhode Island experienced the greatest relativ e decline in smoking prevalence from 1985 to 1992-1993, with a calcula ted relative change of -30.7% (based on a change in rate from 33.5% to 23.2%), followed by Delaware (-25.9%), the of Columbia and New Jersey (-23.9% each), Connecticut (-23.2%), California (-22.9%), Alaska (-22 .8%), Georgia (-22.6%), Massachusetts (-22.1%), and New York (-22.0%). Conclusions: Smoking rates are not uniform in the United States but v ary considerably from state to state, even within the same region of t he country. The CPS is the only mechanism currently capable of simulta neously monitoring smoking trends nationally, regionally, and on a sta te-by-state basis.