Smoking trends in the United States between 1969 and 1995 based on patients hospitalized with non-smoking-related diseases

Background. This study examines smoking trends in the United States by race , gender, education, and occupation. Methods. The data were collected between 1969 and 1995 through a hospital-b ased case-control study on tobacco-related cancers, including 21,057 male a nd 14,448 female control subjects who had been diagnosed of non-smoking-rel ated diseases. Smoking measures were adjusted through direct standardizatio n and regression methods. Results. Despite the decline in smoking, daily cigarette consumption remain ed high among current smokers. Women's smoking prevalence decreased more sl owly than men's and their age at smoking initiation also declined, while th e inverse effects on smoking by education and occupation were more pronounc ed in men than in women. Smoking prevalence was higher, but daily cigarette consumption was lower in blacks compared to caucasians. Conclusions. Despite an overall downward trend in smoking, lung cancer rema ins a major public health concern, particularly among women, blacks, and wh ite men with low education. The development of a systematic mechanism for m ore detailed, regular monitoring of tobacco use by various subpopulations i s, therefore, crucial to future public health planning. (C) 1998 American H ealth Foundation and Academic Press.