HAS SMOKING CESSATION CEASED - EXPECTED TRENDS IN THE PREVALENCE OF SMOKING IN THE UNITED-STATES

From 1965 to 1990, the prevalence of cigarette smoking among US adults (aged greater than or equal to 18 years) fell steadily and substantia lly. Data for the 1990s suggest that the smoking initiation rate is in creasing and that the decline in the prevalence of smoking may have st alled, raising the fear that the historical 25-year decline will not c ontinue, The authors used a new dynamic forecasting model to show that although the decline may slow down, the demographics of smoking imply that prevalence will inexorably continue to decline over the next sev eral decades, even without any intensified efforts aimed at tobacco co ntrol, The authors estimated and validated the model using historical (1965-1993) data collected by the National Health Interview Surveys on the prevalence of smoking among adults. Their results indicate that t he current increase in the smoking initiation rate partially explains the fact that the prevalence of smoking has apparently leveled off, bu t even if the most grim assumptions about future initiation rates are used, the prevalence of smoking among adults will continue to decline for several more decades. The authors predict that if current initiati on and cessation behaviors persist, the prevalence of smoking among ad ults will automatically decline from its current level of 25% to 15-16 % by the second quarter of the next century. Even so, smoking will rem ain the nation's leading cause of premature death. Am J Epidemiol 1998 ;148:249-58.