April 8, 2010

Recent Smoking Cessation

Cigarette smoking continues to be a leading cause of preventable disease and death in the United States, costing our Nation approximately $193 billion each year in health care costs and lost productivity.¹ Given the substantial health and economic burdens caused by the use of cigarettes, much effort has gone into the development of effective smoking cessation programs, such as medications, counseling, telephone help lines, and self-help groups. However, even with the widespread knowledge of the health consequences of smoking and the availability of cessation support services, many people continue to smoke. Understanding the characteristics of individuals who are able to stop smoking may be important to policymakers and service providers in making critical decisions about improving and targeting smoking cessation and outreach efforts.

The National Survey on Drug Use and Health (NSDUH) includes a series of questions about the use of cigarettes and other tobacco products. Respondents aged 12 or older are asked whether they ever smoked all or part of a cigarette, when they last smoked a cigarette, and whether they ever smoked cigarettes on a daily basis. This report examines smoking cessation (i.e., no cigarette use during the 12 months prior to the interview) among individuals who smoked on a daily basis at some time in their lives and who smoked any cigarettes during the period 13 to 24 months prior to the interview (hereafter referred to as "year-before-last smokers"). Excluded from the study are persons who had never smoked daily and those who had stopped smoking more than 2 years prior to the survey interview.² All findings are annual averages based on combined 2005 through 2008 data.

Of year-before-last smokers, 4.1 percent, or 2.2 million persons, had successfully stopped smoking (i.e., did not smoke in the year prior to the survey interview) (Table 1). Rates of past year smoking cessation did not vary by race/ethnicity (data not shown), but differences were found for other sociodemographic characteristics. Among year-before-last smokers, the past year smoking cessation rate was higher among females than males and higher among adults aged 26 to 34 than among persons in other age groups. Cessation rates were also higher among married persons than among persons who were never married and those who were divorced or separated.

Smoking cessation rates increased with increasing levels of education and income. The rate of smoking cessation among persons in households receiving government assistance was about half of that for persons living in households not receiving government assistance.³

Figure 1 shows State differences in the rate of smoking cessation. States with the highest estimates fall into the top fifth (quintile) and are shown in blue; States with the lowest estimates are in the bottom quintile and are shown in red.⁴ The rate of past year smoking cessation varied by State, ranging from a high of 6.8 percent in Vermont to a low of 1.8 percent in South Carolina.

Figure 1. Past Year Cigarette Smoking Cessation among Year-Before-Last Smokers Aged 12 or Older, by State: 2005 to 2008

Figure 1 Table. Past Year Cigarette Smoking Cessation among Year-Before-Last Smokers Aged 12 or Older, by State: 2005 to 2008

Percentages of Persons
5.3% to 6.8%	4.5% to 5.1%	3.9% to 4.3%	3.5% to 3.8%	1.8% to 3.4%
California Connecticut Massachusetts Minnesota Nebraska New Jersey North Dakota Vermont Washington	Alabama Alaska District of Columbia Hawaii Idaho Maryland New Mexico New York North Carolina Rhode Island Texas	Illinois Indiana Kansas Maine Missouri Montana Oregon South Dakota West Virginia Wyoming	Arizona Delaware Florida Iowa Kentucky Michigan Mississippi Ohio Tennessee Utah	Arkansas Colorado Georgia Louisiana Nevada New Hampshire Oklahoma Pennsylvania South Carolina Virginia Wisconsin

Source: 2005 to 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).

Rates of past year smoking cessation were higher among persons who had not used an illicit drug in the past year than among those who had used an illicit drug (4.8 vs. 2.5 percent).⁵ This finding held across age groups and gender (Figure 2). For example, 6.8 percent of year-before-last smokers aged 26 to 34 who did not use an illicit drug in the past year had stopped smoking in the past year compared with 3.3 percent of their counterparts who did use an illicit drug.

Figure 2. Past Year Cigarette Smoking Cessation among Year-Before-Last Smokers Aged 12 or Older, by Illicit Drug Use in the Past Year: 2005 to 2008

Smoking is associated with multiple health problems, and stopping smoking has been identified as the single most important action a smoker can take to improve his or her health. Nevertheless, despite the well-known health risks of cigarettes and the availability of smoking cessation services, many people continue to smoke. In this study, 1 in 25 people who had been smokers during the year before last were found to have stopped in the next 12 months. Smoking cessation rates were lower among certain populations, such as illicit drug users and those who had low incomes or less education. These findings suggest the need for targeted efforts to inform subgroups of smokers about the availability and effectiveness of smoking cessation services.

This report also shows that there is variation in smoking cessation rates across States. These findings might be expected because of variation in State policies on smoking, such as smoke-free ordinances and taxation of tobacco products and the level of coverage of smoking cessation treatment in their Medicaid programs, State employee health plans, and private insurance regulations.⁶