Among the estimated 46 million U.S. adults who used tobacco products in 2021, cigarette smoking prevalence decreased while e-cigarette use increased, according to CDC data published in Morbidity and Mortality Weekly Report.
“Although cigarette smoking decreased over the past year, e-cigarette use increased, from 3.7% to 4.5%, largely driven by higher prevalence in use among persons aged 18 to 24 years,” Monica E. Cornelius, PhD, an epidemiologist and associate service fellow at the CDC, and colleagues wrote. “Further, declines in cigarette smoking among populations with diagnosed depression represent important successes in tobacco control. However, disparities in tobacco use remain.”
Using data from the 2021 National Health Interview Survey, Cornelius and colleagues evaluated tobacco usage of 29,482 adults in the U.S. and weighted data to determine national prevalence estimates of current usage for the year.
Researchers assessed the use of cigarettes, cigars, pipes, e-cigarettes, and smokeless tobacco, and calculated differences in use from past years.
Based on the weighted data, 46 million adults (18.7%) were estimated to be current users of a tobacco product and 35.6 million (14.5%) were estimated to be users of a combustible tobacco product. Use of at least two tobacco products was estimated in 8.3 million adults (3.4%). Researchers also reported 66.5% of adults had quit smoking.
Of the five tobacco products, most people used cigarettes (28.3 million), followed by e-cigarettes (11.1 million), cigars (8.6 million), smokeless tobacco (5.2 million), and pipes (2.3 million), according to researchers.
From 2020 to 2021, the prevalence of cigarette use dropped from 12.5% to 11.5%, although e-cigarette use jumped from 3.7% to 4.5%.
Among users of more than two tobacco products, 31.4% used both cigarettes and e-cigarettes, researchers reported. Other common combinations included cigarettes and cigars (21%), cigarettes and smokeless tobacco (7.9%), e-cigarettes and cigars (7%) and cigarettes and pipes (3.7%). Notably, 14% of adults used three or more products.
According to researchers, cigarette use in 2019 was higher among those diagnosed with depression compared with those who did not have depression (22.9% vs. 12.3%), with similar reports in 2020 (20.5% vs. 10.9%) and 2021 (19.4% vs. 9.9%); still, overall smoking declined among Black, white and Hispanic adults during this time, regardless of depression status.
Among those with depression, cigarette use was highest in Black adults in 2021, a departure from 2019 and 2020 when non-Hispanic adults of other races had the highest usage. However, non-Hispanic adults of other races who had not been diagnosed with depression had the highest prevalence of cigarette smoking in 2021.
Researchers further categorized tobacco product use in 2021 by demographics (sex, age, race, location of residence, education level, marital status, income level, sexuality, type of insurance, presence of a disability and presence of serious psychological distress) and reported higher prevalence in:
- Men (24.1%);
- Adults aged 25 to 44 years (22.1%) and 45 to 64 years (21.1%);
- Non-Hispanic other races (25.6%) and white (21.2%) adults;
- Adults living in rural areas (26.2%);
- Adults with a general educational development certificate as their highest education level (39%);
- Adults divorced/separated/widowed (21.3%) or those single/never married/not living with partner (20.1%);
- Adults with low income (24.7%);
- Lesbian, gay or bisexual adults (27.4%);
- Adults who were uninsured (28.4%) or using Medicaid (28.1%);
- Adults with a disability (24.2%); and
- Adults with serious psychological distress (37.6%).
“Continued surveillance of tobacco product use, implementation of evidence-based tobacco control strategies (eg, hard-hitting media campaigns, smoke-free policies and tobacco price increases), conducting linguistically and culturally appropriate educational campaigns, and FDA regulation of tobacco products will aid in reducing tobacco-related disease, death and disparities among U.S. adults,” Cornelius and colleagues wrote.
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Source: Healio
