2001 tobacco: NHSDA State Estimates, Volume I

4.1. Tobacco

Approximately 66.5 million Americans used a tobacco product in 2001, a prevalence rate of almost 30 percent nationwide (Office of Applied Studies [OAS], 2002c). The State with the highest prevalence rate for persons age 12 or older in 1999–2000 was West Virginia (39.1 percent) (Table A.10). In 2000–2001, the State with the highest rate was Kentucky (38.7 percent), also one of the largest tobacco-producing States (Figure 4.1; Table B.10). Of the top 10 tobacco-using States, 7 were in the South: Kentucky, West Virginia, Louisiana, Oklahoma, Mississippi, Arkansas, and Tennessee. Utah had the lowest rate in the Nation (18.8 percent).

The highest rates of tobacco use in 2000–2001 were in the 18 to 25 age group, and the lowest rates were in the 12 to 17 age group. Three States, Kentucky, West Virginia, and Wyoming, were in the groups with the highest use of tobacco for the three age groups: 12 to 17, 18 to 25, and 26 or older. In the lowest fifth for those age groups, only four States were common to all three: Utah, Hawaii, California, and New York.

Because the youngest age group represents youths just beginning to experiment with tobacco, State rankings for youths are more subject to change than is the case with older age groups. Between 1999–2000 and 2000–2001, the only significant changes in State prevalence rates occurred among youths age 12 to 17. In Arkansas, the prevalence rate dropped from 23.4 percent in 1999–2000 to 18.2 percent in 2000–2001; in Mississippi, the rate decreased from 19.6 to 16.5 percent; and in Oregon the rate decreased from 17.5 to 13.5 percent (Table A.10).

4.2. Cigarettes

For cigarettes, many States with high past month prevalence rates were the same as those that displayed high rates for past month tobacco use. For example, in 2000–2001 for persons age 12 or older, six of the States that ranked in the highest fifth for past month cigarette use also ranked in the highest fifth for tobacco use (Figures 4.1 and 4.5; Table s B.10 and B.11).

For youths age 12 to 17, only three States that fell into the highest fifth for past month cigarette use (Kentucky, West Virginia, and Tennessee) also were in the highest group for all those age 12 or older (Figures 4.5 and 4.6; B.11). Similarly, six other States with the lowest rates of use by youths age 12 to 17 also were in the lowest group for all persons age 12 or older.

In Kentucky among persons age 12 or older, 38.7 percent reported using tobacco in the past month, but only 32.5 percent reported using cigarettes, indicating that about 6.2 percent used a tobacco product other than cigarettes (such as smokeless tobacco, cigars, and pipe tobacco). In Kentucky, 25.5 percent of those age 12 to 17 reported using tobacco in the past month, but only 22.2 percent reported using cigarettes in the same period.

The States comprising the top fifth for past month cigarette use among persons age 12 or older remained fairly constant from 1999–2000 to 2000–2001. Nine States were common to the top fifth for both years: Kentucky, Louisiana, West Virginia, Ohio, Nevada, Tennessee, Arkansas, Missouri, and North Carolina. Three States had significant decreases among youths age 12 to 17 in that period: Arkansas (from 18.6 to 14.6 percent), Oregon (from 15.0 to 11.8 percent), and Pennsylvania (from 16.4 to 14.8 percent). Only one State had a significant increase: in Rhode Island the prevalence rate increased for the 18 to 25 age group from 37.3 to 42.7 percent (Table A.11).

4.3. Perceptions of Risk of Heavy Cigarette Use

States with high prevalence rates for cigarettes often reported low rates of perceived risk for heavy cigarette use. For those age 12 or older, six of the States ranked in the lowest fifth for perceptions of great risk of smoking one or more packs of cigarettes a day also were ranked in the highest fifth for past month cigarette use: Kentucky, Louisiana, West Virginia, Ohio, Arkansas, and North Carolina (Figures 4.5 and 4.9; Table s B.11 and B.12). Similarly, of the 10 States with the highest rates of perceived risk of heavy smoking, 7 States fell into the lowest fifth for reported past month cigarette use.

The lowest rates of reported perceptions of risk were in the 12 to 17 and 18 to 25 age groups (Figures 4.10 and 4.11; Table B.12). The link between perceptions of risk and actual use of cigarettes was not as strong among youths age 12 to 17 as among persons age 12 or older. In the 12 to 17 age group, only 4 States (out of 10) with low perceived (great) risk of smoking one or more packs of cigarettes a day also were ranked in the highest fifth for past month cigarette use (Figures 4.6 and 4.10; Table s B.11 and B.12). On the other hand, 7 States out of 10 having the highest rates of perceived risk among youths also belonged to the lowest fifth among youths for past month use of cigarettes.

A number of States had larger percentages of the population age 12 or older reporting a great risk in smoking one or more packs of cigarettes a day in 2000–2001 than in 1999–2000 (at the 0.10 level or better). In all, there were 15 States with increased perceptions of risk of heavy smoking, including 4 States from the West, 4 from the Midwest, 3 from the Northeast, and 4 from the South (Table A.12). Four of the States with significant increases in perceived risk of heavy smoking were States that ranked in the top fifth for past month use of cigarettes: Kentucky, West Virginia, Ohio, and North Carolina.

Figure 4.1 Percentages Reporting Past Month Use of Any Tobacco Product among Persons Aged 12 or Older, by State: 2000 and 2001

Figure 4.1 D