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3.3 Conceptual Issues for Cigarette Smoking Questions
This section provides the history of selected concepts that underlie the smoking questions used on the NHIS questionnaires.
The components of current smoking status
From the first time that the NHIS asked respondents for information on current smoking status, the two most basic questions included a screener question and, for those who answered “yes” to the screener, a current status question. The two versions of the questions are:
|
1965 - 1991 Screener: |
Have you smoked at least one hundred cigarettes during your entire life? |
| Current status: | Do you smoke cigarettes now? |
|
1992 - 2005 Screener: |
Have you smoked at least one hundred cigarettes in your entire life? |
| Current status: | Do you NOW smoke cigarettes every day, some days or not at all? |
The role of the smoking status recode variable
As mentioned in the smoking status recode section of this site, the direct answers to these two questions are not used. Rather, the basic variable used in any calculations of current smoking prevalence is the “smoking status recode”. This recode is created from the screener and status questions, and in its current formulation, generally includes the following categories: currently smokes, used to smoke, never smoked, smoking status unknown.
A more quantitative definition of “daily smoker”
A WHO panel in the early 1990’s raised the concern that the standard NHIS smoking questions might have missed a large proportion of occasional smokers. In 1990, analysis showed that the terms for the smoking status categories were not sufficiently quantitative. In 1991, the more precise terms “every day smoker” and “some days smoker” were developed.
Split-sample wording experiment
The 1992 Cancer Risk Factor Supplement was the first NHIS questionnaire to use the smoking status question now on the NHIS core questionnaire, “Do you NOW smoke cigarettes every day, some days or not at all?” The 1992 question differed from the question used previously, “Do you smoke cigarettes now?” It was not clear whether this wording change, would affect the smoking prevalence rates. Because the supplement was administered using a split sample and two booklets, it facilitated an experiment in which the old questions were put in one booklet (Cancer Control), and the new questions were tested in the other (Epidemiology).
Analysis showed no significant difference between the prevalences of current smoking obtained from both sets of questions asked in 1992, so they were combined to provide an overall prevalence estimate for the MMWR report [1].
The new questions included more “some days smokers” in the “current smoker” group, which resulted in an increase in the prevalence rate of smoking in US adults of about 1%. Both sets of results were similar enough that the new NHIS question and definition of current smoking were adopted as the CDC standard to measure smoking prevalence. [1]
Reference:
1. CDC. MMWR. Cigarette Smoking Among Adults – United States, 1992, and Changes in the Definition of Current Cigarette Smoking. 1994. 43(19):324-346. May 20.
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This page last reviewed October 15, 2008
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