2000 SAE Report, Volume 1 - 4. Tobacco Use

Tobacco is the second most popular substance in the United States next to alcohol. The National Household Survey on Drug Abuse (NHSDA) includes a series of questions on the use of several tobacco products, including cigarettes, smokeless tobacco, cigars, and pipe tobacco. This chapter includes State estimates on past month use of cigarettes, past month use of tobacco, and the risks of heavy use of cigarettes. Differences in estimates for cigarettes and tobacco represent persons who do not smoke cigarettes, but who use one of the other forms of tobacco.

4.1 Tobacco

Approximately 65 million Americans used a tobacco product in 2000, a prevalence rate of almost 29 percent nationwide (Office of Applied Studies [OAS], 2001b). The State with the highest 1999-2000 prevalence rate for persons aged 12 or older was West Virginia (39.1 percent) (Figure 4.1; Table A.20). Kentucky, the largest tobacco-producing State, was second (37.8 percent). Of the top 10 tobacco-using States, 7 were Southern: West Virginia, Kentucky, Oklahoma, Arkansas, Tennessee, Mississippi, and Alabama. Utah had the lowest rate in the Nation (19.9 percent). The States ranking in the lowest fifth included a mixture of Northeastern States, Western States, and Southern States.

The highest rates of tobacco use were in the 18 to 25 age group. The States with the highest prevalence rates in this age group were mostly Midwestern: North Dakota, Minnesota, Wisconsin, Missouri, Ohio, South Dakota, and Iowa (Figure 4.3; Table A.20). Two Southern States had the highest rates in this age group: Kentucky (55.1 percent) and West Virginia (54.4 percent). Utah had the lowest prevalence rate (27.5 percent) among 18 to 25 year olds.

The lowest tobacco use rates were in the 12 to 17 age group, ranging from 10.4 percent for California to 26.0 percent for Kentucky (Figure 4.2; Table A.20). 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. Only four States in the highest fifth for ages 12 to 17 (Kentucky, Arkansas, West Virginia, and Tennessee) were also included in the highest fifth for persons aged 12 or older; however, seven States in the lowest fifth for ages 12 to 17 (California, Utah, District of Columbia, New York, Hawaii, New Jersey, and Virginia) were common to the lowest fifth for the 12 or older age group. The greater stability of States in the lowest fifth may be attributable in part to cultural norms or continuing prevention efforts in those States.

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 the highest fifth for persons aged 12 or older, eight of the States that ranked high for past month cigarette use also ranked high for tobacco use (Figures 4.1 and 4.5; Table s A.20 and A.22).

For youths aged 12 to 17, four States ranked in the highest fifth (Kentucky, West Virginia, Arkansas, and North Carolina) were also in the highest fifth for the total aged 12 or older (Figures 4.5 and 4.6; Table A.22). Similarly, seven States with the lowest rates among youths could also be found in the lowest fifth for all persons aged 12 or older.

In West Virginia among persons aged 12 or older, 39.1 percent reported using tobacco in the past month, but only 30.5 percent reported using cigarettes, indicating that about 9 percent used a tobacco product other than cigarettes (such as smokeless tobacco, cigars, and pipe tobacco). In Kentucky among youths, 26.0 percent reported using tobacco in the past month, but only 22.4 percent reported using cigarettes in the same period.

4.3 Perceptions of Risk of Heavy Cigarette Use

States that reported high prevalence rates for cigarettes often reported low rates of perceived risk for heavy cigarette use. For those aged 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 (Figures 4.5 and 4.9; Table s A.22 and A.24). Similarly, of the 10 States that reported the highest rates of perceived risk of heavy smoking, only Rhode Island was not among the States in the two lowest fifths 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 A.24). Among youths, the link between perceptions of risk and actual use of cigarettes was not as strong as in the 12 or older age group. In the 12 to 17 age group, only three States (North Carolina, Kentucky, and South Dakota) that reported 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 A.22 and A.24). Among youths, the relationship at the State level between great risk of heavy smoking and having low rates of cigarette was more pronounced: Six States in the highest group of reported risk were among the States in the lowest fifth in past month use of cigarettes (Utah, Florida, California, Idaho, District of Columbia, and New Jersey).

Figure 4.1 Percentages Reporting Past Month Use of Any Tobacco Product among Persons Aged 12 or Older, by State: 1999 and 2000

Figure 4.01 D