Smoking rate stalls after decades of declines

The nation's smoking rate is frozen after years of declining, according to new data from the Centers for Disease Control and Prevention. Physicians can help reduce smoking among Americans by setting a quit date for patients who smoke and lobbying for tighter tobacco control in their states and communities, says the head of the CDC.

One in five adults 18 and older smoked cigarettes in 2009, according to a CDC study published online Sept. 7 in the Morbidity and Mortality Weekly Report. The figure has remained stable during the past five years.

"The 40-year decline in tobacco use in the United States has stalled," said CDC Director Thomas Frieden, MD, MPH. "Between 2005 and 2009, there was no further reduction in tobacco use."

Physicians can take steps to help reduce tobacco use, he said.

He recommends that doctors ask all patients if they smoke. If they do, he suggests that doctors help them set a date to quit.

Dr. Frieden encourages physicians to advocate for tighter tobacco control in their communities and states. Cigarette smoking is the leading cause of preventable deaths in the U.S., killing about 443,000 people each year, the CDC said.

For their latest report, CDC researchers examined data on 27,603 adults 18 and older who participated in the 2009 National Health Interview Survey and the 2009 Behavioral Risk Factor Surveillance System survey (link).

They determined that about 20.6% adults were cigarette smokers in 2009. The figure was 20.9% in 2005.

Of those who smoked in 2009, about 78% did so every day, and 21.9% did on some days. More men smoked (23.5%) than women (17.9%).

A second CDC study looked at more than 30,000 nonsmokers' exposure to secondhand smoke (link). It used data from 1999 to 2008 from the National Health and Nutrition Examination Survey.

Four in 10 nonsmokers had serum cotinine levels of 0.05 ng/mL or greater between 2007 and 2008. Cotinine is a metabolite of nicotine and indicates exposure to cigarette smoke. Levels greater than 10 ng/mL are associated with active smoking within the past few days, the study said.

Exposure to secondhand smoke has decreased but remains high among people living with someone who smokes in the home. About 98% of children and youths in such living situations had detectable levels of cotinine.

"I hope [this] is a wake-up call of the continuing threat of tobacco. ... We need to restart the decline in tobacco use," Dr. Frieden said. "Failure to do so is a tragedy."