Trends in Cigarette Smoking in the United States

Abstract
Trends in the prevalence, initiation, and cessation of cigarette smoking are reported for the US population using weighted and age-standardized data from seven National Health Interview Surveys (1974 to 1985). The decline in prevalence was linear, with the prevalence for men decreasing at 0.91 percentage points per year to 33.5% in 1985 and the prevalence for women decreasing at 0.33 percentage points per year to 27.6% in 1985. For whites the rate of decline (percentage points per year) was 0.57, to 29.4% in 1985, and for blacks the decline was 0.67, to 35.6% in 1985. Smoking cessation increased among all gender-race groups from 1974 to 1985, with the yearly rate of increase (in percentage points per year) about equivalent for blacks (0.75) and whites (0.77), while it was higher in women (0.90) than in men (0.67). Smoking initiation decreased among young men (-1.03), while it remained about the same in young women (+ 0.11). Initiation decreased at a more rapid rate in blacks (-1.02) than in whites (-0.35). We conclude that smoking prevalence is decreasing across all race-gender groups, although at a slower rate for women than men, and that differences in initiation, more than cessation, are primarily responsible for the converging of smoking prevalence rates among men and women. (JAMA1989;261:49-55)