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4. Tobacco Use

Tobacco is the second most commonly used substance in the United States next to alcohol. The National Survey on Drug Use and Health (NSDUH) includes a series of questions on the use of several tobacco products, including cigarettes, smokeless tobacco (chewing tobacco and snuff), cigars, and pipe tobacco. This chapter includes State estimates on the past month use of tobacco, past month use of cigarettes, and the perceptions of great risk of smoking one or more packs of cigarettes per day.

Most tobacco users are cigarette smokers. Nationally, the use of tobacco and cigarettes in the past month among persons aged 12 or older was 27.6 and 23.2 percent, respectively, in 2009-2010 (see Tables B.13 and B.14 in Appendix B). The difference between the two rates (4.4 percentage points) represents persons who did not smoke cigarettes, but who used one or more of the other forms of tobacco (i.e., chewing tobacco, snuff, cigars, or pipe tobacco).

4.1  Tobacco

The State with the highest prevalence rate for tobacco use among persons aged 12 or older was West Virginia (40.2 percent), while Utah had the lowest rate (16.8 percent) (Table B.13). Of the 10 States with the highest rates of past month tobacco use among persons aged 12 or older, 7 States were in the South region (Alabama, Arkansas, Kentucky, Mississippi, Oklahoma, Tennessee, and West Virginia). Kentucky, Missouri, Oklahoma, West Virginia, and Wyoming ranked in the highest fifth for all three age groups (12 to 17, 18 to 25, and 26 or older) and among persons aged 12 or older (Figures 4.1 to 4.4).

Among the 12 or older age group, decreases in past month tobacco use from 2008-2009 to 2009-2010 were seen in Kentucky (from 38.1 to 35.5 percent) and Wisconsin (from 30.2 to 28.0 percent) (Table C.13 in Appendix C). Increases were seen in Alaska and Mississippi. Among youths aged 12 to 17, decreases were seen nationally (from 11.6 to 11.3 percent) and in the Midwest region (from 13.2 to 12.6 percent), Illinois (from 12.5 to 10.9 percent), and Oregon (from 14.9 to 12.9 percent). No increases in past month tobacco use were observed among youths aged 12 to 17.

4.2  Cigarettes

Because cigarettes are the main tobacco product, States that ranked high for past month tobacco use also ranked high for past month cigarette use. Of the 10 States in the highest fifth for past month use of tobacco, 8 States (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia) also were in the highest fifth for past month cigarette use among persons aged 12 or older (Figures 4.1 and 4.5). Similarly, 8 of the 10 States that were ranked in the lowest fifth among persons aged 12 or older were the same for both measures (California, Connecticut, Hawaii, Maryland, Massachusetts, New Jersey, New York, and Utah). West Virginia had the highest rate of past month cigarette use (32.0 percent), and Utah had the lowest rate (15.8 percent) for persons aged 12 or older (Table B.14).

Nationally, decreases in cigarette use were seen among youths aged 12 to 17 (from 9.1 percent in 2008-2009 to 8.7 percent in 2009-2010), young adults aged 18 to 25 (from 35.8 to 35.1 percent), and persons aged 12 or older (from 23.6 to 23.2 percent) (Table C.14). At the State level, a decline in cigarette use from 2008-2009 to 2009-2010 among persons aged 12 or older was observed in Wisconsin (from 25.7 to 23.5 percent). Across all States in the 12 to 17 and 18 to 25 age groups, eight States had declines in cigarette use between 2008-2009 and 2009-2010 (two States among persons aged 12 to 17 and six States among persons aged 18 to 25). Declines in cigarette use also were observed in the Midwest census region for those age groups. No increases were seen for any State or age group.

4.3  Perceptions of Risk of Heavy Cigarette Use

States with high prevalence rates for cigarette use tended to have low rates of perceived great risk of heavy cigarette use (i.e., smoking one or more packs per day). Five States (Kentucky, Missouri, Oklahoma, Tennessee, and West Virginia) that ranked in the lowest fifth for perceptions of great risk of smoking one or more packs of cigarettes per day also were ranked in the highest fifth for past month cigarette use among persons aged 12 or older (Figures 4.5 and 4.9). Kentucky had the lowest rate of perception of great risk for heavy cigarette use (62.3 percent), and New York had the highest rate (76.4 percent) among persons aged 12 or older (Table B.15).

Nationwide, the rates of perception of great risk of smoking one or more packs of cigarettes per day decreased from 2008-2009 to 2009-2010 among persons aged 12 or older (from 72.2 to 71.2 percent), youths aged 12 to 17 (from 67.5 to 65.4 percent), young adults aged 18 to 25 (from 66.8 to 65.2 percent), and persons aged 26 or older (from 73.8 to 73.0 percent) (Table C.15). Decreases also were observed in all four census regions among youths aged 12 to 17, in all but the West region among young adults aged 18 to 25, in the Midwest region among persons aged 26 or older, and in all but the Northeast region among persons aged 12 or older.

At the State level, there were 32 decreases from 2008-2009 to 2009-2010 in the perception of risk of heavy cigarette use across three age groups (12 to 17: 17 States with decreases; 18 to 25: 10 States with decreases; and 26 or older: 5 States with decreases). The only increases were seen in Arkansas (from 69.6 to 72.6 percent) and Massachusetts (from 74.1 to 77.9 percent) for persons aged 26 or older and in Massachusetts for persons aged 12 or older (from 73.0 to 75.9 percent). Eleven States had declines in the perception of risk of heavy cigarette use among persons 12 or older. This is an indication that, across many States, there continues to be an increase in the number of persons who do not think there is great risk in people harming themselves physically or in other ways by smoking one or more packs of cigarettes per day.

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Figure 4.1 Tobacco Product Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.1

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.2 Tobacco Product Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.2

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.3 Tobacco Product Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.3

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.4 Tobacco Product Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.4

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.5 Cigarette Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.5

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.6 Cigarette Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.6

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.7 Cigarette Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.7

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.8 Cigarette Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.8

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.9 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.9

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.10 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.10

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.11 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.11

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 4.12 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 4.12

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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This page was last updated on June 25, 2012.