Now that more than half of America is covered by smoking bans, could it be that the US is experiencing the curse of the smoking ban? From The Washington Times:
Cigarette smoking rose slightly for the first time in almost 15 years, dashing health officials' hopes that the U.S. smoking rate had moved permanently below 20 percent.
As with Ireland, where smoking rates have soared despite being the "world-leader" in tobacco control, advocates are putting their faith in still higher cigarette taxes.
Health officials are optimistic that more and more smokers will be discouraged from lighting up by escalating cigarette taxes, including a 62-cent federal tax that took effect in April. Perhaps the recession will have an impact, too.
"In general, when people have less money, they smoke less," Dr. Frieden said. "Time will tell."
So it is often said, but where is the evidence? Is it not the case that the poor smoke more than the rich? Even if it were true that people smoke less during recessions, it is not the amount people smoke that matters here, but the number of people smoking. The economic depression of the 1930s didn't see a fall in smoking prevalence. It saw quite the reverse.
Evidence that recessions significantly affect smoking prevalence is thin on the ground, as is evidence that tax hikes make a major difference. There are examples of tax rises reducing prevalence (England in the 1940s, America in the early 1980s) but there are more examples of them making no difference or backfiring (America in the early 1990s, Ireland recently).
It's too early to say whether this (small) rise in US smoking prevalence is the start of an upward trend. It may be that the 2007 decline (from 21% to 19.8%) was a blip and that smoking rates have essentially been static in America for the last 5 years.
More interesting, I think, is how these statistics are generated. Always based on surveys, the figures very much depend on what questions are asked. The European journal Public Health has recently published a ground-breaking study which compares the Centers for Disease Control's surveys with those of the National Survey on Drug Use and Health. As co-author Brad Rodu explains on his excellent blog, there is a very significant discrepancy between the two.
In contrast to the decline reported by the CDC, we found evidence from another federal source that the number of adult smokers in the U.S. has been stable for about a decade. In 2005, for example, the CDC estimate was 45.1 million smokers; our analysis revealed that number could be as high as 54.2 million.
You would think that collating data for smoking prevalence would be fairly simple, wouldn't you? A simple yes/no question. But as Brad shows, nothing in tobacco control is ever simple and if the National Survey on Drug Use and Health is correct, the smoking rate has not fallen at all since 1998. Go read.
