Friday 13 November 2009

US smoking rate rises for the first time since 1994

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.


Brad said...

What I sense is happening with smoking, and the way it's being viewed on a subconcious level, is that, to some degree, it's moved away from being a habit - something you did whilst doing something else - and has moved toward being an activity in itself. We no longer just 'smoke'; now we 'go for a smoke', and people who were never interested in adopting the habit, do at times feel left out of the activity.

Something else that has certainly happened to me, and many other smokers that I've spoken to, is that, in the face of all the bullying and banning, we have gone from regular expressions of a personal desire to quit (at some point) to teeth-clenched determination to continue. The sense of defiance becomes so strong it overrides the concern we have for our own health.

Junican said...

From Junican.

I read Brad Rodu's 'excellent blog'. I find that the questions being asked are mostly irrelevent. If the object of these surveys is to count the number of present smokers in the US, what people did in the distant past is irrelevent, isn't it? What is the point of asking people if they have smoked 100 cigarettes or more IN THEIR WHOLE LIFE? There are other questions which involve smoking just ONE cigarette on a particular day. You cannot base smoking on ONE cigarette. ONE cigarette is not smoking. You might as well say that taking a sip of wiskey once a month is 'drinking' or taking one drag on a cannabis cigarette is 'using drugs'.

I suppose that the statisticians involved are trying to compare DIFFERENCES, but, even so, the replies they get must be so unreliable as to be nonsensical. How can they claim 95% confidence?

The best thing to do is to totally disregard these surveys. The real problem, however, is that governments rely on such shit in order to make decisions (or should that be - governments rely on this shit as AN EXCUSE to make decisions.

Anonymous said...

I do not believe the smoking rates have gone up, any more than I believe they went down as much as advertised. Most likely what is happening is that people too embarrassed to admit that they smoked when we were being 'informed' are now sticking two fingers up in the face of getting bullied. Taking Ireland as an example it looks to me that the 'increase' is the result of the ever more extreme and bizarre behaviour of the anti smoking lobby. Where once people thought 'ah well, I guess it really isn't good for me and I should try and give it up' now they are more likely to say: 'Yes I smoke, now go to bloody buggering hell you interfering bastard'.

timbone said...

Me and the wife (nice working class phrase) are off to Spain tomorrow for a few days. We have not bought any tobacco in the UK for years, (are we alone?). Anyway, times are hard (recession and all that), and we have been debating our plight.
The main conclusions are these.
1. How would we have managed without our self imported supply.
2. We will most probably manage enough to feed our smoking pleasure until next time we go.
3. This is the big one. Even if we had not had our overseas supply, and whatever our cashflow, WE WOULD NOT HAVE STOPPED SMOKING - sorry to shout.