Epidemiology of Tobacco Use and Cessation Gary A. Giovino, Ph.D., M.S. Roswell Park Cancer Institute Buffalo, New York Consumer Demand Round Table Washington, DC December 7, 2005

Oral Cancer in a 20 Year-Old Man Who Used ST

Tobacco Control Model of Nicotine Addiction Agent Vector Host Tobacco Products Tobacco Product Manufacturers; Other Users Smoker/Chewer Incidental Host Environment Familial, Social, Cultural, Political, Economic, Historical, Media Involuntary Smoker Source: Orleans & Slade, 1993

Russell’s Motivation/Dependence Model of Quitting Source: Progress in Smoking Cessation; Schwartz JL (ed); ACS/WHO, 1978

Trends in Per Capita Consumption of Various Tobacco Products – United States, Source: Tobacco Situation and Outlook Report, U.S. Department of Agriculture, U.S. Census Note:Among persons > 18 years old. Beginning in 1982, fine-cut chewing tobacco was reclassified as snuff. Estimates for 2002 and 2003 are preliminary.

Current Use Among U.S. Adults of Various Tobacco Products, by Sex – National Health Interview Survey, 2000 Note: Current users report using either every day or on some days Source: National Center for Health Statistics

Men Women Trends in cigarette smoking* among adults aged >18 years, by sex - United States, Source: 1955 Current Population Survey; National Health Interview Surveys. *Before 1992, current smokers were defined as persons who reported having smoked >100 cigarettes and who currently smoked. Since 1992, current smokers were defined as persons who reported having smoked >100 cigarettes during their lifetime and who reported now smoking every day day or some days. 23.4% 18.5%

Percentage of Ever Smokers* Who Have Quit, Adults Aged > 18 Years, by Sex-United States, Source: National Health Interview Surveys, ; Centers for Disease Control and Prevention: National Center for Health Statistics and Office on Smoking and Health. *Ever-smoked >100 cigarettes, Also known as the quit ratio. Note: estimates since 1992 incorporate same-day smoking Men Women 51.4% 49.7%

Trends in cigarette smoking* by age - United States, *Before 1992, current smokers were defined as persons who reported having smoked >100 cigarettes and who currently smoked. Since 1992, current smokers were defined as persons who reported having smoked >100 cigarettes during their lifetime and who reported now smoking every day day or some days. Source: various National Health Interview Surveys from , National Center for Health Statistics

Source: various National Health Interview Surveys, *Ever-smoked Cigarettes Also known as the “quit ratio”, estimates since 1992 incorporates same-day smoking Percentage of Ever Smokers* Who Have Quit, by Age – United States,

Trends in cigarette smoking* a mong adults aged >25 years, by education- United States, *Before 1992, current smokers were defined as persons who reported having smoked >100 cigarettes and who currently smoked. Since 1992, current smokers were defined as persons who reported having smoked >100 cigarettes during their lifetime and who reported now smoking every day day or some days. Source: various National Health Interview Surveys from , National Center for Health Statistics

Source: various National Health Interview Surveys, *Ever-smoked Cigarettes Also known as the “quit ratio”, estimates since 1992 incorporates same-day smoking Percentage of Ever Smokers* Who Have Quit, by Education, Adults Aged > 25 Years – United States,

Percentage of Adults Who Smoke Cigarettes by Race/Ethnicity - United States, 2004 Source: National Center for Health Statistics, 2004 National Health Interview Survey

Cigarette Use and Nicotine Dependence, by Age: 2003 (National Survey on Drug Use and Health) Age in Years Percent in Past Month

The good news is… most smokers want to quit 90% regret ever having started to smoke 89% plan to quit; only 3% don’t want to quit 89% believe health will improve if quit 84% have tried to quit in the past 27% try to quit each year… 2004/2005 Assessing Hard Core Smoking Survey of US smokers ages 25+ years (n = 1,000)

Intentions to quit 22% within next 30 days 38% within 6 months, but not in next 30 days 29% after 6 months 6% don’t have plans, but believe should quit 6% don’t have plans, happy to remain smoking 2004/2005 Assessing Hard Core Smoking Survey of US smokers ages 25+ years (n = 1,000)

Assessing Hard Core Smoking Survey Have you ever used/tried… Percent of baseline smokers (ages 25+ years)

Assessing Hard Core Smoking Survey Smokers are very concerned about… Percent of baseline smokers (ages 25+ years)

Assessing Hard Core Smoking Survey Smoking helps… Percent of baseline smokers (ages 25+ years)

Smokers’ Beliefs that May Impede Quitting - United States, 2004/2005 Source: Assessing Hard Core Smoking Survey (ages 25+ years); n = 1,000

Only one-third of smokers correctly report that patches are less likely to cause a heart attack than cigarettes... Smoker Misperceptions About the Characteristics of Different Nicotine Delivery Devices. H Smoker Misperceptions About the Characteristics of Different Nicotine Delivery Devices. Hyland A, Cummings KM, Giovino GA, Bansal M, Bauer J, Hastrup J, Yost B. Society for Research Nicotine on Tobacco Annual Meeting, February 2002.

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