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  » Smoking and health effect  »  Smoking Statistics: United States of America
Socio-demographic characteristics
Population199019952025
Total249,924,000263,250,000331,152,000
Adult (15+)195,685,000205,210,000265,975,000
% Urban75.276.284.9
% Rural24.823.815.1


Health Status

Life expectancy at birth, 1990-95 : 72.5 (males), 79.3 (females)
Infant mortality rate in 1990-95 : 9 per 1,000 live births

Age-standardized annual death rate per 100,000 (early 1990s)
  Ischaemic heart disease Cerebrovascular disease Chronic Obstructive Pulmonary Disease Lung cancer All cancers All causes
Males 235.5 52.8 45.3 85.9 251.7 1,021.7
Females 126.4 46.2 23.6 36.9 163.4 616.8


Socio-Economic Situation

GNP per capita (US$), 1991 : 22,340, Real GDP per capita (PPP$), 1991 : 22,130
Average distribution of labour force by sector, 1990 - 92 : Agriculture 3%; Industry 25%; Services 72%

Tobacco production, trade and industry

Agriculture In 1995, 277,630 hectares, (approximately 0.1 % of total arable land), were used for growing tobacco, a slight reduction from 278,430 hectares in 1985.

Production and Trade The USA is the largest single cigarette exporting nation in the world, exporting up to 30% of its production. Production of unmanufactured tobacco increased from 663,416 tonnes in 1990 to 702,743 tonnes in 1992, after which it declined to 638,382 tonnes in 1994. Exports increased from 223,412 tonnes in 1990 to 266,526 in 1992, and then fell to 196,792 tonnes in 1994, while imports of unmanufactured tobacco stabilized around 180,000 tonnes. In 1993, Brazil replaced the USA as the world's leading exporter of unmanufactured tobacco. During the early 1990s, cigarette production showed a one year drop to 661,00 million in 1993 (average of the 1990-1992 period was 707,600 million per year). By 1994, this was back up at 725,600 million. During the early 1990s, exports of cigarettes increased substantially (from 164.3 million in 1990 to 220.2 million in 1994) due primarily to opening of markets in Eastern Europe, Asia, and the former Soviet Union. In 1994, cigarette exports from the USA accounted for 23.5% of total exports in the world. Total export earnings on manufactured tobacco was US$ 4,965 million in 1994. Export earnings from tobacco leaf decreased from US$ 1,441 million in 1990 to US$ 1,322 million in 1993. Import costs of tobacco increased from US$ 669 million in 1990 to US$ 1,560 million in 1993, accounting for 0.2% of total imports, with the majority (US$ 1,002 million) spent on tobacco leaf. Revenue derived from tobacco in 1990 included US$ 42,000 million in retail sales and US$ 10,000 million in taxes.

Industry In 1990, 49,000 persons were employed in tobacco manufacturing, approximately 0.4% of the total labour force.

Tobacco consumption

From 1970 to 1992, overall consumption decreased by 31.5%, while from 1970 to 1990, the average number of cigarettes smoked per day declined slightly for both men and women, (21.2 to 20.7 per day and 17.6 to 17.2 per day, respectively). Overall, the percentage of persons smoking 25 or more cigarettes per day has declined only slightly, from 23.5 to 22.9%. Between 1970 and 1992, cigar use declined from 944 to 182 gms per male (age 18 and older), chewing tobacco decreased from 481 to 336 gms per male age 18 and older, but snuff use increased from 86.3 to 132 grams per person (men and women). In 1994, an estimated 3,400 million roll-your-own cigarettes were consumed.

Consumption of Manufactured Cigarettes
  Annual average per adult (15+)
1970-72 3,700
1980-82 3,560
1990-92 2,670


Tar/Nicotine/Filters In 1990, the tar yield of all brands of cigarettes ranged from 0.5 mg to 26 mg (averaging 12.5 mg.), with the most popular brand containing 17 mg of tar. Nicotine yields ranged from 0.05 mg to 1.7 mg, with the most popular brand yielding 1.2 mg of nicotine. In 1994, 98% of manufactured cigarettes consumed were filter-tipped.

Relative cost of cigarettes In 1995, the average retail price of a packet of 20 cigarettes ranged from US $1.73 to US $2.33, with an average of US $1.89. In 1991, the average minutes of labour required to purchase 20 cigarettes in the USA, at the average industrial wage, was 10 minutes.

Prevalence

National surveys of persons age 18 and older from 1970 to 1993 report a decline in prevalence (daily and occasional smoking) among men from 44.1% to 27.7.1%, and among women, from 31.5 % to 22.5%, with overall prevalence of 25.7% in 1991. In 1993, daily smoking prevalence among adults (age 18+) was 22.4%, compared to 22.3% in 1992. The rate of decline among women is less than for men, and the quit index for men is substantially higher than for women (51.6 vs 44.7%).

Tobacco use among population sub-groups The prevalence of smoking is lowest among those with the highest educational level. In 1993, smoking prevalence among those with 16 or more years of education was 13.5%, compared to prevalence of 36.8% among those with 9-11 years of education. By race, smoking among adult blacks is similar to whites (26% vs 25.4%, in 1993), however, among high school students, smoking prevalence is highest for both males and females among white (non-Hispanic) teenagers, followed by Hispanics, and was lowest among blacks. In 1991, 3% of physicians and 18% of registered nurses smoked. The prevalence of smoking is generally higher in the Southeastern US, where tobacco is grown, than in other parts of the country. Regardless of gender, education, age, and race, smoking rates are highest in urban areas. Current smoking prevalence was higher among persons age 18 and above residing in inner cities (32%) than in suburban areas (25%) and nonmetropolitan areas (27%).

Age Patterns Almost 80% of smokers begin to smoke regularly at 16 years and below. For those age 12-17 years, smoking prevalence declined from 25.0% in 1974 to 10.8% in 1991, but the change in prevalence since 1990 is negligible. In 1992, 17.2% of high school seniors smoked, but in 1993, this figure had risen to 19%. In 1991, prevalence was highest in the 35-44 age group among men (33.1%) and in the 25-34 age group among women (28.4%). It is lowest in the 65+ age group (15.1% for men and 12.0% for women). The rate of change is greatest among those in the 18-24 age group for men and in the 35-44 age group for women. Data from a 1991 survey of high school students (grades 9-12) indicated that 19% of males (and only 1% of females) used smokeless tobacco within the past month.

Mortality from Tobacco Use

Lung cancer mortality is increasing steadily among women but appears to be levelling off among men. Substantial decreases in ischemic heart disease mortality rates for men are noted since 1980 (more than 50%). It is estimated that in 1995, around 529,000 deaths were attributable to smoking (24% of total mortality). Among females, smoking attributable mortality in middle age (35-69 years) increased from 5% of all deaths at these ages in 1965 to 31% in 1995. An estimated 52% of all cancer deaths among middleage males (35-69 years) in 1990 were due to smoking.

Tobacco Control Measures

Control on Tobacco Products A number of governmental and nongovernmental organizations are actively involved in tobacco issues, and tobacco control continues to be the subject of much debate in the US. All states prohibit the sale and distribution of tobacco to minors (under age 18), and as of 1994, each state is required to actively enforce their minors' access laws. A rotating system of four health warnings is required on all cigarette packets and advertisements (including at point-of-sale). Federal law prohibits advertising of tobacco via television and radio. Several cities have passed laws prohibiting the advertising of cigarettes on billboards.

Cigarette manufacturers are required to submit a list of cigarette additives to the Department of Health and Human Services. In 1995, the Food and Drug Administration (FDA) proposed restrictions on the sale, distribution, and marketing of nicotine-containing tobacco products to person under age 18. Since the early 1990s, there has been a major increase in anti-smoking litigation, ranging from a class action suit on behalf of everyone who has ever been addicted to nicotine, to state governments attempting to recoup the medical costs of treating patients' smoking-related illnesses. As of 1995, taxes comprised an average of 30% of the retail price of cigarettes (with a range of 20 to 44% from the lowest to the highest state), while most other developed countries' tobacco taxes are in the range of 50% to 86% of the retail price. A few states have earmarked a portion of cigarette tax revenues for comprehensive tobacco control programs.

Protection for non-smokers The 1993 report by the US Environmental Protection Agency, classifying passive smoke as a Class-A carcinogen has been an important factor in greatly strengthening US anti-smoking legislation. President Clinton ruled that the White House was to be smoke-free. Policies of federal agencies generally restrict, but do not ban smoking in the workplace. The General Services Administration has issued regulations on smoking in federal buildings, and the Department of Health and Human Services has issued a total ban on smoking in its buildings. Smoking has been banned in all military areas, and the Labour Department is considering plans to implement a ban on smoking in all workplaces, except in separately ventilated enclosed areas. Smoking is prohibited on buses, on domestic flights and restrictions apply for rail service. Smoking is also prohibited in facilities providing federally funded childrens services including schools and daycare centres. Several states have passed extremely stringent smoking regulations, while some cities have virtually banned all smoking in public places. Many local governments have passed laws prohibiting smoking in restaurants and workplaces.

Health education Many of the health-oriented NGOs offer a variety of materials and information on the hazards of smoking, and also offer smoking cessation classes. The American Cancer Society sponsors an annual "Great American Smoke-Out". The Centers for Disease Control and Prevention has run media campaigns to educate the public on the hazards of smoking and exposure to environmental tobacco smoke, and is distributing media campaigns developed by states throughout the country. The American Medical Association has also taken a strong position in support of increased tobacco control.