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Tobacco Use in the 1998 National Household Survey on Drug Abuse

The results of the 1998 National Household Survey on Drug Abuse (NHSDA) have been released by the U.S. Department of Health and Human Services. The results for tobacco use have been summarized below followed by a summary of the survey design.

Tobacco Use in the United States
An estimated 60 million Americans were current cigarette smokers in 1998. This represents a smoking rate of 27.7 percent for the population age 12 and older. The rate decrease from 29.6 percent in 1997 is statistically significant.

Current smokers were more likely than nonsmokers to be heavy drinkers and illicit drug users. Among current smokers, the rate of heavy alcohol use (five or more drinks on the same occasion on five or more days in the past month) was 14.0 percent, the rate of marijuana/hashish use was 13.6 percent, and the rate of current illicit drug use was 16.1 percent. Among nonsmokers, only 2.9 percent were heavy drinkers, 1.8 percent were marijuana/hashish users, and 2.5 percent were illicit drug users.

An estimated 3.1 percent of the population were current users of smokeless tobacco in 1998. The rate has remained steady since 1991.

An estimated 6.9 percent of the population were current users of cigars in 1998. This represents a statistically significant increase from 1997, when the rate was 5.9 percent.

Approximately 4.1 million youth age 12-17 were current smokers in 1998. The rate of smoking among youth age 12-17 was 18.2 percent. The rate was 18.9 percent in 1994, 20.2 percent in 1995, 18.3 percent in 1996, and 19.9 percent in 1997. There were no statistically significant changes.

  12-17 Age Cohort
18-25 Age Cohort  

The current smoking rate among young adults age 18-25 continues to follow an upward path from 34.6 percent in 1994 to 35.3 percent in 1995, 38.3 percent in 1996, 40.6 percent in 1997, and 41.6 percent in 1998. The 1998 rate is significantly higher than the 1994, 1995 and 1996 rates.

An estimated 5.6 percent of youths age 12-17, or 1.3 million, were current cigar users in 1998. This rate compares to 5.0 percent in 1997; the difference is not statistically significant.

In 1998, current smoking rates were 29 percent among Blacks, 28 percent among Whites, 26 percent among Hispanics, and 24 percent among those of other race/ethnic groups.

Smokeless tobacco use was more prevalent among Whites (3.7 percent) than among Blacks (2.0 percent) or Hispanics (0.8 percent).

Males had higher rates of smoking than females (29.7 percent vs. 25.7 percent). Among youths age 12-17, the rates for males and females were similar (18.7 percent for males, 17.7 percent for females). The rate for females age 12-17 years decreased significantly between 1997 and 1998, from 20.7 percent to 17.7 percent.

The rate of current smokeless tobacco use was significantly higher for men than for women in 1998 (5.9 percent vs. 0.5 percent). About 91 percent of smokeless tobacco users were men. Similarly, males were more likely than females to use cigars (11.9 percent vs. 2.3 percent).

The rate of current cigarette use was 32.0 percent in the North Central region, 27.9 percent in the South, 25.5 percent in the Northeast, and 24.5 percent in the West. The rate of smoking was 26.5 percent in large metropolitan areas, 27.2 percent in small metropolitan areas, and 30.5 percent in nonmetropolitan areas.

Level of educational attainment was correlated with tobacco usage. Fifty percent of adults age 26-34 who had not completed high school smoked cigarettes, while only 15 percent of college graduates in this age group smoked. The opposite relationship was found for cigar use: 10.7 percent of college graduates age 26-34 were current cigar smokers, compared to 7.5 percent of those who had not completed high school.

  Smoking and Education

Tobacco As a "Gateway Drug"
Youths age 12-17 who currently smoked cigarettes were 11.4 times more likely to use illicit drugs and 16 times more likely to drink heavily than nonsmoking youths.

An estimated 5.6 percent of youths age 1217 were current cigar smokers in 1998. This compares to 5.0 percent in 1997, not a statistically significant difference.

Between 1997 and 1998, there was no change in the percentages of youths age 12-17 reporting great risk from using cigarettes, marijuana, cocaine, or alcohol.

The current rate of smoking among young adults age 18-25 has increased from 34.6 percent in 1994 to 40.6 percent in 1997 and 41.6 percent in 1998.

Survey Design
This survey is the primary source of statistical information on the use of illegal drugs by the United States population. Conducted since 1971, the survey collects data by administering questionnaires to a representative sample of the population at their place of residence. The survey covers residents of households, noninstitutional group quarters (e.g., shelters, rooming houses, dormitories), and civilians living on military bases. Persons excluded from the survey include homeless people who do not use shelters, active military personnel, and residents of institutional group quarters, such as jails and hospitals.

Interviews were conducted with 25,500 persons between January and December 1998. Response rates for household screening and for interviewing were 93.0 percent and 77.0 percent, respectively. The sample design oversampled Blacks, Hispanics, and young people, to improve the accuracy of estimates for those populations. In addition, residents of Arizona and California were oversampled to provide direct survey estimates for these state populations.

Editorial Note: The National Household Survey on Drug Abuse is one of the most carefully conducted surveys in the nation. The sample coverage and the response rate are very good. The survey administration methods are designed to elicit accurate responses even to very sensitive questions.

Cigarette smoking has declined slightly among older adults and adolescent females, has remained stable among adolescent males, and has increased substantially among young adults (18-25 years of age). Smokeless tobacco use has remained stable, and cigar smoking has increased.

More attention must be paid to prevention and cessation of smoking among young adults as 42% of this group now smoke cigarettes.

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