Trends In Smoking Behavior Research Articles

Trends in cigarette consumption across the United States, with projections to 2035.

To make projections of cigarette consumption that incorporate state-specific trends in smoking behaviors, assess the potential for states to reach an ideal target, and identify State-specific targets for cigarette consumption. We used 70 years (1950-2020) of annual state-specific estimates of per capita cigarette consumption (expressed as packs per capita or "ppc") from the Tax Burden on Tobacco reports (N = 3550). We summarized trends within each state by linear regression models and the variation in rates across states by the Gini coefficient. Autoregressive Integrated Moving Average (ARIMA) models were used to make state-specific forecasts of ppc from 2021 through 2035. Since 1980, the average rate of decline in US per capita cigarette consumption was 3.3% per year, but rates of decline varied considerably across US states (SD = 1.1% per year). The Gini coefficient showed growing inequity in cigarette consumption across US states. After reaching its lowest level in 1984 (Gini = 0.09), the Gini coefficient began increasing by 2.8% (95% CI: 2.5%, 3.1%) per year from 1985 to 2020 and is projected to continue to increase by 48.1% (95% PI = 35.3%, 64.2%) from 2020 to 2035 (Gini = 0.35; 95% PI: 0.32, 0.39). Forecasts from ARIMA models suggested that only 12 states have a realistic chance (≥50%) of reaching very low levels of per capita cigarette consumption (≤13 ppc) by 2035, but that all US states have opportunity to make some progress. While ideal targets may be out of reach for most US states within the next decade, every US state has the potential to lower its per capita cigarette consumption, and our identification of more realistic targets may provide a helpful incentive.

THE ADVOCACY AND COMMUNICATION OF SMOKE-FREE AREA REGULATION IN EAST JAVA, INDONESIA

Background: The negative impact of tobacco, especially second-hand smokers, requires imperative actions. Introducing tobacco control measures helps protect the public health. Data suggest that there were approximately 44 million daily smokers in Indonesia comprising 49.8 million males and 3.9 million females over ten years of age. East Java Province had the biggest number of smokers in Indonesia. To reduce trends in smoking behavior, we need to advocate local government to release and implement smoke-free regulations. Aims: The study aims to do action research through advocacy and communication for the regulation of smoke-free areas in East Java Province. Methods: The action research involved 12 districts of East Java Province, Indonesia. The method used in this study was Focus Group Discussion (FGD), one-on-one meeting, in-depth interviews, public speaking, press conference, and press release. Results: Intensive advocacy and communication worked successfully. Eight districts of East Java Province implemented local regulations of smoke-free areas. The advocacy and communication of the regulations made it possible to be implemented. Conclusion: Intensive advocacy and communication improve the awareness of executive and legislative government about the importance of smoke-free area regulations. It will be successful if regular meetings, discussions, press conferences, public speaking, and team work are conducted with many stakeholders.

Has increased youth e-cigarette use in the USA, between 2014 and 2020, changed conventional smoking behaviors, future intentions to smoke and perceived smoking harms?

IntroductionAn increase in electronic cigarette (EC) use among US youth has raised concerns that their use may increase conventional cigarette smoking. MethodsRepeated cross-sectional data from two large nationally representative samples of US youth were drawn from the National Youth Tobacco Survey (NYTS) and Monitoring the Future (MTF). Students from grade 6–12 of the NYTS (N = 98,454–132,003) and students from grade 12 of the MTF (N = 17,870–30,981) were included in the analyses. Trends in smoking behavior, intention to smoke in the future and perceived smoking harms among youth who do and do not use ECs were estimated from 2014 to 2020 using weighted multinomial logistic regression and predicted marginal probabilities. ResultsThe prevalence for regular smoking decreased among youth who regularly use ECs. For example, among regular EC users, smoking prevalence decreased from 27.8% to 6.7% (−21%; 99.67% CI:[−32.3%, −9.9%]) in the NYTS between 2014 and 2020 and from 31.8% to 10.6% (−21.2%, 99.67% CI:[−35.0%, −7.3%]) in the MTF between 2014 and 2018. Intent to smoke in the future and perceiving smoking as harmless decreased or remained unchanged during the same period. For example, among regular EC users, there was no significant change in intention to smoke next year in the NYTS between 2014 and 2018; intention to smoke in the next 5 years decreased significantly from 30.7% to 11.2% (−19.5%, 99.67% CI:[−37.7%, −1.3%]) in the MTF. ConclusionsIn two national samples of US youth, smoking prevalence declined by a sizeable relative percentage. Intent to smoke in the future and harm perceptions of smoking declined or remained unchanged while EC use increased. Results provide little evidence that EC use has increased conventional cigarette smoking among youth.

Trends in Smoking Behaviors Among US Adolescent Cigarette Smokers.

Identifying trends in smoking behaviors among youth cigarette smokers could inform youth policy and interventions. Using 2011-2018 National Youth Tobacco Survey data, logistic/linear regressions were used to analyze trends in smoking frequency, intensity, age of first cigarette use, and electronic cigarette (e-cigarette) use frequency among current smokers. Stratified analyses were conducted among male, female, middle school, and high school students and race and ethnicity subgroups separately. From 2011 to 2018, there was a decrease in smoking ≥10 days (50.0% to 38.3%), ≥20 days (37.2% to 26.3%), and 30 days (26.6% to 18.2%) among current smokers. Smoking prevalence decreased among male, female, high school, non-Hispanic white, and non-Hispanic other students. Overall, light smoking (≤5 cigarettes per day [CPDs]) increased (76.6% to 82.7%), and moderate smoking (6-10 CPDs) decreased (10.7% to 8.3%). Trends in light, moderate, and heavy smoking varied by demographic groups. Age at first cigarette use increased among female (12.28 to 13.29), high school (12.91 to 13.18), and non-Hispanic other students (11.64 to 12.83) and decreased among male students (12.90 to 12.57). From 2014 to 2018, there was an increase in e-cigarette use frequency for ≥10 days (20.8% to 40.9%), ≥20 days (13.5% to 31.7%), and all 30 days (9.3% to 22%). From 2011 to 2018, current youth cigarette smokers smoked fewer days and fewer CPDs, and age of first cigarette use increased. However, over time, male youth smoked more heavily and started smoking earlier. E-cigarette use increased from 2014 to 2018. Differences by demographic characteristics can inform future research and interventions.

Effect of the comprehensive smoke-free law on time trends in smoking behaviour in primary healthcare patients in Spain: a longitudinal observational study

ObjectiveThis study aimed to analyse the impact of comprehensive smoke-free legislation (SFL) on the prevalence and incidence of adult smoking in primary healthcare (PHC) patients from three Spanish regions, overall...

Smoking during pregnancy in Finland - Trends in the MATEX cohort.

Aims: In Finland, smoking rates in the general population are decreasing due to increased awareness of the adverse effects and tightened tobacco legislation. However, previous studies have shown that smoking in pregnant Finnish women remained as high as in the general Finnish female population at around 15% in 2010. Our aim was to describe temporal and spatial trends in smoking behaviour, and determinants of changes in smoking behaviour between first and second pregnancy. Methods: Self-reported smoking from the Finnish Medical Birth Register covered the years 1991-2015 (N=1,435,009). The association of maternal age and socioeconomic status with smoking rate was analysed. Spatial trends were assessed at municipality level. Results: The overall smoking rate during early pregnancy remained fairly stable at around 15% from 1991 to 2015, but increased in teenage and young women below 25 years of age. The mean smoking rate (36%) was higher in these age groups than in older pregnant women (11%). Through the study period the smoking rate remained higher in blue collar workers compared with higher socioeconomic groups. Between the first and second child, on average only 4% of women started to smoke and 41% quitted. Smoking rates developed less favourably in Eastern Finland. Conclusions: The observed increase in smoking rate during pregnancy in teenage and young women is concerning. Pregnancy is a trigger point for smoking cessation in a big fraction of pregnant women. More studies are needed to explain the opposite trends of smoking rates in Northern and Western Finland compared with Eastern Finland.

Did Slowdown on Taxes and Program Impact California's Smoking Decline?

Author(s): Pierce, John P; Shi, Yuyan; Hendrickson, Erik; White, Martha; Noble, Madison; Kealey, Sheila; Strong, David | Abstract: Objective: In this paper, we examine whether a slowdown in implementing tobacco control policies in California after 2000 influenced trends in smoking behavior. Methods: We assessed the strength of state tobacco control policies using excise tax data (1990-2014), tobacco control expenditures per capita, and workplace and home smoking restrictions (from the Tobacco Use Supplement of the Current Population Survey, 1992-2015). Smoking prevalence was assessed with the National Health Interview Survey, 1985-2015. We compared trends between California and the rest of the US using split regression models with a knot at 2000. Results: Throughout the 1990s, compared to the rest of the US, California had higher cigarette excise taxes, higher expenditures on tobacco control, more smoke-free workplaces, and more smokers with smoke-free homes. Except for smoke-free homes, these differences disappeared after 2000. During the 1990s, smoking prevalence declined much faster in California than in the rest of the US, but the decline slowed significantly after 2000. Conclusions: Smoking prevalence is sensitive to continued implementation of tobacco control policies.

Trends in smoking behaviour among Estonian physicians in 1982\u20132014

BackgroundSmoking surveys among physicians have proved useful in highlighting the importance of physicians as healthy life style exemplars and role models in tobacco control and smoking cessation. The aim of this study was to give an overview of smoking behaviour among Estonian physicians from 1982 to 2014.MethodsThree cross-sectional postal surveys using a self-administered questionnaire were carried out among all practising physicians in Estonia. The number of physicians participating in this study was 3786 in 1982, 2735 in 2002, and 2902 in 2014. Data analysis involved calculating the age-standardized prevalences of smoking, prevalences of smoking by age group and mean age of smoking initiation. A non-parametric test for trend was used to assess significant changes in smoking over time.ResultsAge-standardized prevalence of current smoking among men was 39.7% in 1982, 20.9% in 2002, and 14.3% in 2014 and among women 12.2%, 8.0%, and 5.2%, respectively (p < 0.0001 for trends). From 1982 to 2014, the biggest decline of current smoking among men and women was in age groups under 35 (from 55.2% to 16.7% and from 16.7% to 2.8%, respectively) and 35–44 (from 47.1% to 8.3% and from 19.5% to 5.1%, respectively) (p < 0.0001 for trends). Mean age of smoking initiation decreased from 20.4 to 19.3 among men and from 24.5 to 20.4 among women over the study period.ConclusionsIn 1982–2014, smoking prevalence among Estonian physicians declined substantially. This may influence the willingness of society to recognize the health consequences of smoking which could give a support to the decline of the smoking epidemic in the country. Differences between smoking among male and female physicians persisted over the study period, but mean age of smoking initiation decreased. A further decline in smoking among Estonian physicians should be encouraged by special efforts targeted at physicians.

Long-term trends and predictors of smoking behaviors among men following first-ever ischemic stroke.

Continued smoking following stroke is associated with adverse outcomes including increased risk of mortality and secondary stroke. The aim of this study was to examine the long-term trends in smoking behaviors and factors associated with smoking relapse among men who survived their first-ever stroke. Data collection for this longitudinal study was conducted at baseline through face-to-face interviews and follow-up was completed every 3 months via telephone, beginning in 2010 and continuing through 2014. Cox proportional hazard regression models were used to identify predictors of smoking relapse behavior. At baseline, 372 male patients were recruited into the study. Totally, 155 (41.7%) of these patients stopped smoking for stroke, and 61 (39.3%) began smoking again within 57 months after discharge with an increasing trend in the number of cigarettes smoked per day. Exposure to environmental tobacco smoke at places outside of home and work (such as bars, restaurants) (HR, 2.34; 95% CI, 1.04-5.29, P=0.04), not having a spouse (HR, 0.12; 95% CI, 0.04-0.36; P=0.0002) and smoking at least 20 cigarettes per day before stroke (HR, 2.42; 95% CI, 1.14-5.14, P=0.02) were predictors of smoking relapse. It was concluded that environmental tobacco smoke is an important determinant of smoking relapse among men who survive their first stroke. Environmental tobacco smoke should be addressed by smoke-free policies in public places.

Trends in smoking behavior in adolescents and young adults in the Netherlands

Trends in smoking behavior in adolescents and young adults in the Netherlands

Smoking and Passive Smoking

Objective: To review the literature on associations between cardiovascular diseases and tobacco use, including recent trends in smoking behaviors and clinical approaches for cessation of smoking. Methods: A literature review of recent scientific findings for smoking and cardiovascular diseases and recommendations for obtaining cessation. Results: Tobacco smoking is causally related to cardiovascular disease, with nearly a half million deaths annually attributed to cigarette smoking in the United States. The human, economic, medical, and indirect costs are enormous. Secondhand smoke as inhaled from the environment also plays an important role in the genesis of cardiovascular diseases. A recent trend in the use of e-cigarettes is noted particularly among youth. For children, prevention is the best strategy. For adult smokers, behavioral treatments, self-help approaches, and pharmacologic therapies are readily available. Clinicians can have a significant impact on patients’ smoking habits. Adding to individual strategies, regulatory community and public health approaches provide the potential for eliminating the use of tobacco. Conclusion: Tobacco smoke causes cardiovascular morbidity and death. Clinicians can play a role in preventing smoking and promoting cessation.

Teenage smoking behaviour following a high-school smoking ban in Chile: interrupted time-series analysis.

ObjectiveTo evaluate the effect of a smoking ban in high schools on smoking behaviour among Chilean students.MethodsWe conducted an interrupted time-series analysis, using repeated cross-sectional data from Chile’s school population survey (2000–2011) for high-school students aged 12–18 years and a control group of persons aged 19–24 years. Poisson regression models were used to assess trends in smoking behaviour before and after the policy changes. The outcome measures were self-reported smoking prevalence (any smoking in the past month) and high frequency of smoking (smoking 15 days or more per month).FindingsFrom 2005 to 2011, the prevalence of smoking declined among high-school students by 6.8% per year compared with 3.6% decline per year in the control group. The decline in the target group was 2.9% (95% confidence interval, CI: 0.18 to 5.00) greater. We estimated that 5–6 years after enforcing the law, smoking prevalence among high-school students was 13.7% lower as a result of the ban. The impact of the smoking ban was primarily driven by declines in smoking prevalence among students in grades 8 to 10. The smoking ban did not significantly alter the frequency of smoking.ConclusionThe 2005 school smoking ban reduced smoking prevalence among younger high-school students in Chile. Further interventions targeting older individuals and frequent smokers may be needed.

Bending the curve on psychosis outcomes

Comment report; 7 however, of individuals who accepted referral, only 14% actually engaged with stop smoking services to the point of setting a quit date and only 9% stopped smoking for 4 weeks. By contrast, an approach in which opt-out services were integrated into care on a general medical ward achieved much greater uptake of cessation support and roughly doubled the proportion of smokers quitting relative to usual care, dependent on the clinician’s initiative. 8 For these reasons, among others, the UK National Institute for Health and Care Excellence (NICE) issued guidance in 2013 on smoking cessation in secondary care, which for psychiatry includes much care delivered in the community. 5 An integrated systematic approach to treatment of smoking was endorsed, similar to the active intervention tested in SCIMITAR. The research priority now is not to establish whether the systematic approach is more eff ective but how best to integrate smoking services to maximise uptake and delivery in both secondary and primary mental health care services. Examples of good practice in the NHS exist. Cheshire and Wirral Partnership Trust went smoke free in February, 2014. As part of a comprehensive nicotine management policy, 9 the Trust aims to ensure that all patients admitted acutely who smoke are seen and provided with treatment, including provision of nicotine replacement treatment, by a trained cessation practitioner within 15 min. Furthermore, the South London and Maudsley Trust went smoke free in October, 2014, and other Trusts are following suit. Reversing the legacy of high smoking prevalence in mental health populations is not going to be easy or quick, but enough evidence is available to know one place to start. John Britton UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, City Hospital, Nottingham NG5 1PB, UK j.britton@outlook.com I declare no competing interests. Health and Social Care Information Centre. Table 2.6: cigarette smoking status among adults, by gender and marital status, 2009. Aug 16, 2011. http://www.hscic.gov.uk/catalogue/PUB00693/smok-eng-2011-tab.xls (accessed March 6, 2015). Royal College of Physicians, Royal College of Psychiatrists. Smoking and mental health: a joint report by the Royal College of Physicians and the Royal College of Psychiatrists. 2013. http://www.rcplondon.ac.uk/sites/ default/fi les/smoking_and_mental_health_-_full_report_web.pdf (accessed March 6, 2015). Szatkowski L, McNeill A. Diverging trends in smoking behaviors according to mental health status. Nicotine Tob Res 2015; 17: 356–60. Chang CK, Hayes RD, Perera G, et al. Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS One 2011; 6: e19590. National Institute for Health and Care Excellence. Smoking cessation: acute, maternity and mental health services (PH48). November, 2013. http://www.nice.org.uk/guidance/ph48 (accessed March 6, 2015). Gilbody S, Peckham E, Man M-S, et al. Bespoke smoking cessation for people with severe mental ill health (SCIMITAR): a pilot randomised controlled trial. Lancet Psychiatry 2015; published online April 1. http://dx.doi.org/10.1016/S2215-0366(15)00091-7. National Centre for Smoking Cessation Training. Streamlined secondary care system: project report. June, 2012. http://www.ncsct.co.uk/usr/pub/ ncsct-streamlined-secondary-care-fi nal-report.pdf (accessed March 6, Murray RL, Leonardi-Bee J, Marsh J, et al. Systematic identifi cation and treatment of smokers by hospital based cessation practitioners in a secondary care setting: cluster randomised controlled trial. BMJ 2013; 347: f4004. Cheshire and Wirral Partnership NHS Foundation Trust. Nicotine management policy. June 20, 2013. http://www.cwp.nhs.uk/ uploads/2460 (accessed March 6, 2015). Bending the curve on psychosis outcomes Priorities for the development of treatments for psychosis have gradually shifted to early interventions that are designed to soften or even prevent the debilitating course of illness. To “bend the curve”—ie, change the conditions such that individual outcomes improve and societal eff ects of psychotic disorders are reduced, 1 we must advance our understanding of the neurobiological substrates of their most dis- abling symptoms, and use this information to guide mechanistic, hypothesis-driven treatment studies. Although functional outcomes in psychotic dis- orders are closely linked to the severity of negative www.thelancet.com/psychiatry Vol 2 May 2015 symptoms and cognitive impairment, 2 few, if any, pharmacological treatments exist for these disabling symptoms. The need for novel therapeutics that improve function in patients with psychosis is evident in the rates at which these patients are homeless, incarcerated, or reside in long-term residential care facilities. In The Lancet Psychiatry, Joshua Kantrowitz and colleagues 3 convincingly show that a rationally selected modulator of the N-methyl-D-aspartate-type glutamate receptor (NMDAR) might substantially reduce negative symptoms in young people at clinical high risk of developing psychosis. The investigators See Articles page 403

Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California.

The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.

Diverging trends in smoking behaviors according to mental health status.

People with mental health disorders are much more likely to smoke compared to those who do not. This study investigates recent trends in smoking behaviors among both these populations in England. We used survey responses from adults (aged 16 years and older) living in households in England who participated in the Health Survey for England from 1993 to 2011 (n = 11,300 per year on average). Linear regression was used to quantify annual changes over the time period in smoking prevalence, daily cigarette consumption, and desire to quit among respondents with and without 2 indicators of mental disorder (self-reported longstanding mental illness and recent use of psychoactive medication). Among survey respondents who did not report a longstanding mental illness, there were long-term declines in smoking prevalence (-0.48% per year, 95% confidence interval [CI] = -0.56 to -0.40) and daily cigarette consumption (-0.14% per year, 95% CI = -0.17 to -0.11). Similar declines were also seen among respondents not taking psychoactive medications. However, there were no long-term changes in smoking prevalence and cigarette consumption among respondents who reported these indicators of mental disorder, although smoking prevalence among those taking psychoactive medications may have declined during the later part of the study period. Smokers both with and without the 2 indicators of mental disorder showed similar levels of desire to quit smoking. Smoking is largely unchanged since 1993 among those with indicators of longstanding mental disorders or recent psychoactive medication usage, although declines have been observed among those without such indicators of mental disorder.

0189 Application of a dynamic population-based model to assess the effect of silica exposure interventions on COPD in Dutch construction workers: results from the ‘Relieved Working Study’

ObjectivesA multidimensional intervention aimed at reducing silica exposure in the Dutch construction industry was performed. The objective of this study was to assess the effect of the achieved reduction in...

National Trends in Smoking Behaviors Among Mexican, Puerto Rican, and Cuban Men and Women in the United States

We examined trends in smoking behaviors across 2 periods among Mexicans, Puerto Ricans, and Cubans in the United States. We analyzed data from the 1992-2007 Tobacco Use Supplements to the Current Population Survey. We constructed 2 data sets (1990s vs 2000s) to compare smoking behaviors between the 2 periods. Significant decreases in ever, current, and heavy smoking were accompanied by increases in light and intermittent smoking across periods for all Latino groups, although current smoking rates among Puerto Rican women did not decline. Adjusted logistic regression models revealed that in the 2000s, younger Mexicans and those interviewed in English were more likely to be light and intermittent smokers. Mexican and Cuban light and intermittent smokers were less likely to be advised by healthcare professionals to quit smoking. Mexicans and Puerto Ricans who were unemployed and Mexicans who worked outdoors were more likely to be heavy smokers. Increases in light and intermittent smoking among Mexican, Puerto Rican, and Cuban Americans suggest that targeted efforts to further reduce smoking among Latinos may benefit by focusing on such smokers.

Time trends of cigarette and waterpipe smoking among a cohort of school children in Irbid, Jordan, 2008-11

Coordinated high-impact interventions and community-level changes in smoking behaviour norms effectively reduced prevalence of smoking among youth in many developed countries. Smoking trends among Jordanian adolescents are likely different than their Western counterparts and must be understood in the context of their daily lives to tailor interventions specifically for adolescents in this setting. Between 2008 and 2011, a school-based longitudinal study was conducted in Irbid, Jordan. All seventh-grade students in 19 randomly selected schools (of 60) were surveyed annually for 4 years. Outcomes of interest were time trends in smoking behaviour, age at initiation and change in frequency of smoking. Among 1781 participants, baseline prevalence of current smoking (cigarettes or waterpipe) for boys was 22.9% and 8.7% for girls. Prevalence of ever-smoking and current any smoking, cigarette smoking, waterpipe smoking and dual cigarette/waterpipe smoking was significantly higher in boys than girls each year (P < 0.001). Smoking prevalence increased every year after year 2 for current smoking (P < 0.05) across all methods (any, cigarette, waterpipe and dual). At all time points for both boys and girls, prevalence of waterpipe smoking was higher than that of cigarette smoking (P < 0.001). This study shows intensive smoking patterns at early ages among Jordanian youth in Irbid, characterized by a predominance of waterpipe smoking and steeper age-related increase in cigarette smoking. It also points to the possibility of waterpipe being the favourite method for introducing youth to tobacco, as well as being a vehicle for tobacco dependence and cigarette smoking.

Chapter 2: Birth‐Cohort‐Specific Estimates of Smoking Behaviors for the U.S. Population

We present methods for estimating five‐year birth‐cohort‐specific trends in smoking behavior for individuals born between 1910 and 1984. We combine cross‐sectional survey data on smoking behavior from the National Health Interview Surveys (NHIS) conducted between 1965 and 2001 into a single data set. The cumulative incidence of smoking by year of age and calendar year is constructed for each birth cohort from this data set and the effect of differential mortality on ever smoking prevalence is adjusted by modeling the ever smoking prevalence of each cohort for each survey year and back extrapolating that effect to age 30. Cumulative incidence is then scaled to match the ever smoking prevalence at age 30. Survival analyses generate the cumulative cessation among ever smokers across year of age and calendar year and are used to estimate current smoking prevalence. Data from Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health is used to divide those initiating smoking into quintiles of number of cigarettes smoked per day (CPD) and the mean CPD for each quintile in each calendar year is estimated from the NHIS data. For five‐year birth cohorts of white, african‐american, Hispanic and all race/ethnicity groupings of males and females born between 1910 and 1984, estimates are provided for prevalence of current and ever smoking, incidence of cessation, incidence of initiation, and the distribution of smoking duration and CPD for each calendar year and each single year of age through the year 1999. We believe that we are the first to provide birth‐cohort‐specific estimates of smoking behaviors for the U.S. population that include distributions of duration of smoking and number of cigarettes per day. These additional elements substantively enhance the utility of these estimates for estimating lung cancer risks.

Smoking and lung cancer: current trends in Austria.

Despite a recent decline in smoking behavior in many European countries, lung cancer rates remain high, especially in Central and Eastern Europe. This paper aims to describe trends in smoking behavior and lung cancer incidence and mortality, including histopathological classification of lung cancer, in a Central European country: Austria. Using data from the Austrian Central Cancer Registry, we calculated age-standardized incidence, histopathology-specific incidence, and age-standardized and birth cohort-specific mortality rates for all lung cancer cases in Austria. Using national survey data, we estimated prevalence of smoking in the Austrian population. Our analysis covers the time period from 1970 to 2009. In 2009, lung cancer incidence rates were 41.3/100,000 and 18.5/100,000 and mortality rates were 36.3/100,000 and 14.5/100,000, for males and females, respectively. Male lung cancer rates declined but increased steadily in females over the past three decades. In 2009, the most common histological type is adenocarcinoma, which reflects a shift from predominantly squamous cell carcinoma and large cell carcinoma in the mid 1980s. In 2009, 27 % of men and 19 % of women were smokers, which represent a rise of smoking rates in women, especially in younger women, and a decline in the men. While in Austrian men the lung cancer rates, in accordance with their decreasing prevalence of smoking, declined over the past 30 years, the increasing smoking prevalence and lung cancer rates in women remain a public health concern. Antismoking laws and public health initiatives to curtail smoking habits are needed in Austria, especially targeting younger women.