The American Cancer Society's Cancer Prevention & Early Detection Facts & Figures 2013 report notes that cigarette smoking continues to decline. However, tobacco use remains the single largest preventable cause of disease and premature death in the United States, a problem that could be mitigated through legislative efforts.

Good news: The prevalence of adults who smoke cigarettes declined from 20.9% to 19.0% between 2005 and 2011, according to a report from the American Cancer Society released in April. The report also notes that heavy smoking declined significantly during that time, and that smoking among high school students dropped from a high of 22.0% to 18.1%, a new low, between 2003 and 2011.

Yet the report, Cancer Prevention & Early Detection Facts & Figures 2013, which also outlines the prevalence of obesity and inactivity plus the use of screening tests for cancer detection, estimates that 174,000 people will die this year from cancers caused by tobacco use alone, making it “the single largest preventable cause of disease and premature death in the U.S.”

Furthermore, although cigarette smoking continues to decline, the rate of the decline is slowing, and the use of other tobacco products is on the rise. The report cites these statistics:

  • While cigarette sales decreased by 18% between 2000 and 2007, sales of small cigars increased by 115%, roll-your-own tobacco by 91%, and moist snuff by 33%.

  • The use of smokeless tobacco products among high school boys, which had dropped to 11% in 2003, rose to 12.8% in 2011.

  • Cigar use among non-Hispanic African Americans has increased significantly.

  • Adolescent and young adult smokers are increasingly using tobacco water pipes, or hookahs.

  • Electronic cigarettes (battery-operated devices that produce a vapor from cartridges filled with nicotine, flavoring, and other chemicals) have also grown in popularity despite the lack of evidence to support claims that they are healthier than conventional cigarettes.

“The slowed decline in youth smoking since 2003 may be related to declines in funding for comprehensive tobacco control programs and increases in tobacco industry expenditures on marketing and promotions, including extensive industry price discounting to offset increases in retail cigarette prices,” the report says.

In comparison, states have spent relatively little to counter industry claims or to prevent tobacco use. States spent less on tobacco prevention between 2011 and 2012—less than 2% of their tobacco-related revenues—than at any time since 1998. The report recommends implementation of advertising to rebut industry claims, increased regulation of smoking in public places, and comprehensive tobacco cessation programs.

Both the report and tobacco experts say that the most effective way to reduce tobacco consumption and promote cessation is to increase taxes on tobacco products, adding that a 10% increase in price reduces cigarette consumption by 3% to 5%. Because states often tax cigars and other tobacco products at lower rates than cigarettes, the report suggests that making the taxes equal might further boost cessation. The additional funds could help to cover growing expenses associated with cancer treatment.

“The current tax rates are low and do not even come close to reimbursing society for the medical costs from smoking,” says K. Michael Cummings, PhD, MPH, professor in the department of psychiatry and behavioral sciences at the Medical University of South Carolina in Charleston. “In New Zealand and other countries, there is serious discussion about policies that will work to eradicate cigarettes within the next 20 to 30 years. Raising the price of the product is the best way to accomplish this.

“Our challenge,” Cummings continues, “is to find ways to push the price up faster.”

©2013 American Association for Cancer Research.
2013