National Cancer Institute NCI Cancer Bulletin: A Trusted Source for Cancer Research News
August 7, 2012 • Volume 9 / Number 16

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CDC Update

Drop in Cigarette Smoking Offset by Rise in Use of Other Forms of Smoked Tobacco

Consumption of all smoked tobacco products in the United States fell by more than one-quarter between 2000 and 2011. But the drop in cigarette smoking was partly offset by a rise in consumption of other smoked tobacco products. These findings appeared August 3 in Morbidity and Mortality Weekly Report.

Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from the U.S. Department of the Treasury's Alcohol and Tobacco Tax and Trade Bureau to calculate consumption of cigarettes, loose tobacco, and cigars. Although cigarette smoking declined by 32.8 percent from 2000 to 2011, the use of certain other smoked tobacco products more than doubled during that time. The largest increases were in pipe tobacco (482 percent) and large cigars (233 percent).

Last year alone, total consumption of non-cigarette smoked tobacco products rose more than 17 percent. That jump offset much of the decline in cigarette smoking. As a result, total smoked tobacco consumption fell a mere 0.8 percent in 2011, compared with 3.8 percent in 2010. 

U.S. Consumption of Cigarettes and Other Combustible Tobacco Products, 2001–2011

Graph showing consumption of cigarettes and other combustible tobacco products in the United States during 2001-2011

The CDC report cited two explanations for the increases in consumption of non-cigarette smoked tobacco products. Such products are taxed at substantially lower rates, making them a cheaper alternative to manufactured cigarettes.

In addition, the products are subject to fewer manufacturing and marketing restrictions than cigarettes. For example, the Food and Drug Administration prohibits the use of flavoring or misleading descriptors such as "light" or "low tar" in cigarettes, but cigars and loose tobacco are not subject to these restrictions.

"The availability of low-priced and less-regulated alternative products to smokers who might have otherwise quit smoking has diminished the public health impact that excise tax increases and uniform regulation might otherwise have had on preventing youth initiation, reducing consumption, and prompting quit attempts," the CDC authors wrote.

"The smoke from non-cigarette combustibles contains the same toxic and cancer-causing chemicals as cigarette smoke," added Dr. Yvonne Hunt of NCI's Tobacco Control Research Branch. "The increase in consumption of these tobacco products is concerning. There is no safe level of exposure to tobacco smoke in any form." 

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