State-Specific Patterns of Cigarette Smoking, Smokeless Tobacco Use, and E-Cigarette Use Among Adults — United States, 2016

Abstract

Introduction State-level monitoring of changes in tobacco product use can help inform tobacco control policy and practice. This study examined state-specific prevalence of cigarette, smokeless tobacco, and e-cigarette use among US adults. Methods Data came from the 2016 Behavioral Risk Factor Surveillance System (BRFSS), a state-based telephone survey of US adults aged 18 years or older (N = 477,665). Prevalence estimates for current (every day or some days) cigarette smoking, smokeless tobacco use, and e-cigarette use were calculated for all 50 states and the District of Columbia (DC) and stratified by sex and race/ethnicity. Because the 2016 BRFSS measured e-cigarette use for the first time, estimates of ever e-cigarette use and concurrent use of cigarettes and e-cigarettes were also calculated. We assessed subgroup differences with χ 2 tests. Results In 2016, prevalence of current cigarette smoking among US adults ranged from 8.8% (Utah) to 24.8% (West Virginia), while prevalence of current smokeless tobacco use ranged from 1.3% (DC) to 9.8% (Wyoming). For e-cigarettes, ever use ranged from 16.2% (DC) to 28.4% (Arkansas), and current use ranged from 2.4% (DC) to 6.7% (Oklahoma). Across all states, current e-cigarette use was significantly higher among current cigarette smokers than among former or never cigarette smokers. States with the highest prevalence of cigarette smoking generally had a high prevalence of current e-cigarette use. Conclusion Prevalence of adult cigarette smoking, smokeless tobacco use, and e-cigarette use varies across states. These findings underscore the importance of comprehensive statewide tobacco control and use prevention efforts that address the diverse tobacco products used among adults.

Use of Cigarettes and E-Cigarettes and Dual Use Among Adult Employees in the US Workplace

“…Previous studies found differences in employee tobacco use, including use of e-cigarettes, by sociodemographic characteristics such as sex and race (8,9). Tobacco use also varies by state (10,11). Our study explored the prevalence and determinants of type of tobacco use (cigarette-only, e-cigarette-only, and dual) among US adult employees to better understand their relationship with sociodemographic characteristics and employment type.…”

The Kentucky SimSmoke Tobacco Control Policy Model of Smokeless Tobacco and Cigarette Use

“…The Behavioral Risk Factor Surveillance System (BRFSS) found that Kentucky SLT prevalence was 7.6% (almost 14% among males) 1 in 2017 compared to the 4.1% national average. [6][7][8] Also, any past-30 day use of SLT products among Kentucky high schoolers was estimated at 10.6% in 2017, with the national average rate at 5.5%. 9 While much of SLT use takes the traditional forms of snuff and chewing tobacco, new forms of smokeless, such as different varieties of snus and other oral tobacco products, have also become available in recent years.…”

E-cigarette Aerosol Condensate Enhances Metabolism of Benzo(a)pyrene to Genotoxic Products, and Induces CYP1A1 and CYP1B1, Likely by Activation of the Aryl Hydrocarbon Receptor

“…E-cigarette (e-cig) usage has become widely prevalent in the U.S. and other countries. There is considerable controversy as to the potential cancer risks and benefits posed by e-cigs [1,2]. Although studies on e-cig liquids, aerosols and condensates have indicated that they contain much lower levels of known carcinogens than tobacco or tobacco smoke [3], there is little reported research on the effects of e-cig usage on cancer risk in current tobacco users (dual users).…”