U.S. Smoking Habits Have Come a Long Way, Baby

by Rick Blizzard, D.B.A.
Health and Healthcare Editor

About one in four Americans (25%) say they have smoked a cigarette within the past week, according to Gallup's 2004 Consumption Habits poll conducted in July. This represents a significant decline since Gallup began asking the question in 1944, when 41% of Americans said they'd smoked.

Americans have come a long way, but they didn't quit smoking overnight. Historical data from the Gallup Brain shows that the incidence of smoking in the United States did not begin to decrease steadily until after 1972, and the decline was most dramatic between 1972 and 1989. A look at the history of the anti-smoking movement over the last several decades provides an interesting parallel to this trend.

1944-1972

Reported cigarette smoking held relatively stable between 1944 and 1972, ranging between 40% and 45%. But the cultural foundation of the campaign against smoking was being laid.

In 1954, only 41% of Americans thought that cigarette smoking was one of the causes of lung cancer, while 31% said it was not one of the causes and 26% didn't know. In 1957, after the release of what was then a controversial report on the link between cigarettes, heart disease, and lung cancer, 50% of Americans said smoking caused lung cancer.

In 1964 -- a landmark year -- the first major report on the negative health effects of smoking, "Smoking and Health: Report of the Advisory Committee to the Surgeon General," was published. And the American Medical Association officially defined smoking as a serious health hazard. The trend continued in 1965, when Congress passed the Federal Cigarette Labeling and Advertising Act, which required that all cigarette packages include a label warning consumers that "cigarette smoking may be hazardous to your health." In 1967, the Surgeon General reported that smoking was a principal cause of lung cancer.

By 1969, 64% of Americans said they believed smoking was a cause of lung cancer. But it was some time before many Americans were convinced to quit; the long-term decline in cigarette smoking did not begin until after 1972. This decline was shortly preceded by the end of all cigarette advertising on radio and television in 1971. By April 1972, 70% of Americans believed that smoking caused lung cancer.

1972-1989

Shortly after cigarette companies were deprived of the primary mass communication media to promote their product, reported cigarette smoking coincidentally went into a sustained decline, dropping from 43% in 1972 to an average of 28% in 1989. In 1973, the Civil Aeronautics Board required all commercial airline flights to have nonsmoking sections. Arizona became the first state to restrict smoking in public places that same year. The provision of cigarettes in U.S. soldiers' K-rations and C-rations was discontinued in 1975. In 1977, 81% of Americans said they believed smoking caused lung cancer.

In 1980, the U.S. Public Health Service set a goal to reduce the incidence of smoking to 25% by 1990, a goal that Gallup's smoking trend indicates was nearly achieved. In 1981, 83% of Americans said they believed smoking caused lung cancer.

In the mid-1980s, serious tobacco education and prevention programs began to take hold. Minnesota became the first state to set aside a portion of its cigarette excise taxes for smoking prevention programs in 1985. Smoking restrictions also became more widespread: The U.S. Department of Health and Human Services became smoke-free in 1987, and smoking was banned on all domestic flights lasting fewer than two hours in 1988.

1989-2004

Starting in 1989, Gallup data show that the decline in reported cigarette use leveled off, fluctuating between 23% and 28%. In 1990, 94% of Americans said that smoking caused lung cancer, and since then, that percentage has held around 9 in 10 Americans.

In 1994, Mississippi became the first state to sue the tobacco industry to recover Medicaid costs for tobacco-related illness. In 1999, 46 states and five U.S. territories signed the Master Settlement Agreement, in which the country's largest tobacco companies agreed to pay the states $206 billion to settle Medicaid suits.

Bottom Line

Over the past 40 years, federal and state governments have done a great deal to reduce the demand for tobacco products in the United States, by educating the public about the health risks. But those examining Gallup's historical smoking trend could make the case that the greatest successes have come from the supply perspective -- through restricting the ability of the tobacco industry to market its products, and restricting people's ability to smoke in public places.


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