Addressing Cigarette Use is Simply Not Enough When it Comes to Tobacco Control

Cigarette smoking causes 443,000 deaths annually and is the predominant form of tobacco used in the United States. However, adults also use other tobacco products either singly or in combination. The need to address this issue in tobacco use led the Centers for Disease Control and Prevention to analyze data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS), which is a state-based telephone survey of non-institutionalized adults who are eighteen years or older, and publish a report in today’s Morbidity and Mortality Weekly Report (MMWR), “Any Tobacco Use in 13 States – Behavioral Risk Factor Surveillance System.”

The CDC analyzed data on the use of tobacco products other than cigarettes that had been collected from thirteen states who agreed to an optional BRFSS module. The CDC looked at data for current cigarette use, any tobacco use (tobacco users who currently used cigarettes, smokeless tobacco, or other tobacco products), and current polytobacco users (tobacco users who currently used cigarettes and also another form of tobacco). These three different variables were also analyzed according to various risk factors such as gender, household income, education, age, ethnicity, etc.

Researchers found that simply focusing on cigarette use may not be the best solution when it comes to tobacco control. According to the study, in 2008 cigarette use ranged from 14.6% to 26.6%, any tobacco use ranged from 18.4% to 35.0%, and polytobacco use ranged from 1.0% to 3.7% among the thirteen states. Use of any tobacco product was more prevalent among persons who were a member of an unmarried couple, (36.3%), single adults (30.3%), and those who were widowed or divorced (29.1%) compared to married persons (21.2%). Polytobacco use was found to be more prevalent among men (4.4%), young adults between the ages of eighteen and twenty-four (5.7%), those who were single (4.8%), those who had a household income of less than $35,000 a year, adults with less than a high school education (3.6%), and those adults with only a high school diploma or GED (3.6%).

Results from this study show that while tobacco control efforts have focused mainly on decreasing the prevalence of cigarette smoking, the use of other tobacco products also needs to be addressed if we are to improve the health of our nation. When we consider any tobacco use, an additional 5% of the adult population in these thirteen states is added to the prevalence rate for tobacco use. Using multiple tobacco products can also have adverse health effects, lead to higher nicotine addiction, and make the tobacco user unable to quit using tobacco. For these reasons, and the fact that youth have higher polytobacco use than adults, prevention and health policy efforts need to be targeted towards all forms of tobacco and not just cigarette use.

Partnership for Prevention, a long standing advocate for evidence-based tobacco cessation policies, believes that tobacco control should be at the top of our health agenda and should involve proven strategies such as public awareness efforts, youth tobacco use prevention, tobacco tax increases, and smoke free air policies that address all forms of tobacco use.


Katie Burggraf
Tobacco Control Team
Partnership for Prevention